High Sensitive C-reactive Protein for Prediction of Cardiovascular Risk Level in Patients with Metabolic Syndrome in Sulaimania-Iraq

Abstract

Background and objective: Metabolic syndrome is a group of characteristics, which include obesity, high blood pressure, elevated blood sugar levels, and high triglycerides (fat-like substances in the blood). Having a combination of these characteristics increases the risk of developing type 2 diabetes and heart disease. People with central obesity have an increased risk for developing metabolic syndrome, type 2 diabetes, and cardiovascular disease. However, a substantial number of obese individuals have no other cardiovascular risk factors, besides their obesity. C-reactive protein (CRP) is an acute phase protein produced predominantly by hepatocytes under the influence of cytokines such as IL -6 and TNF-α. Determination of hs-CRP was carried out in this study to discriminate between centrally obese people with and without metabolic syndrome. Patients and Methods: One hundred and forty subject with central obesity aged 20-70 years underwent a physical examination and laboratory assays to determine the presence of metabolic syndrome (NCEP ATP III criteria). The subjects were categorized into metabolic syndrome and non -metabolic syndrome group to decide whether CRP has an impact on the development of metabolic syndrome, and further subdivision have made to sub classify them to five sub-groups according to the existence of components of metabolic syndrome. Results: Mean hs-CRP levels were significantly higher in individuals with central obesity with metabolic syndrome (n = 101; 72.1%) compared to individuals with central obesity without metabolic syndrome (3.64 mg/L versus 1.75 mg/L (IQR 1.25-2.24); p < 0.0001). Mean hs-CRP levels increased with increasing number of metabolic syndrome components present. In univariable linear regression analyses, hs-CRP was significantly correlated positively with body mass index, waist circumference, and atherogenic index, while a significant negative correlations was found with HDL-C level. All the obese participants were at risk of cardiovascular events. Conclusions: The degree of central obesity (waist circumference) and BMI seemed to be the main determinant of an increased hs-CRP level. Serum hs-CRP was significantly correlated with the presence of metabolic syndrome; strong relationship between serum hs-CRP and various features of metabolic syndrome. The addition of serum hs-CRP to the present definition of the metabolic syndrome may help to identify patients at high risk for future cardiovascular disease.

Keywords: Abdominal obesity, Metabolic syndrome, High sensitive C-reactive protein.