The DOI matches its Crossref record; 35 of the 36 references it cites were found in a registry or an index.
C-Reactive Protein, the Metabolic Syndrome, and Prediction of Cardiovascular Events in the Framingham Offspring Study
Abstract
Background— Inflammation (assessed by C-reactive protein [CRP]) and the metabolic syndrome (MetS) are associated with cardiovascular disease (CVD), but population-based data are limited. Methods and Results— We assessed the cross-sectional relations of CRP to the MetS (National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Adult Treatment Panel III definition) in 3037 subjects (1681 women; mean age, 54 years) and the utility of CRP and the MetS to predict new CVD events (n=189) over 7 years. MetS (≥3 of 5 traits) was present in 24% of subjects; mean age-adjusted CRP levels for those with 0, 1, 2, 3, 4, or 5 MetS traits were 2.2, 3.5, 4.2, 6.0, or 6.6 mg/L, respectively ( P trend <0.0001). In persons with MetS, age-adjusted CRP levels were higher in women than men (7.8 versus 4.6 mg/L; P <0.0001). MetS and baseline CRP were individually related to CVD events (for MetS: age-sex-adjusted hazard ratio [HR], 2.1; 95% CI, 1.5 to 2.8; for highest versus lowest CRP quartile: HR, 2.2; 95% CI, 1.4 to 3.5). Greater risk of CVD persisted for MetS and CRP even after adjustment in a model including age, sex, MetS (HR, 1.8; 95% CI, 1.4 to 2.5), and CRP (HR, 1.9; 95% CI, 1.2 to 2.9). The c-statistic associated with the age- and sex-adjusted model including CRP was 0.72; including MetS, 0.74; and including CRP and MetS, 0.74. Conclusions— Elevated CRP levels are related to insulin resistance and the presence of the MetS, especially in women. Although discrimination of subjects at risk of CVD events using both MetS and CRP is not better than using either phenotype alone, both CRP and MetS are independent predictors of new CVD events.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The MS has been associated with incident CHD and CHD mortality, [5][6][7][8][9][10][11]”
From Diabetes, the Metabolic Syndrome, and Angiographic Progression of Coronary Arterial Disease in Postmenopausal Women (2006) · cites this paper as [10]
Citations
Cites
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011
The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men
Lakka, H.-M. (2002) · JAMA · doi:10.1001/jama.288.21.2709 · Cited by 5,033
Yudkin, J. S., Stehouwer, C. D. A., Emeis, J. J., & Coppack, S. W. (1999) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/01.atv.19.4.972 · