Relation of C-Reactive Protein to Insulin Resistance and Cardiovascular Risk Factors in Youth

Abstract

OBJECTIVE -Insulin resistance and C-reactive protein (CRP) levels are strongly correlated in adults. This study explored the relationship in youth.RESEARCH DESIGN AND METHODS -Associations between CRP levels, cardiovascular risk, and insulin resistance measured by the euglycemic clamp were investigated in 342 healthy Minneapolis youth.RESULTS -There was no difference in mean CRP levels among boys (n ϭ 189, CRP 1.10 Ϯ 0.46 mg/l) and girls (n ϭ 153, CRP 1.16 Ϯ 0.63 mg/l; P ϭ 0.32). There was also no difference between CRP and Tanner stage. CRP, adjusted for BMI, was significantly greater in black subjects compared with white subjects (P ϭ 0.03). CRP was strongly related to adiposity in both girls and boys. CRP levels were related to fasting insulin levels (r ϭ 0.16, P ϭ 0.003) but this association was not significant after adjustment for BMI (r ϭ 0.07, P ϭ 0.21). Similarly, M, the euglycemic clamp measurement of insulin sensitivity, was significantly related to CRP levels (r ϭ Ϫ0.13, P ϭ 0.02) but not when M was normalized to lean body mass (M lbm ) (r ϭ Ϫ0.10, P ϭ 0.09). There was a significant inverse correlation between M lbm and CRP quartiles, which disappeared after adjustment for BMI. There was no significant association between CRP levels and lipids, blood pressure, physical activity, or left ventricular mass.CONCLUSIONS -In contrast to adult subjects, after adjustment for adiposity, CRP levels in children age 10 -16 years were not significantly associated with insulin resistance or with other factors comprising the metabolic syndrome. This is consistent with the concept that insulin resistance may precede the development of CRP elevation in the evolution of the metabolic syndrome. Diabetes Care 28:1763-1768, 2005C -reactive protein (CRP) is an acutephase reactant usually associated with serious infection and inflammation. More recently, it has become clear that subtle elevation of CRP levels within the "normal" adult range is an indicator of subclinical disease, such as that related to 1) the risk of cardiovascular disease in healthy men and women and in individuals with type 1 diabetes (1), 2) the risk factors associated with the metabolic syndrome (1-3), and 3) the onset of type 2 diabetes (4). The mechanisms accounting for these relations are not well understood.Insulin resistance and CRP levels are strongly correlated in adults (2,3,5,6). Although CRP is known to be associated with adiposity in youth (7-12), there are no data relating it to insulin resistance in children or adolescents. These data may be important because the insulin resistance syndrome has its origins in youth (13-15) and the independent roles of insulin resistance and adiposity in establishment of the syndrome (and in ongoing development from childhood into adulthood) have not been defined. If inflammation is a precursor to cardiovascular disease, determining these early relations would be highly relevant to the design of further investigation and prevention strategies. As recently suggested (16), this developmental period might be p...

Circulating proinflammatory peptides related to abdominal adiposity and cardiometabolic risk factors in healthy prepubertal children

“…linking MetS components to hsCRP levels in children and adolescents (8,13,26). However, similar to other reports (29), the associations (except for SBP) disappeared after controlling for adiposity measures, suggesting that in healthy prepubertal children, the observed relationships were mediated through the obesity status. Hence, it could be hypothesized that a longer period of exposure to or accumulation of excessive fat mass may be required, or a critical degree of inflammation must be reached before the effects of hsCRP become significant.…”

Relationship Between C-Reactive Protein and Atherosclerotic Risk Factors and Oxidative Stress Markers Among Young Persons 10–18 Years Old

“…However, other investigators found that, after adjustment for adiposity in adolescents, CRP was not significantly associated with the MetS and its components. These authors suggested that the MetS may precede the development of CRP elevation (38 ). Ford et al (36 ) showed an independent association between abdominal obesity and CRP concentrations.…”

Inflammation and Changes in Metabolic Syndrome Abnormalities in US Adolescents: Findings from the 1988–1994 and 1999–2000 National Health and Nutrition Examination Surveys

“…The relationship with obesity is particularly well documented (14,18,(22)(23)(24)(25). Higher blood pressure and dyslipidemias are also correlated with CRP in some reports, whereas the relationship between CRP and insulin resistance in children is less clear (13,19,22,26,27 ). Our findings were also consistent with reports of CRP concentrations in children from the 1999 -2000 NHANES database, including findings that CRP is higher in girls compared with boys, in Mexican Americans compared with non-Hispanic whites, and in overweight adolescents compared with normal-weight adolescents (28 ).…”