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Visceral adiposity and leptin are independently associated with C-reactive protein in Korean type 2 diabetic patients

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Abstract

The inflammatory marker, C-reactive protein (CRP) is associated with long-term cardiovascular events. The aim of the study was to investigate the factors contributing to serum CRP, assess the relationship between CRP level and the parameters of visceral obesity, and examine the association between leptin and CRP level in type 2 diabetic patients. 150 patients with type 2 diabetes were enrolled. These patients were recently diagnosed (≤3 years) with type 2 diabetes and were drug naive or taking sulfonylureas only. BMI, WC, and serum concentration of CRP, glycosylated hemoglobin (HbA1c), glucose, lipids, plasminogen activator-1 (PAI-1) and leptin were measured. Insulin resistance was estimated by the insulin resistance index of homeostasis model assessment (HOMA-IR). We measured the carotid intima-media thickness (IMT). Fat mass assessed by dual-energy X-ray absorptionmetry and abdominal fat distribution was determined by CT scan. Serum concentration of CRP was significantly correlated with BMI (γ = 0.257, P < 0.01), WC (γ = 0.293, P < 0.01), fat mass (γ = 0.213, P < 0.01), total adipose tissue (γ = 0.263, P < 0.01), visceral adipose tissue (γ = 0.296, P < 0.01), insulin (γ = 0.189, P = 0.047), PAI-1 (γ = 0.206, P < 0.01), leptin (γ = 0.322, P < 0.01), mean IMT (γ = 0.132, P = 0.042), and HOMA-IR (γ = 0.172, P = 0.045). After adjustment for age and gender, multiple regression analysis showed that serum CRP was significantly associated with leptin (β = 0.326, P = 0.01) and visceral adipose tissue (β = 0.265, P = 0.035). In conclusion, serum CRP level is significantly associated with obesity, especially the visceral adipose tissue, and serum leptin is another important independent factor associated with CRP in Korean type 2 diabetic patients.

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References

  1. Ross R (1999) Atherosclerosis—an inflammatory disease. N Engl J Med 340:115–126

    Article  CAS  PubMed  Google Scholar 

  2. Libby P (2001) Current concepts of the pathogenesis of the acute coronary syndromes. Circulation 104:365–372

    CAS  PubMed  Google Scholar 

  3. Ramakrishna V, Jailkhani R (2008) Oxidative stress in non-insulin-dependent diabetes mellitus (NIDDM) patients. Acta Diabetol 45:41–46

    Article  CAS  PubMed  Google Scholar 

  4. Ridker PM, Buring JE, Cook NR et al (2003) 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 107:391–397

    Article  PubMed  Google Scholar 

  5. Kim CS, Song MK, Park JS et al (2007) The clinical and immunogenetic characteristics of adult-onset type 1 diabetes mellitus in Korea. Acta Diabetol 44:45–54

    Article  CAS  PubMed  Google Scholar 

  6. Ridker PM (2003) Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation 107:363–369

    Article  PubMed  Google Scholar 

  7. Jialal I, Devaraj S (2003) Role of C-reactive protein in the assessment of cardiovascular risk. Am J Cardiol 91:200–202

    Article  CAS  PubMed  Google Scholar 

  8. Ridker PM, Rifai N, Pfeffer MA et al (1999) Long-term effects of pravastatin on plasma concentration of C-reactive protein: the cholesterol and recurrent events (CARE) investigators. Circulation 100:230–235

    CAS  PubMed  Google Scholar 

  9. Matsumoto K, Sera Y, Abe Y et al (2003) Inflammation and insulin resistance are independently related to all-cause of death and cardiovascular events in Japanese patients with type 2 diabetes mellitus. Atherosclerosis 169:317–321

    Article  CAS  PubMed  Google Scholar 

  10. Krauss RM, Winston M, Fletcher BJ et al (1998) Obesity: impact on cardiovascular disease. Circulation 98:1472–1476

    CAS  Google Scholar 

  11. Bouchard L, Faucher G, Tchernof A et al (2009) Comprehensive genetic analysis of the dipeptidyl peptidase-4 gene and cardiovascular disease risk factors in obese individuals. Acta Diabetol 46:13–21

