Inflammatory Biomarkers Predictive of Metabolic Syndrome in a Nigerian Population: A Case-Control Study
Background: Inflammation is linked to the aetiopathogenesis of Metabolic syndrome (MetS).
Objective: To assess the ability of high sensitivity C-Reactive Protein (hs-CRP), Tumour Necrosis Factor-alpha (TNFα) and Interleukin-6 (IL-6) to predict MetS.
Methods: A case-control study involving 123 subjects with MetS (cases) and age-matched 123 subjects. without MetS (controls) was conducted. The levels of TNFα, IL-6, and hs-CRP between independent groups were compared. The Receiver Operative Characteristic Curve was used to assess the ability of inflammatory markers to discriminately identify MetS.
Results: The mean age of the case and control groups was 49.9±0.9 years and 48.1±1.1 years (p = 0.274) respectively. The median levels of TNFα, IL-6 and hS-CRP were significantly higher among the cases than the control group in both genders (p <0.001). There was a significant increase in the serum values of the markers with increasing components of MetS (p <0.001). The Area Under the Curve of TNFα, IL-6 and hs-CRP was > 0.9 in both males and females.
Conclusion: TNFα, IL-6, and hs-CRP identified MetS. There is a need for further studies to determine the inflammatory marker most predictive of MetS.
Alberti KG, Zimmet P, Shaw J. Metabolic syndrome-a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med 2006; 23: 469-480. doi:10.1111/j.1464-5491.2006.01858.
Rochlani Y, Pothineni NV, Kovelamudi S, Mehta JL. Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Ther Adv Cardiovasc Dis 2017; 11: 215–225. doi:10.1177/1753944717711379.
Dallmeier D, Larson MG, Vasan RS, Keaney Jr. FR, Fontes JD, Meigs JB, et al. Metabolic syndrome and inflammatory biomarkers: a community-based cross-sectional study at the Framingham Heart Study. Diabetol Metab Syndr 2012; 4: 28. https://doi.org/10.1186/1758-5996-4-28.
Selleck MJ, Senthil M, Wall NR. Making Meaningful Clinical Use of Biomarkers. Biomark Insights 2017; 12: 1–7. doi:10.1177/1177271917715236.
Sur G, Floca E, Kudor-Szabadi L, Sur ML, Sur D, Samasca G. The Relevance of Inflammatory Markers in Metabolic Syndrome. Maedica (Bucur) 2014; 9: 15–18.
Moreira PF, Dalboni MA, Cendoroglo M, Santos GM, Cendoroglo MS. Postprandial interleukin-6 response in elderly with abdominal obesity and metabolic syndrome. J Nutr Health Aging 2013; 17: 206–210. doi:10.1007/s12603-012-0400.
Balasoiu M, Balasoiu AT, Stepan AE, Dinescu SN, Avramescu CS, Dumitrescu D. Proatherogenic adipocytokines levels in metabolic syndrome. Rom J Morphol Embryol. 2014; 55: 29-33.
Ghantous CM, Azrak Z, Hanache S, Abou-Kheir W, Zeidan A. Differential Role of Leptin and Adiponectin in cardiovascular system. Int J Endocrinol 2015; 2015:534320. https://doi.org/10.1155/2015/534320.
Pulkkinen L, Ukkola O, Kolehmainen M, Uusitupa M. Ghrelin in diabetes and metabolic syndrome. Int J Pept 2010, Article ID 248948. https://doi.org/10.1155/2010/248948.
Kodaman N, Aldrich MC, Sobota R, Asselbergs FW, Brown NJ, Moore JH, et al. Plasminogen Activator Inhibitor-1 and Diagnosis of the Metabolic Syndrome in a West African Population. J Am Heart Assoc 2016; 5: e003867. doi:10.1161/JAHA.116.003867.
Billiet L, Doaty S, Katz JD, Velasquez MT. Review of hyperuricemia as new marker for metabolic syndrome. ISRN Rheumatol 2014; 2014: 852954. doi:10.1155/2014/852954.
Pohjantahti-Maaroos H, Palomaki A, Kankkunen P, Laitinen R, Husgafvel S, Oksanen K. Circulating oxidized low-density lipoproteins and arterial elasticity: comparison between men with metabolic syndrome and physically active counterparts. Cardiovasc Diabetol 2010; 9: 41.doi:10.1186/1475-2840-9-41.
Martinelli N, Micaglio R, Consoli L, Guarini P, Grison E, Pizzolo F, et al. Low levels of serum paraoxonase activities are characteristic of metabolic syndrome and may influence the metabolic-syndrome-related risk of coronary artery disease. Exp Diabetes Res 2012; 2012: 231502. doi:10.1155/2012/231502.
