High-Sensitivity C-Reactive Protein Leads to Increased Incident Metabolic Syndrome in Women but Not in Men: A Five-Year Follow-Up Study in a Chinese Population

Guo-Bao Hong; Pei-Chun Gao; Yun-Yin Chen; Yue Xia; Xiao-Su Ke; Xiao-Fei Shao; Chong-Xiang Xiong; Hai-Shan Chen; Hua Xiao; Jing Ning; He-Qun Zou

doi:10.2147/DMSO.S241774

High-Sensitivity C-Reactive Protein Leads to Increased Incident Metabolic Syndrome in Women but Not in Men: A Five-Year Follow-Up Study in a Chinese Population

Diabetes Metab Syndr Obes. 2020 Feb 28:13:581-590. doi: 10.2147/DMSO.S241774. eCollection 2020.

Authors

Guo-Bao Hong^{1

2}, Pei-Chun Gao^{1

3}, Yun-Yin Chen¹, Yue Xia¹, Xiao-Su Ke¹, Xiao-Fei Shao¹, Chong-Xiang Xiong¹, Hai-Shan Chen¹, Hua Xiao¹, Jing Ning¹, He-Qun Zou¹

Affiliations

¹ Department of Nephrology, Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, People's Republic of China.
² Department of Nephrology, The Affiliated Nanhai Hospital of Southern Medical University, Foshan 528200, People's Republic of China.
³ School of Public Health, Southern Medical University, Guangzhou, Guangdong 510630, People's Republic of China.

Abstract

Purpose: Metabolic syndrome (MetS), characterized by a constellation of insulin resistance, central obesity, hypertension, and hyperlipidemia, is a global health threat. High-sensitivity C-reactive protein (hs-CRP) has been shown to be associated with type 2 diabetes and cardiovascular disease; however, its association with incident MetS is less known. Therefore, the aim of this study was to examine the prospective association between hs-CRP and MetS among a Chinese population in a 5-year follow-up study.

Patients and methods: The levels of hs-CRP were measured using serum samples collected at baseline recruitment in 2012 from 886 participants without MetS. Follow-up interviews were conducted in 2018, and MetS was diagnosed by 2017 criteria from the Chinese Diabetes Society. Multivariate logistic regression models were used to assess the overall and sex-specific associations between hs-CRP and incident MetS. The odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were computed with adjustment for demographic, socioeconomic, clinical, and lifestyle factors.

Results: After a mean follow-up duration of 5.40 ± 0.56 years, 116 (13.3%) participants developed MetS. In the total study population, increased hs-CRP levels were associated with a higher risk of MetS (OR comparing extreme quartiles of hs-CRP: 4.06 [95% CI: 1.91-8.65]) in the fully-adjusted model. When stratified by sex, the positive association was only observed in women (OR: 4.82 [1.89-12.3]) but not in men (OR: 3.15 [0.82-12.1]; P-interaction = 0.039).

Conclusion: In this study of a Chinese population, a positive association between hs-CRP and incident MetS was found only in women and not in men. Sex-specific prediction and intervention of MetS using hs-CRP as a target should be further evaluated.

Keywords: cohort study; follow up; high-sensitivity C-reactive protein; inflammation; metabolic syndrome.

Grants and funding

This study was supported by the following sources: (1) Clinical Research Startup Program of Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education (LC2016PY047, 2016, ChiCTR1800016248); (2) Science and Technique Program of Guangzhou (201604020015, 2015); (3) Medical Scientific Research Foundation of Guangdong Province of China (A2017450); (4) South Wisdom Valley Innovative Research Team Program (CXTD-004, 2014); (5) Guangdong Provincial Science and Technique Program (No. 2011B031800386, 2011); (6) The National Natural Science Foundation of China (81873620); (7) ISN Research Committee grant, 2007; (8) EU FP7 Program, UroSense, 2011; (9) ISN Research Committee grant, 2004.