Abstract
The aim of this study was to investigate whether the metabolic syndrome (MS) was associated with an elevated level of C-reactive protein (CRP) and increased arterial stiffness, and to clarify whether combined MS and CRP data had a stronger relation to arterial stiffness than did MS data alone. Brachial-ankle pulse wave velocity (baPWV), CRP, and conventional risk factors were evaluated in 3,412 men and 854 women. Adjusted mean values of baPWV in men with 0, 1, 2, and ≥3 components were 1,309, 1,372, 1,422, and 1,462 cm/s, respectively (p for trend <0.001). Adjusted mean values of baPWV in women with 0, 1, 2, and ≥3 components were 1,212, 1,292, 1,357, and 1,391 cm/s, respectively (p for trend <0.001). Adjusted geometric mean concentrations of CRP in men with 0, 1, 2, and ≥3 components were 0.036, 0.049, 0.059, and 0.076 mg/dl, respectively (p for trend <0.001). Adjusted geometric mean concentrations of CRP in women with 0, 1, 2, and ≥3 components were 0.023, 0.030, 0.057, and 0.077 mg/dl, respectively (p for trend <0.001). In analyses of adjusted mean values of baPWV according to the number of MS components and according to CRP levels within or without top quartile levels, the p value for the trend was significant (<0.001) in both men and women but, in post hoc analyses, comparing high and low CRP levels in each MS component–number group, no significant difference was found. These results suggest that, for prediction of increased arterial stiffness, combining MS and CRP data has little additive effect compared to the use of MS data alone.
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Isomaa B, Almgren P, Tuomi T, et al: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683–689.
Lakka HM, Laaksonen DE, Lakka TA, et al: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709–2716.
Malik S, Wong ND, Franklin SS, et al: Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 2004; 110: 1245–1250.
Ishizaka N, Ishizaka Y, Toda E, Hashimoto H, Nagai R, Yamakado M : Hypertension is the most common component of metabolic syndrome and the greatest contributor to carotid arteriosclerosis in apparently healthy Japanese individuals. Hypertens Res 2005; 28: 27–34.
Takeuchi H, Saitoh S, Takagi S, et al: Metabolic syndrome and cardiac disease in Japanese men: applicability of the concept of metabolic syndrome defined by the National Cholesterol Education Program–Adult Treatment Panel III to Japanese Men—the Tanno and Sobetsu Study. Hypertens Res 2005; 28: 203–208.
Fernandez-Real JM, Ricart W : Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocr Rev 2003; 24: 278–301.
Lemieux I, Pascot A, Prud'homme D, et al: Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity. Arterioscler Thromb Vasc Biol 2001; 21: 961–967.
Saijo Y, Kiyota N, Kawasaki Y, et al: Relationship between C-reactive protein and visceral adipose tissue in healthy Japanese subjects. Diabetes Obes Metab 2004; 6: 249–258.
Ridker PM, Hennekens CH, Buring JE, Rifai N : C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342: 836–843.
Koenig W, Sund M, Frohlich M, et al: C-reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992. Circulation 1999; 99: 237–242.
Danesh J, Whincup P, Walker M, et al: Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ 2000; 321: 199–204.
Ridker PM, Rifai N, Rose L, Buring JE, Cook NR : Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002; 347: 1557–1565.
Ridker PM, Buring JE, Cook NR, Rifai N : C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation 2003; 107: 391–397.
Rutter MK, Meigs JB, Sullivan LM, D'Agostino RB Sr, Wilson PW : C-reactive protein, the metabolic syndrome, and prediction of cardiovascular events in the Framingham Offspring Study. Circulation 2004; 110: 380–385.
Lehmann ED : Clinical value of aortic pulse-wave velocity measurement. Lancet 1999; 354: 528–529.
Asmar R, Benetos A, Topouchian J, et al: Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies. Hypertension 1995; 26: 485–490.
Laurent S, Katsahian S, Fassot C, et al: Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke 2003; 34: 1203–1206.
Laurent S, Boutouyrie P, Asmar R, et al: Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37: 1236–1241.
Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM : Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation 2001; 103: 987–992.
Grundy SM, Cleeman JI, Merz CN, et al: Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004; 110: 227–239.
Examination Committee of Criteria for 'Obesity Disease' in Japan, Japan Society for the Study of Obesity : New criteria for ‘obesity disease’ in Japan. Circ J 2002; 66: 987–992.
Yamashina A, Tomiyama H, Takeda K, et al: Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002; 25: 359–364.
Tomiyama H, Yamashina A, Arai T, et al: Influences of age and gender on results of noninvasive brachial-ankle pulse wave velocity measurement—a survey of 12517 subjects. Atherosclerosis 2003; 166: 303–309.
