The Study On The Relationship Between Inflammatory Factors And Carotid Atherosclerosis In The Subjects With Metabolic Syndrome

Objective The purpose of this study is to examine the relationship between inflammatory factors and carotid atherosclerosis in the subjects with metabolic syndrome (MS). Methods According to the definition of MS by Chinese Diabetes Society in 2004, 88 subjects were enrolled and divided into three groups, including MS group with three to four components (n=44), MS subgroup with one to two components (n=23),and control group (n=21). Levels of serum high-sensitivity C-reactive protein (hsCRP),tumor necrosis factor-alpha(TNF-α) and adiponectin (ADPN) were detected in all the subjects by the enzyme linked immunosorbent assay (ELISA). Carotid intima-media thickness (IMT)and the parameters of carotid blood flow were measured. The carotid atherosclerotic plagues were also assessed by the color Doppler ultrasound. Results (1) Levels of serum hsCRP and TNF-αwere significantly higher in MS group as compared with those in control group (P<0.01), while concentration of serum ADPN was significantly lower in MS group than that in control group (P<0.01). Increasing numbers of the MS components leaded to higher level of serum hsCRP and TNF-α, rather lower concentration of serum ADPN. (2) The subjects in MS group had thicker IMT and higher carotid resistance index compared with those in both MS subgroup and control group (P<0.05). The occurrence of carotid atherosclerotic plagues in MS group was much higher than that in control group. The severity of carotid atherosclerosis in all subjects rose with the increasing numbers of the MS components (P<0.05).(3)Correlation analyses indicated that level of serum hsCRP was associated with body mass index (BMI) and triglyceride positively, and negatively with high density lipoprotein cholesterol(P < 0.05). Level of serum TNF-αwas positively correlated with waist-hip ratio (WHR) and low density lipoprotein cholesterol(P<0.05). Concentration of serum ADPN was negatively with BMI and WHR, and positively with HDL-C(P<0.05). Moreover, there was a positive correlation between homaostasis model assessment estimate of insulin resistance (HOMA-IR) with levels of serum hsCRP and TNF-α(P<0.05). Highly negative correlation between HOMA-IR with concentration of serum ADPN was also detected (P<0.05).(4) Levels of serum hsCRP and TNF-αwere significantly higher in subjects with thicker carotid IMT(IMT≥0.9mm)when compared with those who have normal carotid IMT(IMT <0.9mm)(P<0.05,P<0.01,respectively), while concentration of serum ADPN was significantly lower in subjects with thicker carotid IMT(IMT≥0.9mm) than those with normal carotid IMT(IMT<0.9mm)(P<0.01). The subjects with carotid atherosclerotic plagues had higher levels of serum hsCRP and TNF-αcompared with those without carotid atherosclerotic plagues (P<0.05,P<0.01,respectively), while concentration of serum ADPN was significantly lower in subjects with carotid atherosclerotic plagues than those without carotid atherosclerotic plagues (P<0.01). (5)Multiple linear regression analysis showed that age and level of serum hsCRP had significant influence on the carotid IMT (P<0.01,P<0.05,respectively). Multivariate logistic regression analysis revealed that independent risk factors for the occurrence of carotid atherosclerotic plague were age (OR=2.002,P=0.011)and HOMA-IR (OR=1.079, P=0.018), while concentration of serum ADPN was found to be an independent protective factor (OR=0.779, P=0.045).(6) Another logistic regression model showed that level of serum hsCRP was a independent factor for MS (OR=2.44, P=0.047). Conclusions (1) Levels of serum hsCRP, TNF-α, and ADPN are closely related to the components and quantity of MS. MS features a chronic,systemic low-grade state of inflammation.(2) The level of serum hsCRP is responsible for MS. The elevated hsCRP level may be one of bio-markers of MS.(3) The subjects with MS already exhibit pathological changes of carotid atherosclerosis. (4) High level of serum hsCRP and low concentration of serum ADPN could involve in the progress of carotid atherosclerosis.