C-Reactive Protein in Healthy Subjects: Associations With Obesity, Insulin Resistance, and Endothelial Dysfunction: A Potential Role for Cytokines Originating From Adipose Tissue?
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Abstract —C-reactive protein, a hepatic acute phase protein largely regulated by circulating levels of interleukin-6, predicts coronary heart disease incidence in healthy subjects. We have shown that subcutaneous adipose tissue secretes interleukin-6 in vivo. In this study we have sought associations of levels of C-reactive protein and interleukin-6 with measures of obesity and of chronic infection as their putative determinants. We have also related levels of C-reactive protein and interleukin-6 to markers of the insulin resistance syndrome and of endothelial dysfunction. We performed a cross-sectional study in 107 nondiabetic subjects: (1) Levels of C-reactive protein, and concentrations of the proinflammatory cytokines interleukin-6 and tumor necrosis factor-α, were related to all measures of obesity, but titers of antibodies to Helicobacter pylori were only weakly and those of Chlamydia pneumoniae and cytomegalovirus were not significantly correlated with levels of these molecules. Levels of C-reactive protein were significantly related to those of interleukin-6 ( r =0.37, P <0.0005) and tumor necrosis factor-α ( r =0.46, P <0.0001). (2) Concentrations of C-reactive protein were related to insulin resistance as calculated from the homoeostasis model assessment model, blood pressure, HDL, and triglyceride, and to markers of endothelial dysfunction (plasma levels of von Willebrand factor, tissue plasminogen activator, and cellular fibronectin). A mean standard deviation score of levels of acute phase markers correlated closely with a similar score of insulin resistance syndrome variables ( r =0.59, P <0.00005), this relationship being weakened only marginally by removing measures of obesity from the insulin resistance score ( r =0.53, P <0.00005). These data suggest that adipose tissue is an important determinant of a low level, chronic inflammatory state as reflected by levels of interleukin-6, tumor necrosis factor-α, and C-reactive protein, and that infection with H pylori , C pneumoniae , and cytomegalovirus is not. Moreover, our data support the concept that such a low-level, chronic inflammatory state may induce insulin resistance and endothelial dysfunction and thus link the latter phenomena with obesity and cardiovascular disease.
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Slightly elevated serum levels of C-reactive protein (IL-6-dependent) are closely interrelated with insulin resistance.
“This is confirmed by studies that describe a close interrelation of slightly elevated serum levels of C-reactive protein (IL-6-dependent) and a key element of the energy re-allocation program, namely insulin resistance [9,10].”
From Interaction of the endocrine system with inflammation: a function of energy and volume regulation (2014) · cites this paper as [10]
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- Authors
- Yudkin, J. S., Stehouwer, C. D. A., Emeis, J. J., & Coppack, S. W.
- Affiliations
- Whittington Hospital (GB)
- Venue
- Arteriosclerosis, Thrombosis, and Vascular Biology
- Published
- 1999-04
- Volume
- 19
- Issue
- 4
- Pages
- 972-978
- ISSN
- 1079-5642 (ISSN-L)
- 1524-4636
- OpenAlex
- W2119316150
- Cited by
- 2,465
- References
- 51
- Citations by year
- 2026: 19 · 2025: 22 · 2024: 21 · 2023: 45 · 2022: 50 · 2021: 61 · 2020: 44 · 2019: 57 · 2018: 57 · 2017: 67 · 2016: 80 · 2015: 100 · 2014: 111 · 2013: 116 · 2012: 117
- FWCI
- 54.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- TNO Repository (submittedVersion)
- Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Wellcome Trust
- British Heart Foundation
- Diabetes Fonds
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- C-reactive protein, interleukin-6, TNF-α, obesity, insulin resistance, endothelial dysfunction, adipose tissue, chronic inflammation, Helicobacter pylori, Chlamydia pneumoniae, cytomegalovirus, acute phase proteins, cardiovascular risk
- MeSH terms
- Adipose Tissue, Adult, Aged, C-Reactive Protein, Endothelium, Vascular, Female, Follow-Up Studies, United Kingdom, Humans, Insulin Resistance, Male, Middle Aged, Obesity, Random Allocation, Cytokines
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