C-Reactive Protein, Insulin Resistance, and Metabolic Syndrome in a Population With a High Burden of Subclinical Infection

Insights from the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study

Howard, Barbara V. PHD
Best, Lyle MD
Comuzzie, Anthony PHD
Ebbesson, Sven O.E. PHD
Epstein, Stephen E. MD
Fabsitz, Richard R. PHD
Howard, Wm. James MD
Silverman, Angela CNP
Wang, Hong MS, MD
Zhu, Jianhui PHD
Umans, Jason MD, PHD

From the ¹MedStar Research Institute, Hyattsville, Maryland; ²Missouri Breaks Industries Research Inc, Timber Lake, South Dakota; ³Southwest Foundation for Biomedical Research, San Antonio, Texas; ⁴Norton Sound Health Corporation, Nome, Alaska; ⁵National Heart, Lung, and Blood Institute, Bethesda, Maryland; ⁶Washington Hospital Center, Washington, DC

Corresponding author: Barbara V. Howard, [email protected]

Published ahead of print at http://care.diabetesjournals.org on 16 September 2008.

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Received 29 April 2008 and accepted 5 September 2008.

Diabetes Care 31(12):p 2312-2314, December 2008.

OBJECTIVE

To explore relationships between C-reactive protein (CRP), subclinical infection, insulin resistance, and metabolic syndrome.

RESEARCH DESIGN AND METHODS

Data from 1,174 Eskimos, aged ≥18 years, from the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study were analyzed; 40 participants with diabetes were eliminated. Baseline assessment included interviews, physical exam, and blood and urine sampling. Metabolic syndrome was assessed using Adult Treatment Panel III criteria. CRP and antibodies to common pathogens were measured.

RESULTS

Although CRP was related in univariate analyses to insulin resistance and metabolic syndrome, relations were attenuated or eliminated after adjustment for relevant covariates. CRP was not higher among those with impaired fasting glucose (IFG), and pathogen burden was not related to insulin resistance, metabolic syndrome, or IFG.

CONCLUSIONS

Pathogen burden and inflammation do not seem to be related to insulin resistance, metabolic syndrome, or IFG in this population. The inflammatory process may reflect insulin resistance or its correlates but most likely is not causative.