    Article  CAS  PubMed  Google Scholar 

  12. Tessari P, Tiengo A (2008) Metformin treatment of rats with diet-induced overweight and hypertriglyceridemia decreases plasma triglyceride concentrations, while decreasing triglyceride and increasing ketone body output by the isolated perfused liver. Acta Diabetol 45:143–145

    Article  CAS  PubMed  Google Scholar 

  13. Flegal KM, Carroll MD, Ogden CL et al (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723–1727

    Article  PubMed  Google Scholar 

  14. Abdul-Ghani MA, Molina-Carrion M et al (2008) Adipocytes in subjects with impaired fasting glucose and impaired glucose tolerance are resistant to the anti-lipolytic effect of insulin. Acta Diabetol 45:147–150

    Article  CAS  PubMed  Google Scholar 

  15. Yudkin JS, Stehouwer CD, Emeis JJ et al (1999) C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue. Arterioscler Thromb Vasc Biol 19:972–978

    CAS  PubMed  Google Scholar 

  16. Festa A, D’Agostino R Jr, Tracy RP et al (2002) Elevated levels of acute-phase proteins and plasminogen activator inhibitor-1 predict the development of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes 51:1131–1137

    Article  CAS  PubMed  Google Scholar 

  17. Hak AE, Stehouwer CD, Bots ML et al (1999) Associations of C-reactive protein with measures of obesity, insulin resistance, and subclinical atherosclerosis in healthy, middle-aged women. Arterioscler Thromb Vasc Biol 19:1986–1991

    CAS  PubMed  Google Scholar 

  18. Lemieux I, Pascot A, Prud’homme D et al (2001) Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity. Arterioscler Thromb Vasc Biol 21:961–967

    CAS  PubMed  Google Scholar 

  19. Halaas JL, Gajiwala KS, Maffei M et al (1995) Weight-reducing effects of the plasma protein encoded by the obese gene. Science 269:543–546

    Article  CAS  PubMed  Google Scholar 

  20. Wallace AM, McMahon AD, Packard CJ et al (2001) Plasma leptin and the risk for cardiovascular disease in the west of Scotland coronary prevention study (WOSCOPS). Circulation 104:3052–3056

    Article  CAS  PubMed  Google Scholar 

  21. Gomez-Ambrosi J, Salvador J, Silva C et al (2005) Leptin therapy does not affect inflammatory markers. J Clin Endocrinol Metab 90:3803

    Article  CAS  PubMed  Google Scholar 

  22. Gomez-Ambrosi J, Salvador J, Paramo JA et al (2002) Involvement of leptin in the association between percentage of body fat and cardiovascular risk factors. Clin Biochem 35:315–320

    Article  CAS  PubMed  Google Scholar 

  23. Shamsuzzaman AS, Winnicki M, Wolk R et al (2004) Independent association between plasma leptin and C-reactive protein in healthy humans. Circulation 109:2181–2185

    Article  CAS  PubMed  Google Scholar 

  24. Kim DM, Nam SY, Ahn CW et al (2003) Correlation between mid-thigh low density muscle and insulin resistance in obese nondiabetic patients in Korea. Diabtes Care 26:1825–1830

    Article  Google Scholar 

  25. Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of preparative ultracentrifuge. Clin Chem 18:499–502

    CAS  PubMed  Google Scholar 

  26. Matthews DR, Hosker JP, Rudenski AS et al (1985) Homeostasis model assessment: insulin resistance and cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419

    Article  CAS  PubMed  Google Scholar 

  27. Saijo Y, Kiyota N, Kawasaki Y et al (2004) Relationship between C reactive protein and visceral adipose tissue in healthy Japanese subjects. Diabetes Obes Metab 6:249–258

    Article  CAS  PubMed  Google Scholar 

  28. Iwasaki T, Nakajima A, Yoneda M et al (2006) Repationship between the serum concentrations of C reactive protein and parameters of adiposity and insulin resistance in patients with type 2 diabetes mellitus. Endocrine Journal 53:345–356

