Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Sex difference in the association of metabolic syndrome with high sensitivity C-reactive protein in a Taiwanese population

Authors: Ming-May Lai, Chia-Ing Li, Sharon LR Kardia, Chiu-Shong Liu, Wen-Yuan Lin, Yih-Dar Lee, Pei-Chia Chang, Cheng-Chieh Lin, Tsai-Chung Li

Published in: BMC Public Health | Issue 1/2010

Login to get access

Abstract

Background

Although sex differences have been reported for associations between components of metabolic syndrome and inflammation, the question of whether there is an effect modification by sex in the association between inflammation and metabolic syndrome has not been investigated in detail. Therefore, the aim of this study was to compare associations of high sensitivity C-creative protein (hs-CRP) with metabolic syndrome and its components between men and women.

Methods

A total of 1,305 subjects aged 40 years and over were recruited in 2004 in a metropolitan city in Taiwan. The biochemical indices, such as hs-CRP, fasting glucose levels, lipid profiles, urinary albumin, urinary creatinine and anthropometric indices, were measured. Metabolic syndrome was defined using the American Heart Association and the National Heart, lung and Blood Institute (AHA/NHLBI) definition. The relationship between metabolic syndrome and hs-CRP was examined using multivariate logistic regression analysis.

Results

After adjustment for age and lifestyle factors including smoking, and alcohol intake, elevated concentrations of hs-CRP showed a stronger association with metabolic syndrome in women (odds ratio comparing tertile extremes 4.80 [95% CI: 3.31-6.97]) than in men (2.30 [1.65-3.21]). The p value for the sex interaction was 0.002. All components were more strongly associated with metabolic syndrome in women than in men, and all sex interactions were significant except for hypertension.

