Insulin resistance in Chinese patients with type 2 diabetes is associated with C-reactive protein independent of abdominal obesity

Bin Lu,Xiaocheng Feng,Renming Hu,Zhaoyun Zhang,Zhihong Yang,Xuanchun Wang,Yehong Yang

doi:10.1186/1475-2840-9-92

Abstract

BackgroundThere is debate as to whether the association between C-reactive protein (CRP) and insulin resistance is independent of body fatness, particularly central obesity. Therefore, the association among CRP, insulin resistance and obesity was analyzed in Chinese patients with type 2 diabetes.MethodsThe study included 520 Chinese patients diagnosed with type 2 diabetes with CRP levels not exceeding 10 mg/L. The degree of insulin resistance was determined with the homeostasis model assessment of insulin resistance (HOMA-IR). The CRP levels were categorized into quartiles from the lowest to the highest concentrations (Q1-Q4).ResultsBody mass index (BMI) and waist circumference (WC) were both higher in Q4, Q3 and Q2 than those in Q1. HOMA-IR was higher in Q2, Q3 and Q4 than that in Q1 (Q1 vs Q4, P < 0.001; Q1 vs Q3, P < 0.001; Q1 vs Q2, P = 0.028). Log CRP was significantly correlated with log HOMA-IR (correlation coefficient: 0.230, P < 0.001) and BMI (correlation coefficient: 0.305, P < 0.001) and WC (correlation coefficient: 0.240, P < 0.001) by Spearman correlation analysis. Multiple linear regression analysis adjusting for age, gender and components of metabolic syndrome, log CRP was also independently associated with log HOMA-IR (β coefficient, 0.168; P < 0.001) and WC (β coefficient, 0.131; P = 0.006).ConclusionThese findings showed that insulin resistance was associated with CRP levels independent of abdominal obesity in Chinese patients with type 2 diabetes, suggesting that abdominal obesity could only partly explain the link between subclinical inflammation and insulin resistance.

Highlights

There is debate as to whether the association between C-reactive protein (CRP) and insulin resistance is independent of body fatness, central obesity
The aim of our study was to investigate whether insulin resistance is associated with CRP independent of abdominal obesity in the Chinese patients diagnosed with type 2 diabetes
Blood urea nitrogen and serum creatinine were both not significantly correlated with CRP levels

Summary

Introduction

There is debate as to whether the association between C-reactive protein (CRP) and insulin resistance is independent of body fatness, central obesity. The association among CRP, insulin resistance and obesity was analyzed in Chinese patients with type 2 diabetes. C-reactive protein (CRP), an measured marker of systemic inflammation, is stimulated by other cytokines, especially interleukin-6 (IL-6). Insulin resistance is fundamental to the pathogenesis of type 2 diabetes mellitus. During the last few years, insulin resistance has been shown to be strongly associated with CRP and body fat, visceral fat. The relationships among obesity, CRP, and insulin resistance are complex. There is debate as to whether the association between CRP and insulin resistance is independent of body

Objectives

Methods

Results

Conclusion