    Article  CAS  PubMed  Google Scholar 

  29. Fried SK, Bunkin DA, Greenberg AS (1998) Omental and subcutaneous adipose tissues of obese subjects release interleukin-6: depot difference and regulation by glucocorticoid. J Clin Endocrinol Metab 83:847–850

    Article  CAS  PubMed  Google Scholar 

  30. Lear SA, Chen MM, Birmingham CL et al (2003) The relationship between simple anthropometric indices and C-reactive protein: ethnic and gender differences. Metabolism 52:1542–1546

    Article  CAS  PubMed  Google Scholar 

  31. Lakoski SG, Cushman M, Criqui M et al (2006) Gender and C-reactive protein: data from the Multiethnic Study of Atherosclerosis (MESA) cohort. Am Heart J 152:593–598

    Article  CAS  PubMed  Google Scholar 

  32. Khera A, McGuire DK, Murphy SA et al (2005) Race and gender differences in C-reactive protein levels. J Am Coll Cardiol 46:464–469

    Article  CAS  PubMed  Google Scholar 

  33. Saad MF, Damani S, Gingerich RL et al (1997) Sexual dimorphism in plasma leptin concentration. J Clin Endocrinol Metab 82:579–584

    Article  CAS  PubMed  Google Scholar 

  34. Abdullah SM, Khera A, Leonard D et al (2007) Sex differences in the association between leptin and CRP: results from the Dallas Heart Study. Atherosclerosis 195:404–410

    Article  CAS  PubMed  Google Scholar 

  35. Friedman JM, Halaas JL (1998) Leptin and the regulation of body weight in mammals. Nature 395:763–770

    Article  CAS  PubMed  Google Scholar 

  36. Yanagawa T, Taniguchi A, Fukushima M et al (2007) Leptin, triglycerides, and interleukin 6 are independently associated with C-reactive protein in Japanese type 2 diabetic patients. Diabetes Res Clin Pract 75:2–6

    Article  CAS  PubMed  Google Scholar 

  37. Grunfeld C, Zhao C, Fuller J et al (1996) Endotoxin and cytokines induce expression of leptin, the ob gene product, in hamsters. J Clin Invest 97:2152–2157

    Article  CAS  PubMed  Google Scholar 

  38. Kirchgessner TG, Uysal KT, Wiesbrock SM et al (1997) Tumor necrosis factor-alpha contributes to obesity-related hyperleptinemia by regulating leptin release from adipocytes. J Clin Invest 100:2777–2782

    Article  CAS  PubMed  Google Scholar 

  39. Santos-Alvarez J, Goberna R, Sanchez-Margalet V (1999) Human leptin stimulates proliferation and activation of human circulating monocytes. Cell Immunol 194:6–11

    Article  CAS  PubMed  Google Scholar 

  40. Dowidar L, Dejong CHC, Fearon KCH et al (2000) Effects of leptin on isolated human hepatocyte C reactive protein production. Br J Surg 87:643–644

    Google Scholar 

  41. Ble A, Windham BG, Bandinelli S et al (2005) Relation of plasma leptin to CRP Protein in older adults. Am J Cardiol 96:991–995

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgment

This study was supported by a grant of the Seoul R&BD Program, Republic of Korea (10526) and Yonsei University Research Fund of 2007.

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Authors and Affiliations

  1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

    Jong Suk Park, Min Ho Cho, Ji Sun Nam, Chul Woo Ahn, Bong Soo Cha, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim & Hyun Chul Lee

  2. Division of Endocrinology, Department for Internal Medicine, Youngdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Kangnam-ku, P.O. Box 135-720, Seoul, Korea

    Chul Woo Ahn

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  1. Jong Suk Park
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Correspondence to Chul Woo Ahn.

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Park, J.S., Cho, M.H., Nam, J.S. et al. Visceral adiposity and leptin are independently associated with C-reactive protein in Korean type 2 diabetic patients. Acta Diabetol 47, 113–118 (2010). https://doi.org/10.1007/s00592-009-0125-4

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  • DOI: https://doi.org/10.1007/s00592-009-0125-4

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