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Open Access 01-12-2018 | Research

Association of dietary patterns, anthropometric measurements, and metabolic parameters with C-reactive protein and neutrophil-to-lymphocyte ratio in middle-aged and older adults with metabolic syndrome in Taiwan: a cross-sectional study

Authors: Ahmad Syauqy, Chien-Yeh Hsu, Hsiao-Hsien Rau, Jane C.-J. Chao

Published in: Nutrition Journal | Issue 1/2018

Abstract

Background

Metabolic syndrome is commonly associated with inflammation. The underlying factors of inflammation in metabolic syndrome are not fully understood. The objective of the study was to determine the association of dietary patterns, anthropometric measurements, and metabolic parameters with inflammatory markers in middle-aged and older adults with metabolic syndrome in Taiwan.

Methods

A total of 26,016 subjects aged ≥35 y with metabolic syndrome were recruited from Mei Jau institution between 2004 and 2013 for a cross sectional study. Metabolic syndrome was defined by the International Diabetes Federation. Multivariate logistic regression was performed to evaluate the association of dietary patterns, anthropometric measurements, and metabolic parameters with C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in men and women with metabolic syndrome. Crude and adjusted models were analyzed by gender.

Results

The western dietary pattern, obesity, high body fat, high waist or hip circumference, and high waist-to-hip ratio were significantly associated with increased odds ratios of high CRP and NLR in both genders. High systolic or diastolic blood pressure (BP), low high-density lipoprotein-cholesterol (HDL-C), high low-density lipoprotein-cholesterol (LDL-C), high total cholesterol (TC), high serum triglycerides (TG), and high fasting blood glucose (FBG) were significantly correlated with increased odds ratios of high CRP in both genders. Low HDL-C, high LDL-C, high serum TG, and high FBG were significantly associated with increased odds ratios of high NLR in both genders. However, high systolic (OR = 1.124, 95% CI 1.047–1.206, P < 0.01) or diastolic BP (OR = 1.176, 95% CI 1.087–1.273, P < 0.001) and high TC (OR = 1.138, 95% CI 1.062–1.220, P < 0.001) were significantly correlated with increased odds ratios of high NLR only in men.

Conclusions

The western dietary pattern, obese-related anthropometric parameters, and most components of metabolic syndrome are positively associated with CRP levels and NLR in men and women with metabolic syndrome.

Alberti KG, Zimmet P, Shaw J. The metabolic syndrome-a new worldwide definition. Lancet. 2005;366:1059–62. https://doi.org/10.1016/s0140-6736(05)67402-8.CrossRefPubMed

Beltran-Sanchez H, Harhay MO, Harhay MM, McElligott S. Prevalence and trends of metabolic syndrome in the adult U.S. population, 1999-2010. J Am Coll Cardiol. 2013;62:697–703. https://doi.org/10.1016/j.jacc.2013.05.064.CrossRefPubMedPubMedCentral

Gundogan K, Bayram F, Capak M, Tanriverdi F, Karaman A, Ozturk A, et al. Prevalence of metabolic syndrome in the Mediterranean region of Turkey: evaluation of hypertension, diabetes mellitus, obesity, and dyslipidemia. Metab Syndr Relat Disord. 2009;7:427–34. https://doi.org/10.1089/met.2008.0068.CrossRefPubMed

Scuteri A, Laurent S, Cucca F, Cockcroft J, Cunha PG, Manas LR, et al. Metabolic syndrome across Europe: different clusters of risk factors. Eur J Prev Cardiol. 2015;22:486–91. https://doi.org/10.1177/2047487314525529.CrossRefPubMed

Yeh CJ, Chang HY, Pan WH. Time trend of obesity, the metabolic syndrome and related dietary pattern in Taiwan: from NAHSIT 1993-1996 to NAHSIT 2005-2008. Asia Pac J Clin Nutr. 2011;20:292–300.PubMed

Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14719 initially healthy American women. Circulation. 2003;107:391–7.CrossRef

Lopez-Garcia E, Schulze MB, Meigs JB, Manson JE, Rifai N, Stampfer MJ, et al. Consumption of trans fatty acids is related to plasma biomarkers of inflammation and endothelial dysfunction. J Nutr. 2005;135:562–6. https://doi.org/10.1093/jn/135.3.562.CrossRefPubMed

Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Dietary patterns and markers of systemic inflammation among Iranian women. J Nutr. 2007;137:992–8. https://doi.org/10.1093/jn/137.4.992.CrossRefPubMed

Syauqy A, Hsu C-Y, Rau H-H, JC-J C. Association of dietary patterns with components of metabolic syndrome and inflammation among middle-aged and older adults with metabolic syndrome in Taiwan. Nutrients. 2018;10:143. https://doi.org/10.3390/nu10020143.CrossRefPubMedCentral

10.

Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr. 2006;84:1489–97. https://doi.org/10.1093/ajcn/84.6.1489.CrossRefPubMed

11.

Lee Y, Kang D, Lee SA. Effect of dietary patterns on serum C-reactive protein level. Nutr Metab Cardiovasc Dis. 2014;24:1004–11. https://doi.org/10.1016/j.numecd.2014.05.001.CrossRefPubMed

12.

DeLoach S, Keith SW, Gidding SS, Falkner B. Obesity associated inflammation in African American adolescents and adults. Am J Med Sci. 2014;347:357–63. https://doi.org/10.1097/MAJ.0b013e31829555f0.CrossRefPubMedPubMedCentral

13.

Menke A, Muntner P, Wildman RP, Reynolds K, He J. Measures of adiposity and cardiovascular disease risk factors. Obesity (Silver Spring). 2007;15:785–95. https://doi.org/10.1038/oby.2007.593.CrossRef

14.

Vikram NK, Misra A, Dwivedi M, Sharma R, Pandey RM, Luthra K, et al. Correlations of C-reactive protein levels with anthropometric profile, percentage of body fat and lipids in healthy adolescents and young adults in urban North India. Atherosclerosis. 2003;168:305–13.CrossRef

15.

Yasar Z, Buyuksirin M, Ucsular FD, Kargi A, Erdem F, Talay F, et al. Is an elevated neutrophil-to-lymphocyte ratio a predictor of metabolic syndrome in patients with chronic obstructive pulmonary disease? Eur Rev Med Pharmacol Sci. 2015;19:956–62.PubMed

16.

Sun M, Zhang L, Chen S, Liu X, Shao X, Zou H. Association of C-reactive protein and metabolic disorder in a Chinese population. Int J Environ Res Public Health. 2015;12:8228–42. https://doi.org/10.3390/ijerph120708228.CrossRefPubMedPubMedCentral

17.

Tang L, Peng H, Xu T, Wang A, Wang G, Tong W, et al. Association of biomarkers of inflammation with dyslipidemia and its components among Mongolians in China. PLoS One. 2014;9:e89023. https://doi.org/10.1371/journal.pone.0089023.CrossRefPubMedPubMedCentral

18.

Gouda M, Moustafa A, Hussein L, Hamza M. Three week dietary intervention using apricots, pomegranate juice or/and fermented sour sobya and impact on biomarkers of antioxidative activity, oxidative stress and erythrocytic glutathione transferase activity among adults. Nutr J. 2016;15:52. https://doi.org/10.1186/s12937-016-0173-x.CrossRefPubMedPubMedCentral

19.

Zaki M, Hussein L, Gouda M, Bassuoni R, Hassanein A. Nutritional epidemiological study to estimate usual intake and to define optimum nutrient profiling choice in the diet of Egyptian youths. Food Nutr Sci. 2015;6:1422–36.

20.

Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med. 2000;342:836–43. https://doi.org/10.1056/nejm200003233421202.CrossRefPubMed

21.

Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO 3rd, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107:499–511. https://doi.org/10.1161/01.CIR.0000052939.59093.45.CrossRefPubMed

22.

Arbel Y, Finkelstein A, Halkin A, Birati EY, Revivo M, Zuzut M, et al. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis. 2012;225:456–60. https://doi.org/10.1016/j.atherosclerosis.2012.09.009.CrossRefPubMed

23.

Osler M, Heitmann BL, Gerdes LU, Jorgensen LM, Schroll M. Dietary patterns and mortality in Danish men and women: a prospective observational study. Br J Nutr. 2001;85:219–25.CrossRef

24.

Newby PK, Tucker KL. Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev. 2004;62:177–203.CrossRef

25.

Muga MA, Owili PO, Hsu CY, Rau HH, Chao JC. Dietary patterns, gender, and weight status among middle-aged and older adults in Taiwan: a cross-sectional study. BMC Geriatr. 2017;17:268. https://doi.org/10.1186/s12877-017-0664-4.CrossRefPubMedPubMedCentral

26.

Lee O-G, Hur Y-I, Kang J-H, Park H-A, Kim K-W, Cho Y-G, et al. The cutoff value of waist circumference for predicting metabolic risks in pre- and post-menopausal Korean women: analysis of 2010 Korean National Health and nutrition examination survey data. Korean J Fam Med. 2013;34:307–18. https://doi.org/10.4082/kjfm.2013.34.5.307.CrossRefPubMedPubMedCentral

27.

Cho YG, Song HJ, Kim JM, Park KH, Paek YJ, Cho JJ, et al. The estimation of cardiovascular risk factors by body mass index and body fat percentage in Korean male adults. Metabolism. 2009;58:765–71. https://doi.org/10.1016/j.metabol.2009.01.004.CrossRefPubMed

28.

