Inflammatory Biomarkers in Metabolic Syndrome and Diabetes

Chronic low-grade inflammation underlies the pathogenesis of metabolic syndrome and type 2 diabetes, driving insulin resistance, β-cell dysfunction and vascular complications. Inflammatory biomarkers, notably C-reactive protein (CRP) and its high-sensitivity variant (hsCRP), together with cytokines such as interleukin-6 and tumour necrosis factor α, reflect adipose-tissue dysregulation and endothelial activation. Emerging markers—presepsin, neutrophil-to-lymphocyte ratio and adipokine profiles—offer insights into gut barrier integrity and innate immune activation. Integrated omics and multiplex assays are refining risk stratification, facilitating personalised interventions. Globally, these biomarkers inform early identification of individuals at high cardiometabolic risk, guide anti-inflammatory or lifestyle therapies and underpin novel therapeutic targets to attenuate progression from insulin resistance to overt diabetes.

Research from Nature Portfolio

A large population-based Korean cohort study evaluated baseline CRP concentrations in over 22 000 adults followed for three years, revealing that those in the highest CRP tertile had a two- to threefold greater risk of developing type 2 diabetes compared with the lowest tertile. The association was particularly pronounced in women and participants aged over 50. Moreover, CRP’s predictive value was amplified when combined with obesity and hypertension, emphasising the synergistic impact of inflammatory status and classical cardiometabolic risk factors on diabetes onset.

Inflammatory Biomarkers in Metabolic Syndrome and Diabetes publication trend

The graph below shows the total number of articles in inflammatory biomarkers in metabolic syndrome and diabetes across all publications each year (not limited to Nature Index journals).

Technical terms

C-reactive protein (CRP): An acute-phase plasma protein produced by the liver in response to interleukin-6, marker of systemic inflammation.

High-sensitivity CRP (hsCRP): A refined assay detecting low CRP concentrations (<1 mg/L), enabling cardiovascular and diabetes risk assessment.

Presepsin: A soluble fragment of CD14 released during innate immune activation, emerging as a biomarker of systemic inflammation in metabolic disorders.

Insulin resistance: A state in which peripheral tissues exhibit diminished responsiveness to insulin, leading to compensatory hyperinsulinaemia and dysglycaemia.

Homeostasis Model Assessment of Insulin Resistance (HOMA-IR): A calculated index using fasting insulin and glucose levels to estimate insulin sensitivity.

References

1. Association of C-Reactive Protein with Risk of Developing Type 2 Diabetes Mellitus, and Role of Obesity and Hypertension: A Large Population-Based Korean Cohort Study. Scientific Reports (2019).
2. Contributions of elevated CRP, hyperglycaemia, and type 2 diabetes to cardiovascular risk in the general population: observational and Mendelian randomization studies. Cardiovascular Diabetology (2024).
3. Presepsin Levels in Infection-Free Subjects with Diabetes Mellitus: An Exploratory Study. Biomedicines (2024).
4. Associations of Insulin Resistance and High-Sensitivity C-Reactive Protein with Metabolic Abnormalities in Korean Patients with Type 2 Diabetes Mellitus: A Preliminary Study. Metabolites (2024).