C‐reactive protein, its role in inflammation, Type 2 diabetes and cardiovascular disease, and the effects of insulin‐sensitizing treatment with thiazolidinediones
Abstract
Increased concentrations of the marker of inflammation, C‐reactive protein (CRP), are associated with insulin resistance, Type 2 diabetes and the development of cardiovascular disease. In particular, inflammation is closely associated with endothelial dysfunction and is recognized as one of the cardiovascular risk factors clustering in the Insulin Resistance Syndrome or Metabolic Syndrome. The exact mechanisms linking insulin resistance and inflammation remain unclear. However, the close association between insulin resistance and inflammation in atherogenesis suggests that therapies that address both parameters may have benefits in reducing diabetes‐related macrovascular complications. The thiazolidinedione class of oral anti‐diabetic agents are powerful insulin sensitizers that also have anti‐inflammatory properties. Treatment with these agents has a range of anti‐atherogenic effects, including reduced levels of CRP, plasminogen activator inhibitor‐1 (PAI‐1), TNF‐α and reactive oxygen species. Additionally, the insulin‐sensitizing effect of thiazolidinediones improves other factors of the Insulin Resistance Syndrome, including dyslipidaemia and hypertension. Outcome studies are underway to determine if the effects of improving insulin sensitivity and reducing inflammation will translate into clinical benefits and reduce the cardiovascular morbidity and mortality associated with insulin resistance and Type 2 diabetes.
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Several medications prescribed for other metabolic risk factors, including statins, nicotinic acid, fibrates, ACE inhibitors, and thiazolidinediones, have been reported to lower CRP levels.
“treat other metabolic risk factors have been reported to reduce CRP levels (eg, statins, nicotinic acid, fibrates, ACE inhibitors, thiazolidinediones). 186 -188”
From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [188]
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- Authors
- Nesto, R.
- Affiliations
- Lahey Hospital and Medical Center (US)
- Corresponding author
- Nesto, R.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2004-07-20
- Volume
- 21
- Issue
- 8
- Pages
- 810-817
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2050135792
- Cited by
- 140
- References
- 76
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 1 · 2023: 5 · 2022: 6 · 2021: 1 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 1 · 2015: 3 · 2014: 4 · 2013: 6 · 2012: 5
- FWCI
- 12.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- C-reactive protein, inflammation, type 2 diabetes, cardiovascular disease, insulin resistance, thiazolidinediones, insulin sensitizers, endothelial dysfunction, metabolic syndrome, atherogenesis, plasminogen activator inhibitor-1, TNF-α, reactive oxygen species, dyslipidemia, hypertension, macrovascular complications
- MeSH terms
- Arteriosclerosis, C-Reactive Protein, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Inflammation, Insulin Resistance, Risk Factors, Metabolic Syndrome, Thiazolidinediones
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