Relationship between C-Reactive Protein, White Blood Cell Count and Metabolic Syndrome in Nigerians with Type 2 Diabetes Mellitus — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Relationship between C-Reactive Protein, White Blood Cell Count and Metabolic Syndrome in Nigerians with Type 2 Diabetes Mellitus
Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
,
Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
,
Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
,
Department of Haematology and Immunology, Obafemi Awolowo Umiversity, Ile-Ife, Nigeria
,
Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
,
Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
,
Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
,
Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
1 Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
2 Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
3 Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
4 Department of Haematology and Immunology, Obafemi Awolowo Umiversity, Ile-Ife, Nigeria
5 Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
6 Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
7 Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
8 Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
Background : Presence of metabolic syndrome (MS) in people with diabetes confers increased cardiovascular and diabetes-specific micro- and macrovascular complications. The pathogenic pathways for metabolic syndrome are still issues for discussion especially in some special groups like those with type 2 diabetes mellitus (T2DM). Recent evidences suggest that inflammation may play a key role in MS. This study assessed the relationship between MS (and its component risks) and markers of inflammation (high-sensitivity C-reactive protein {hs-CRP} and white blood cells {WBC}). Methods : A cross-sectional study involving 108 patients with T2DM. Anthropometric measurements and clinical examination were conducted. Blood sample was collected for hs-CRP, WBC, glycated haemoglobin etc. Metabolic syndrome was defined using the International Diabetes Federation criteria. Ethical approval was granted and informed consent was obtained from participants. Results : Mean age of male and female participants were 58.00 ± 7.01 years and 55.48 ± 8.35 years respectively (p = 0.092). Eighty-two (75.9%) participants had metabolic syndrome. Median values of hs-CRP and total WBC were 0.89mg/L and 5.73 x10 3 /mm 3 respectively. On correlation, hs-CRP showed statistically significant association with waist circumference (r = 0.194; p = 0.044), fasting plasma glucose (r = 0.191; p = 0.048) and serum triglycerides (p = 0.226; r = 0.019). There was no statistically significant association between WBC and the metabolic components. Conclusion : Prevalence of metabolic syndrome is high, and C-reac tive protein was associated with waist circumference, fasting plasma glucose and serum triglycerides.
Eckel, R.H., Grundy, S.M. and Zimmet, P.Z. (2005) The Metabolic Syndrome. Lancet, 365, 1415-1428. https://doi.org/10.1016/S0140-6736(05)66378-7
Hjermann, I. (1992) The Metabolic Cardiovascular Syndrome: Syndrome X, Reaven’s Syndrome, Insulin Resistance Syndrome, Atherothrombogenic Syndrome. Journal of Cardiovascular Pharmacology, 20, S5-S10. https://doi.org/10.1097/00005344-199220008-00002
Li, C. and Ford, E.S. (2006) Definition of the Metabolic Syndrome: What’s New and What Predicts Risk? Metabolic Syndrome and Related Disorders, 4, 237-251. https://doi.org/10.1089/met.2006.4.237
The IDF Consensus Worldwide Definition of the Metabolic Syndrome (2006) https://www.idf.org/component/attachments/attachments.html?id=705&task=download
Alberti, K.G.M.M., Eckel, R.H., Grundy, S.M., Zimmet, P.Z., Cleeman, J.I., Donato, K.A., et al. (2009) Harmonizing the Metabolic Syndrome: A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120, 1640-1645. https://doi.org/10.1161/CIRCULATIONAHA.109.192644
Lakka, H.M., Laaksonen, D.E., Lakka, T.A., Niskanen, L.K., Kumpusalo, E., Tuomilehto, J., et al. (2002) The Metabolic Syndrome and Total and Cardiovascular Disease Mortality in Middle-Aged Men. Journal of the American Medical Association, 288, 2709-2716. https://doi.org/10.1001/jama.288.21.2709
Lorenzo, C., Okoloise, M., Williams, K., Stern, M.P., Haffner, S.M. and San Anthonio Heart Study (2003) The Metabolic Syndrome as Predictor of Type 2 Diabetes: The San Antonio Heart Study. Diabetes Care, 26, 3153-3156. https://doi.org/10.2337/diacare.26.11.3153
Ford, E.S. (2005) Risks for All-Cause Mortality, Cardiovascular Disease, and Diabetes Associated with the Metabolic Syndrome: A Summary of the Evidence. Diabetes Care, 28, 1769-1778. https://doi.org/10.2337/diacare.28.7.1769
Moehlecke, M., Leitao, C.B., Kramer, C.K., Rodrigues, T.C., Nickel, C., Silveiro, S.P., et al. (2010) Effect of Metabolic Syndrome and of Its Individual Components on Renal Function of Patients with Type 2 Diabetes Mellitus. Brazilian Journal of Medical and Biological Research, 43, 687-693. https://doi.org/10.1590/S0100-879X2010007500054
Metascreen Writing Committee, Bonadonna, R., Cucinotta, D., Fedele, D., et al. (2006) The Metabolic Syndrome Is a Risk Indicator of Microvascular and Macrovascular Complications in Diabetes: Results from Metascreen, a Multicenter Diabetes Clinic-Based Survey. Diabetes Care, 29, 2701-2707. https://doi.org/10.2337/dc06-0942
Reaven, G.M. (1988) Role of Insulin Resistance in Human Disease. Diabetes, 37, 1595-1607. https://doi.org/10.2337/diab.37.12.1595
Laclaustra, M., Corella, D. and Ordovas, J.M. (2007) Metabolic Syndrome Pathophysiology: The Role of Adipose Tissue. Nutrition, Metabolism & Cardiovascular Diseases, 17, 125-139.