Purohit A, Ghilchik MW, Duncan L, et al: Aromatase activity and interleukin-6 production by normal and malignant breast tissues. J Clin Endocrinol Metab 1995; 80: 3052–3058.
Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Spiegelman BM : Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. J Clin Invest 1995; 95: 2409–2415.
Heinrich PC, Castell JV, Andus T : Interleukin-6 and the acute phase response. Biochem J 1990; 265: 621–636.
Festa A, D'Agostino R Jr, Howard G, Mykkanen L, Tracy RP, Haffner SM : Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 2000; 102: 42–47.
Warren RS, Starnes HF Jr, Gabrilove JL, Oettgen HF, Brennan MF : The acute metabolic effects of tumor necrosis factor administration in humans. Arch Surg 1987; 122: 1396–1400.
Wu T, Dorn JP, Donahue RP, Sempos CT, Trevisan M : Associations of serum C-reactive protein with fasting insulin, glucose, and glycosylated hemoglobin: the Third National Health and Nutrition Examination Survey, 1988–1994. Am J Epidemiol 2002; 155: 65–71.
Aronson D, Bartha P, Zinder O, et al: Association between fasting glucose and C-reactive protein in middle-aged subjects. Diabet Med 2004; 21: 39–44.
Morohoshi M, Fujisawa K, Uchimura I, Numano F : Glucose-dependent interleukin 6 and tumor necrosis factor production by human peripheral blood monocytes in vitro. Diabetes 1996; 45: 954–959.
Guha M, Bai W, Nadler JL, Natarajan R : Molecular mechanisms of tumor necrosis factor alpha gene expression in monocytic cells via hyperglycemia-induced oxidant stress-dependent and -independent pathways. J Biol Chem 2000; 275: 17728–17739.
Lakoski SG, Cushman M, Palmas W, Blumenthal R, D'Agostino RB Jr, Herrington DM : The relationship between blood pressure and C-reactive protein in the Multi-Ethnic Study of Atherosclerosis (MESA). J Am Coll Cardiol 2005; 46: 1869–1874.
Piche ME, Lemieux S, Weisnagel SJ, Corneau L, Nadeau A, Bergeron J : Relation of high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and fibrinogen to abdominal adipose tissue, blood pressure, and cholesterol and triglyceride levels in healthy postmenopausal women. Am J Cardiol 2005; 96: 92–97.
Nakanishi N, Suzuki K, Tatara K : Clustered features of the metabolic syndrome and the risk for increased aortic pulse wave velocity in middle-aged Japanese men. Angiology 2003; 54: 551–559.
Tomiyama H, Koji Y, Yambe M, et al: Elevated C-reactive protein augments increased arterial stiffness in subjects with the metabolic syndrome. Hypertension 2005; 45: 997–1003.
Nakanishi N, Shiraishi T, Wada M : Brachial-ankle pulse wave velocity and metabolic syndrome in a Japanese population: the Minoh study. Hypertens Res 2005; 28: 125–131.
Wilson PW, Nam BH, Pencina M, D'Agostino RB Sr, Benjamin EJ, O'Donnell CJ : C-reactive protein and risk of cardiovascular disease in men and women from the Framingham Heart Study. Arch Intern Med 2005; 165: 2473–2478.
Pearson TA, Mensah GA, Alexander RW, et al: Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003; 107: 499–511.
Anand SS, Razak F, Yi Q, et al: C-reactive protein as a screening test for cardiovascular risk in a multiethnic population. Arterioscler Thromb Vasc Biol 2004; 24: 1509–1515.
Yamada S, Gotoh T, Nakashima Y, et al: Distribution of serum C-reactive protein and its association with atherosclerotic risk factors in a Japanese population: Jichi Medical School Cohort Study. Am J Epidemiol 2001; 153: 1183–1190.
Jilma B, Dirnberger E, Loscher I, et al: Menstrual cycle–associated changes in blood levels of interleukin-6, alpha1 acid glycoprotein, and C-reactive protein. J Lab Clin Med 1997; 130: 69–75.
Macy EM, Hayes TE, Tracy RP : Variability in the measurement of C-reactive protein in healthy subjects: implications for reference intervals and epidemiological applications. Clin Chem 1997; 43: 52–58.
Saijo Y, Utsugi M, Yoshioka E, et al: Relationships of C-reactive protein, uric acid, and glomerular filtration rate to arterial stiffness in Japanese subjects. J Hum Hypertens 2005; 19: 907–913.
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Saijo, Y., Yoshioka, E., Fukui, T. et al. Metabolic Syndrome, C-Reactive Protein and Increased Arterial Stiffness in Japanese Subjects. Hypertens Res 29, 589–596 (2006). https://doi.org/10.1291/hypres.29.589
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DOI: https://doi.org/10.1291/hypres.29.589
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