Conclusions

Our data suggest that inflammatory processes may be of particular importance in the pathogenesis of metabolic syndrome in women.
Appendix
Available only for authorised users
Literature
1.
Chen J, Muntner P, Hamm LL, Jones DW, Batuman V, Fonseca V, Whelton PK, He J: The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med. 2004, 140: 167-174.CrossRefPubMed
2.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. 10.1001/jama.285.19.2486.CrossRef
3.
Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, Taskinen MR, Groop L: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001, 24: 683-689. 10.2337/diacare.24.4.683.CrossRefPubMed
4.
Groop L: Genetics of the metabolic syndrome. Br J nutr. 2000, 83 (suppl 1): S39-S48.PubMed
5.
Lidfeldt J, Nyberg P, Nerbrand C, Samsioe G, Scherstén B, Agardh CD: Sociodemographic and psychological factors are associated with features of the metabolic syndrome: the Women's Health in the Lund Area (WHILA) study. Diabetes Obes Metab. 2003, 5: 106-112. 10.1046/j.1463-1326.2003.00250.x.CrossRefPubMed
6.
Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM: C-reactive protein, interleukin 6, and the risk of developing type 2 diabetes mellitus. JAMA. 2001, 286: 327-334. 10.1001/jama.286.3.327.CrossRefPubMed
7.
Freeman DJ, Norrie J, Caslake MJ, Gaw A, Ford I, Lowe GD, O'Reilly DS, Packard CJ, Sattar N: C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland Coronary Prevention Study. Diabetes. 2002, 51: 1596-1600. 10.2337/diabetes.51.5.1596. West of Scotland Coronary Prevention StudyCrossRefPubMed
8.
Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH: Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997, 336: 973-979. 10.1056/NEJM199704033361401.CrossRefPubMed
9.
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: 836-843. 10.1056/NEJM200003233421202.CrossRefPubMed
10.
Ridker PM, Rifai N, Clearfield M, Downs JR, Weis SE, Miles JS, Gotto AM: Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events. N Engl J Med. 2001, 344: 1959-1965. 10.1056/NEJM200106283442601. Air Force/Texas Coronary Atherosclerosis Prevention Study InvestigatorsCrossRefPubMed
11.
Tracy RP, Lemaitre RN, Psaty BM, Ives DG, Evans RW, Cushman M, Meilahn EN, Kuller LH: Relationship of C-reactive protein to risk of cardiovascular disease in the elderly: results from the Cardiovascular Health Study and the Rural Health Promotion Project. Arterioscler Thromb Vasc Biol. 1997, 17: 1121-1127.CrossRefPubMed
12.
Koenig W, Sund M, Fröhlich M, Fischer HG, Löwel H, Döring A, Hutchinson WL, Pepys MB: C-reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring trends and determinants in cardiovascular disease) Augsberg Cohort Study, 1984 to 1992. Circulation. 1999, 99: 237-242.CrossRefPubMed
13.
Ridker PM, Stampfer MJ, Rifai N: Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA. 2001, 285: 2481-2485. 10.1001/jama.285.19.2481.CrossRefPubMed
14.
Danesh J, Wheeler JG, Hirschfield GM, Eda S, Eiriksdottir G, Rumley A, Lowe GD, Pepys MB, Gudnason V: C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med. 2004, 350: 1387-1397. 10.1056/NEJMoa032804.CrossRefPubMed
15.
Ridker PM, Rifai N, Rose L, Buring JE, Cook NR: Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med. 2002, 347: 1557-1565. 10.1056/NEJMoa021993.CrossRefPubMed
16.
Kuller LH, Tracy RP, Shaten J, Meilahn EN: Relation of C-reactive protein and coronary heart disease in the MRFIT nested case control study. Am J Epidemiol. 1996, 144: 537-547.CrossRefPubMed
17.
Folsom AR, Aleksic N, Catellier D, Juneja HS, Wu KK: C-reactive protein and incident coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J. 2002, 144: 233-238. 10.1067/mhj.2002.124054.CrossRefPubMed
18.
Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH: Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation. 1998, 98: 731-733.CrossRefPubMed
19.
Mendall MA, Patel P, Ballam L, Strachan D, Northfield TC: C-reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study. BMJ. 1996, 312: 1061-1065.CrossRefPubMedPubMedCentral
20.
Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW: 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 Bio. 1999, 19: 972-978.CrossRef
21.
Lakoski SG, Cushman M, Criqui M, Rundek T, Blumenthal RS, D'Agostino RB, Herrington DM: Gender and C-reactive protein: Data from the Multiethnic Study of Atherosclerosis (MESA) cohort. Amer Heart J. 2006, 152 (3): 593-598. 10.1016/j.ahj.2006.02.015.CrossRefPubMed
22.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F: Diagnosis and management of the metabolic syndrome: an American heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005, 112 (17): 2735-2752. 10.1161/CIRCULATIONAHA.105.169404. American Heart Association; National Heart, Lung, and Blood InstituteCrossRefPubMed
23.
Chen C, Li TC, Li CI, Liu CS, Lin WY, Wu MT, Lai MM, Lin CC: The Relationship between Visfatin Levels and Anthropometric and Metabolic Parameters: Association with Cholesterol Levels in Women. Metabolism. 2007, 56: 1216-1220. 10.1016/j.metabol.2007.04.018.CrossRefPubMed
24.
Lin CC, Liu CS, Li TC, Chen CC, Li CI, Lin WY: Microalbuminuria and the metabolic syndrome and its components in the Chinese population. European Journal of Clinical Investigation. 2007, 37 (10): 783-790. 10.1111/j.1365-2362.2007.01865.x.CrossRefPubMed
25.
Lin CC, Liu CS, Lai MM, Li CI, Chen CC, Chang PC, Lin WY, Lee YD, Lin T, Li TC: Metabolic Syndrome and Its Associated Risk Factors in a Taiwanese Metropolitan Adult Population. BMC Public Health. 2007, 7 (1): 739-743.
26.
Lin WY, Liu CS, Li TC, Tsann Lin, Walter Chen, Chen CC, Li CI, Lin CC: In addition to insulin resistance and obesity, hyperuricemia is strongly associated with metabolic syndrome using different definitions in Chinese populations: a population-based study (Taichung Community Health Study). Ann Rheum Dis. 2008, 67 (3): 432-433. 10.1136/ard.2007.073601.CrossRefPubMed