Sutherland, J.P., Mckinley, B. and Eckel, R.H. (2004) The Metabolic Syndrome and Inflammation. Metabolic Syndrome and Related Disorders, 2, 82-104. https://doi.org/10.1089/met.2004.2.82
Dokken, B.B. (2008) The Pathophysiology of Cardiovascular Disease and Diabetes: Beyond Blood Pressure and Lipids. Diabetes Spectrum, 21, 160-165. https://doi.org/10.2337/diaspect.21.3.160
World Health Organization (2008) Waist Circumference and Waist-Hip Ratio Report of a WHO Expert Consultation. WHO, Geneva.
World Health Organization (1995) World Health Organisation. Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series No 854.
Alberti, K.G., Zimmet, P. and Shaw, J. (2006) Metabolic Syndrome—A New World-Wide Definition. A Consensus Statement from the International Diabetes Federation. Diabetic Medicine, 23, 469-480. https://doi.org/10.1111/j.1464-5491.2006.01858.x
Ogbera, A.O. (2010) Prevalence and Gender Distribution of the Metabolic Syndrome. Diabetology & Metabolic Syndrome, 2, 1. https://doi.org/10.1186/1758-5996-2-1
Puepet, F.H., Uloko, A., Akogu, I.Y. and Aniekwensi, E. (2009) Prevalence of the Metabolic Syndrome among Patients with Type 2 Diabetes Mellitus in Urban North-Central Nigeria. African Journal of Endocrinology and Metabolism, 8, 12-14.
Isezuo, S.A. and Ezunu, E. (2005) Demographic and Clinical Correlates of Metabolic Syndrome in Native African Type-2 Diabetic Patients. Journal of the National Medical Association, 97, 557-563.
Adediran, O.S., Edo, A.E., Jimoh, A.K. and Ohwovoriole, A.E. (2007) Prevalence of the Metabolic Syndrome among Nigerians with Type 2 Diabetes. Diabetes International, 15, 13-14.
Alebiosu, C.O. and Odusan, B.O. (2004) Metabolic Syndrome in Subjects with Type-2 Diabetes Mellitus. Journal of the National Medical Association, 96, 817-821.
Chandrashekara, S. (2014) C-Reactive Protein: An Inflammatory Marker with Specific Role in Physiology, Pathology, and Diagnosis. Internet Journal of Rheumatology and Clinical Immunology, 2, SR3.
Florez, H., Castillo-Florez, S., Mendez, A., Casanova-Romero, P., Larreal-Urdaneta, C., Lee, D., et al. (2006) C-Reactive Protein Is Elevated in Obese Patients with the Metabolic Syndrome. Diabetes Research and Clinical Practice, 71, 92-100.
Ye, X., Yu, Z., Li, H., Franco, O.H., Liu, Y. and Lin, X. (2007) Distributions of C-Reactive Protein and Its Associations with Metabolic Syndrome in Middle-Aged and Older Chinese People. Journal of the American College of Cardiology, 49, 1798-1805.
Zuliani, G., Volpato, S., Galvani, M., Ble, A., Corsi, A.M., et al. (2009) Elevated C-Reactive Protein Levels and Metabolic Syndrome in the Elderly: The Role of Central Obesity Data from the in Chianti Study. Atherosclerosis, 203, 626-632.
Huffman, F.G., Gomez, G.P. and Zarini, G.G. (2009) Metabolic Syndrome and High-Sensitivity C-Reactive Protein in Cubans. Ethinicity and Disease, 19, 115-120.
Den Engelsen, C., Koekkoek, P.S., Gorter, K.J., van der Donk, M., Salome, P.L. and Rutten, G.E. (2012) High-Sensitivity C-Reactive Protein to Detect Metabolic Syndrome in a Centrally Obese Population: A Cross-Sectional Analysis. Cardiovascular Diabetology, 11, 25. https://doi.org/10.1186/1475-2840-11-25
Mirhafez, S.R., Ebrahim, M., Saberi Karimian, M., Avan, A., Tayefi, M., Heidari-Bakavoli, A., et al. (2016) Serum High-Sensitivity C-Reactive Protein as a Biomaker in Patients with Metabolic Syndrome: Evidence-Based Study with 7284 Subjects. European Journal of Clinical Nutrition, 70, 1298-1304. https://doi.org/10.1038/ejcn.2016.111
Park, J.T., Chang, T.I., Kim, D.K., Choi, H.Y., Lee, J.E., Kim, H.W., et al. (2009) Association of White Blood Cell Count with Metabolic Syndrome in Patients Undergoing Peritoneal Dialysis. Metabolism, 58, 1379-1385.
Hotamisligil, G.S., Shargill, N.S. and Spiegelman, B.M. (1993) Adipose Expression of Tumor Necrosis Factor-α: Direct Role in Obesity Linked Insulin Resistance. Science, 259, 87-91. https://doi.org/10.1126/science.7678183
Crichton, M.B., Nichols, J.E., Zhao, Y., Bulun, S.E. and Simpson, E.R. (1996) Expression of Transcripts of Interleukin-6 and Related Cytokines by Human Breast Tumors, Breast Cancer Cells, and Adipose Stromal Cells. Molecular and Cellular Endocrinology, 118, 215-220.
Monteiro, R. and Azevedo, I. (2010) Chronic Inflammation in Obesity and the Metabolic Syndrome. Mediators of Inflammation, 2010, Article ID: 289645. https://doi.org/10.1155/2010/289645
Dandona, P., Aljada, A. and Bandyopadhyay, A. (2004) Inflammation: The Link between Insulin Resistance, Obesity and Diabetes. Trends in Immunology, 25, 4-7.