Srikanthan K, Feyh A, Visweshwar H, Shapiro JI, Sodhi K. Systematic Review of Metabolic Syndrome Biomarkers: A Panel for Early Detection, Management, and Risk Stratification in the West Virginian Population. Int J Med Sci 2016; 13: 25-38. doi:10.7150/ijms.13800.
Udenze IC, Amadi EC, Awolola AN, Makwe CC, Ajie IO. Plasma levels of inflammatory cytokines in adult Nigerians with the metabolic syndrome. Niger Med J 2016; 57: 64–68. doi:10.4103/0300-1652.180569.
Ogbera AO, Azenabor A, Ogundahunsi OA, Ekun AO, Adejumo EN. Cytokines, Type 2 DM and the Metabolic Syndrome. Nig Qt J Hosp Med. 2013: 23: 318-322.
Adejumo EN, Ogundahunsi OA, Adejumo AO, Sotunsa J, Jagun O. Prevalence of metabolic syndrome in a rural and urban community in South-west Nigeria using three different definitions. Int J Trop Dis Health 2017; 24: 1e9. https://doi.org/10.9734/IJTDH/2017/33993.
National Cholesterol Education Program (NCEP). Expert panel on detection and treatment of high blood cholesterol in adults. 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) Final Report. Circulation 2002; 106: 3143e421.
Reddy P, Lent-Schochet D, Ramakrishnan N, McLaughlin M, Jialal I. Metabolic syndrome is an inflammatory disorder: A conspiracy between adipose tissue and phagocytes. Clin Chim Acta 2019; 496: 35-44. doi:10.1016/j.cca.2019.06.019.
Le Lay S, Simard G, Martinez MC, Andriantsitohaina R. Oxidative stress and metabolic pathologies: from an adipocentric point of view. Oxid Med Cell Longev 2014; 2014: 908539. https://doi.org/10.1155/2014/908539.
Dallmeier D, Larson MG, Vasan RS, Keaney Jr JF, Fontes JD, Meigs JB, et al. Metabolic syndrome and inflammatory biomarkers: a community-based cross-sectional study at the Framingham Heart Study. Diabetol Metab Syndr 2012; 4: 28. doi:10.1186/1758-5996-4-28.
Phosat C, Panprathip P, Chumpathat N, Prangthip P, Chantratita N, Soonthornworasisi N, et al. Elevated C-reactive protein, interleukin 6, tumor necrosis factor-alpha and glycemic load associated with Type 2 diabetes mellitus in rural Thais: a cross-sectional study. BMC Endocr Disord 2017; 17: 44. https://doi.org/10.1186/s12902-017-0189-z.
Al-Shukaili A, AL-Ghafri S, Al-Marhoobi S, Al-Abri S, Al-Lawati J, Al-Maskari M. Analysis of inflammatory mediators in Type 2 diabetes patients. Int J Endocrinol 2013; 2013: 976810. http://dx.doi.org/10.1155/2013/976810.
Hossain M, Faruque MO, Kabir G, Hassan N, Sikdar D, Nahar Q, Ali L. Association of serum TNF-α and IL-6 with insulin secretion and insulin resistance in IFG and IGT subjects in a Bangladeshi population. Int J Diabetes Mellit 2010; 2:165–168. https://doi.org/10.1016/j.ijdm.2010.08.004.
Sharma, P. Inflammation and the metabolic syndrome. Indian J Clin Biochem 2011; 26: 317‑318. doi: 10.1007/s12291-011-0175-6.
Esmaillzadeh A, Azadbakht L. Increased levels of inflammation among women with enlarged waist and elevated triglyceride concentrations. Ann Nutr Metab 2010; 57: 77-84..https://doi.org/10.1159/000318588.
Garcia VP, Rocha HNM, Sales ABK, Rocha NG, Lucas da Nóbrega AC. Sex Differences in High Sensitivity C-Reactive Protein in Subjects with Risk Factors of Metabolic Syndrome. Arq Bras Cardiol 2016; 106: 182-187. http://dx.doi.org/10.5935/abc.20160027.
Lainampetch J, Panprathip P, Phosat C, Chumpathat N, Prangthip P, Soonthornworasiri N, et al. Association of Tumor Necrosis Factor Alpha, Interleukin 6, and C-Reactive Protein with the Risk of Developing Type 2 Diabetes: A Retrospective Cohort Study of Rural Thais. J Diabetes Res 2019; Article ID 9051929. https://doi.org/10.1155/2019/9051929.
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