27.
Chen CC, Li TC, Chang PC, Liu CS, Lin WY, Wu MT, Li CI, Lai MM, Li CC: Association among cigarette smoking, metabolic syndrome and its individual components: the metabolic syndrome study in Taiwan. Metabolism. 2008, 57: 544-548. 10.1016/j.metabol.2007.11.018.CrossRefPubMed
28.
Pietrobelli A, Rubiano F, St Onge MP, Heymsfield SB: New bioimpedance analysis system: improved phenotyping with whole-body analysis. Eur J Clin Nutr. 2004, 58: 1479-1484. 10.1038/sj.ejcn.1601993.CrossRefPubMed
29.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985, 28 (7): 412-419. 10.1007/BF00280883.CrossRefPubMed
30.
Foundation NK: K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002, 39 (2 Suppl 1): S1-266.
31.
Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, Koji Y, Hori S, Yamamoto Y: Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res. 2002, 25: 359-364. 10.1291/hypres.25.359.CrossRefPubMed
32.
Weitz JI, Byrne J, Clagett GP, Farkouh ME, Porter JM, Sackett DL, Strandness DE, Taylor LM: Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation. 1996, 94: 3026-3049.CrossRefPubMed
33.
Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB: Prediction of coronary heart disease using risk factor categories. Circulation. 1998, 97: 1837-1847.CrossRefPubMed
34.
Guh JY, Chuang LY, Chen HC: Betel-quid use is associated with the risk of the metabolic syndrome in adults. Am J Clin Nutr. 2006, 83: 1313-1320.PubMed
35.
Tung TH, Chiu YH, Chen LS, Wu HM, Boucher BJ, Chen TH: A population-based study of the association between areca nut chewing and type 2 diabetes mellitus in men (Keelung Community-based Integrated Screening programme No. 2). Diabetologia. 2004, 47: 1776-1781. 10.1007/s00125-004-1532-2. Keelung Community-based Integrated Screening programme No. 2CrossRefPubMed
36.
Kang IM, Chou CY, Tseng YH, Huang CC, Ho WY, Shih CM, Chen W: Association between betelnut chewing and chronic kidney disease in adults. J Occup Environ Med. 2007, 49: 776-779. 10.1097/JOM.0b013e318095a48a.CrossRefPubMed
37.
Lin WY, Chiu TY, Lee LT, Lin CC, Huang CY, Huang KC: Betel nut chewing is associated with increased risk of cardiovascular disease and all-cause mortality in Taiwanese men. Am J Clin Nutr. 2008, 87: 1204-1211.PubMed
38.
Crepaldi Gaetano, Maggi Stefania: The metabolic syndrome: a historical context. Diabetes voice. 2006, 51: 8-10.
39.
Laaksonen DE, Niskanen L, Nyyssönen K, Punnonen K, Tuomainen TP, Valkonen VP, Salonen R, Salonen JT: C-reactive protein and the development of the metabolic syndrome and diabetes in middle-aged men. Diabetologia. 2004, 47: 1403-1410. 10.1007/s00125-004-1472-x.CrossRefPubMed
40.
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: 391-397. 10.1161/01.CIR.0000055014.62083.05.CrossRefPubMed
41.
Chien KL, Hsu HC, Chen MF, Lee YT: Association of C-reactive Protein, Smoking and Metabolic Syndrome Among the Health Check-up Population. Acta Cardiol Sin. 2005, 21: 98-104.
42.
Ye X, Yu Z, Li H, Franco OH, Liu Y, Lin X: Distributions of C-Reactive Protein and its Association With Metabolic Syndrome in Middle-Aged and Older Chinese People. J Am Coll Cardiol. 2007, 49: 1798-1805. 10.1016/j.jacc.2007.01.065.CrossRefPubMed
43.
Ahonen T, Saltevo J, Laakso M, Kautiainen H, Kumpusalo E, Vanhala M: Gender differences relating to metabolic syndrome and proinflammation in Finnish subjects with elevated blood pressure. Mediators Inflamm. 2009, 959281:
44.
Pasceri V, Cheng JS, Willerson JT, Yeh ET: Modulation of C-reactive proteinmediated monocyte chemoattractant protein-1 induction in human endothelial cells by anti-atherosclerosis drugs. Circulation. 2001, 103: 2531-2534.CrossRefPubMed
45.
Bersoux S, Asbury KL, Cook CB, Verheijde JL, Larson MH, Aponte-Furlow RT, Flatten SS, Hooley SA, LaRosa CS, Seifert KM, Verona PM, Castro JC, Jameson KA: An outpatient-based clinical program for type 2 diabetes prevention. Endocrine Practice. 2010, 16 (1): 21-29. 10.4158/EP09151.OR.CrossRefPubMed
46.
Albu JB, Heilbronn LK, Kelley DE, Smith SR, Azuma K, Berk ES, Pi-Sunyer FX, Ravussin E: Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes. Diabetes. 2010, 59 (3): 627-33. 10.2337/db09-1239. Look AHEAD Adipose Research GroupCrossRefPubMed
Metadata
Title
Sex difference in the association of metabolic syndrome with high sensitivity C-reactive protein in a Taiwanese population
Authors
Ming-May Lai
Chia-Ing Li
Sharon LR Kardia
Chiu-Shong Liu
Wen-Yuan Lin
Yih-Dar Lee
Pei-Chia Chang
Cheng-Chieh Lin
Tsai-Chung Li
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-429

Other articles of this Issue 1/2010

BMC Public Health 1/2010 Go to the issue

Debate

A precautionary public health protection strategy for the possible risk of childhood leukaemia from exposure to power frequency magnetic fields

Study protocol

A tailored lifestyle intervention to reduce the cardiovascular disease risk of individuals with Familial Hypercholesterolemia (FH): design of the PRO-FIT randomised controlled trial

Study protocol

Early incidence of occupational asthma among young bakers, pastry-makers and hairdressers: design of a retrospective cohort study

Research article

An increase in the burden of neonatal admissions to a rural district hospital in Kenya over 19 years

Research article

Social capital in relation to depression, musculoskeletal pain, and psychosomatic symptoms: a cross-sectional study of a large population-based cohort of Swedish adolescents

Research article

Knowledge and perception of pulmonary tuberculosis in pastoral communities in the middle and Lower Awash Valley of Afar region, Ethiopia