Kim JY, Han SH, Yang BM. Implication of high-body-fat percentage on cardiometabolic risk in middle-aged, healthy, normal-weight adults. Obesity (Silver Spring). 2013;21:1571–7. https://doi.org/10.1002/oby.20020.CrossRef

29.

Jaeschke L, Steinbrecher A, Pischon T. Measurement of waist and hip circumference with a body surface scanner: feasibility, validity, reliability, and correlations with markers of the metabolic syndrome. PLoS One. 2015;10:e0119430. https://doi.org/10.1371/journal.pone.0119430.CrossRefPubMedPubMedCentral

30.

Grundy SM, Cleeman JI, Bairey Merz CN, Brewer HB, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. J Am Coll Cardiol. 2004;44:720–32. https://doi.org/10.1016/j.jacc.2004.07.001.CrossRef

31.

Svensson E, Mor A, Rungby J, Berencsi K, Nielsen JS, Stidsen JV, et al. Lifestyle and clinical factors associated with elevated C-reactive protein among newly diagnosed type 2 diabetes mellitus patients: a cross-sectional study from the nationwide DD2 cohort. BMC Endocr Disord. 2014;14:74. https://doi.org/10.1186/1472-6823-14-74.CrossRefPubMedPubMedCentral

32.

Fung TT, Rimm EB, Spiegelman D, Rifai N, Tofler GH, Willett WC, et al. Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr. 2001;73:61–7. https://doi.org/10.1093/ajcn/73.1.61.CrossRefPubMed

33.

Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE, et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2004;80:1029–35. https://doi.org/10.1093/ajcn/80.4.1029.CrossRefPubMed

34.

Maysami S, Haley MJ, Gorenkova N, Krishnan S, McColl BW, Lawrence CB. Prolonged diet-induced obesity in mice modifies the inflammatory response and leads to worse outcome after stroke. J Neuroinflammation. 2015;12:140. https://doi.org/10.1186/s12974-015-0359-8.CrossRefPubMedPubMedCentral

35.

Root MM, McGinn MC, Nieman DC, Henson DA, Heinz SA, Shanely RA, et al. Combined fruit and vegetable intake is correlated with improved inflammatory and oxidant status from a cross-sectional study in a community setting. Nutrients. 2012;4:29–41. https://doi.org/10.3390/nu4010029.CrossRefPubMedPubMedCentral

36.

Adamsson V, Reumark A, Marklund M, Larsson A, Riserus U. Role of a prudent breakfast in improving cardiometabolic risk factors in subjects with hypercholesterolemia: a randomized controlled trial. Clin Nutr. 2015;34:20–6. https://doi.org/10.1016/j.clnu.2014.04.009.CrossRefPubMed

37.

Bonaccio M, Di Castelnuovo A, Bonanni A, Costanzo S, De Lucia F, Pounis G, et al. Adherence to a Mediterranean diet is associated with a better health-related quality of life: a possible role of high dietary antioxidant content. BMJ Open. 2013;3. https://doi.org/10.1136/bmjopen-2013-003003.CrossRef

38.

Arouca A, Michels N, Moreno LA, Gonzalez-Gil EM, Marcos A, Gomez S, et al. Associations between a Mediterranean diet pattern and inflammatory biomarkers in European adolescents. Eur J Nutr. 2017. https://doi.org/10.1007/s00394-017-1457-4.CrossRef

39.

Bonaccio M, Di Castelnuovo A, De Curtis A, Costanzo S, Persichillo M, Donati MB, et al. Adherence to the Mediterranean diet is associated with lower platelet and leukocyte counts: results from the Moli-sani study. Blood. 2014;123:3037–44. https://doi.org/10.1182/blood-2013-12-541672.CrossRefPubMed

40.

Bédard A, Lamarche B, Corneau L, Dodin S, Lemieux S. Sex differences in the impact of the Mediterranean diet on systemic inflammation. Nutr J. 2015;14:46. https://doi.org/10.1186/s12937-015-0035-y.CrossRefPubMedPubMedCentral

41.

Furuncuoglu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016;20:1300–6.PubMed

42.

Kitahara CM, Trabert B, Katki HA, Chaturvedi AK, Kemp TJ, Pinto LA, et al. Body mass index, physical activity, and serum markers of inflammation, immunity, and insulin resistance. Cancer Epidemiol Biomark Prev. 2014;23:2840–9. https://doi.org/10.1158/1055-9965.epi-14-0699-t.CrossRef

43.

Nakamura H, Ito H, Egami Y, Kaji Y, Maruyama T, Koike G, et al. Waist circumference is the main determinant of elevated C-reactive protein in metabolic syndrome. Diabetes Res Clin Pract. 2008;79:330–6. https://doi.org/10.1016/j.diabres.2007.09.004.CrossRef

44.

