As several studies have reported that inflammation plays an important role in the pathophysiology of insulin resistance and the metabolic syndrome, Ingelsson et al. hypothesized that specific inflammatory markers involved in different steps of atherogenesis might show different associations with either the metabolic syndrome or insulin resistance. For that purpose, they measured several inflammatory markers in 943 men and women 70 years of age who participated in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Among 17 inflammatory markers studied, only 3 markers, vascular cell adhesion molecule-1 (VCAM-1), E-selectin, and C-reactive protein (CRP), showed positive associations with the metabolic syndrome [odds ratios per 1-standard deviation increase: 1.40 (95% CI, 1.17-1.67), 1.26 (95% CI, 1.06-1.50) and 1.49 (95% CI, 1.25-1.77), respectively, for VCAM-1, E-selectin, and CRP]. Among the 5 clinical criteria for diagnosing the metabolic syndrome, only waist circumference was simultaneously associated with variation in these 3 inflammatory markers. These 3 markers, along with leukocyte count, were associated with insulin resistance, as defined by the homeostasis model assessment of insulin resistance [β=0.084 (95% CI, 0.043-0.125), β=0.068 (95% CI, 0.027-0.109), β=0.071 (95% CI, 0.032-0.111) and β=0.092 (95% CI, 0.054-0.130), respectively, for VCAM-1, E-selectin, CRP, and leukocyte count. Based on the results, the authors concluded that VCAM-1, E-selectin, CRP, and leukocyte count may play a key role in the relationship between the metabolic syndrome, insulin resistance, and the development of atherosclerosis. They also acknowledged that the results should be validated in longitudinal studies.
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