Santos AC, Lopes C, Guimaraes JT, Barros H. Central obesity as a major determinant of increased high-sensitivity C-reactive protein in metabolic syndrome. Int J Obes. 2005;29:1452–6. https://doi.org/10.1038/sj.ijo.0803035.CrossRef

45.

Vuong J, Qiu Y, La M, Clarke G, Swinkels DW, Cembrowski G. Reference intervals of complete blood count constituents are highly correlated to waist circumference: should obese patients have their own “normal values”? Am J Hematol. 2014;89:671–7. https://doi.org/10.1002/ajh.23713.CrossRefPubMed

46.

Motie M, Evangelista LS, Horwich T, Lombardo D, Zaldivar F, Hamilton M, et al. Association between inflammatory biomarkers and adiposity in obese patients with heart failure and metabolic syndrome. Exp Ther Med. 2014;8:181–6. https://doi.org/10.3892/etm.2014.1673.CrossRefPubMedPubMedCentral

47.

Yilmaz H, Ucan B, Sayki M, Unsal I, Sahin M, Ozbek M, et al. Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity. Diabetes Metab Syndr. 2015;9:299–304. https://doi.org/10.1016/j.dsx.2014.04.009.CrossRef

48.

Sur G, Floca E, Kudor-Szabadi L, Sur ML, Sur D, Samasca G. The relevance of inflammatory markers in metabolic syndrome. Maedica (Buchar). 2014;9:15–8.

49.

Surendar J, Indulekha K, Mohan V, Pradeepa R. Association of neutrophil-lymphocyte ratio with metabolic syndrome and its components in Asian Indians (CURES-143). J Diabetes Complicat. 2016;30:1525–9. https://doi.org/10.1016/j.jdiacomp.2016.08.006.CrossRefPubMed

50.

Buyukkaya E, Karakas MF, Karakas E, Akcay AB, Tanboga IH, Kurt M, et al. Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome. Clin Appl Thromb Hemost. 2014;20:159–63. https://doi.org/10.1177/1076029612459675.CrossRefPubMed

51.

Soehnlein O, Drechsler M, Hristov M, Weber C. Functional alterations of myeloid cell subsets in hyperlipidaemia: relevance for atherosclerosis. J Cell Mol Med. 2009;13:4293–303. https://doi.org/10.1111/j.1582-4934.2009.00965.x.CrossRefPubMedPubMedCentral

52.

Guerrero-Romero F, Simental-Mendía LE, Rodríguez-Morán M. Association of C-reactive protein levels with fasting and postload glucose levels according to glucose tolerance status. Arch Med Res. 2014;45:70–5. https://doi.org/10.1016/j.arcmed.2013.11.004.CrossRef

53.

Jaiswal A, Tabassum R, Podder A, Ghosh S, Tandon N, Bharadwaj D. Elevated level of C-reactive protein is associated with risk of prediabetes in Indians. Atherosclerosis. 2012;222:495–501. https://doi.org/10.1016/j.atherosclerosis.2012.02.034.CrossRef

54.

Brooks GC, Blaha MJ, Blumenthal RS. Relation of C-reactive protein to abdominal adiposity. Am J Cardiol. 2010;106:56–61. https://doi.org/10.1016/j.amjcard.2010.02.017.CrossRefPubMed

55.

Bahadir A, Baltaci D, Turker Y, Turker Y, Iliev D, Ozturk S, et al. Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome? Anatol J Cardiol. 2015;15:816–22. https://doi.org/10.5152/akd.2014.5787.CrossRefPubMed

56.

Lin CC, Kardia SL, Li CI, Liu CS, Lai MM, Lin WY, et al. The relationship of high sensitivity C-reactive protein to percent body fat mass, body mass index, waist-to-hip ratio, and waist circumference in a Taiwanese population. BMC Public Health. 2010;10:579. https://doi.org/10.1186/1471-2458-10-579.CrossRefPubMedPubMedCentral

57.

Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol. 2006;97:993–6. https://doi.org/10.1016/j.amjcard.2005.10.034.CrossRefPubMed

58.

Uthamalingam S, Patvardhan EA, Subramanian S, Ahmed W, Martin W, Daley M, et al. Utility of the neutrophil to lymphocyte ratio in predicting long-term outcomes in acute decompensated heart failure. Am J Cardiol. 2011;107:433–8. https://doi.org/10.1016/j.amjcard.2010.09.039.CrossRefPubMed

Title: Association of dietary patterns, anthropometric measurements, and metabolic parameters with C-reactive protein and neutrophil-to-lymphocyte ratio in middle-aged and older adults with metabolic syndrome in Taiwan: a cross-sectional study
Authors: Ahmad Syauqy
Chien-Yeh Hsu
Hsiao-Hsien Rau
Jane C.-J. Chao
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Nutrition Journal / Issue 1/2018
Electronic ISSN: 1475-2891
DOI: https://doi.org/10.1186/s12937-018-0417-z

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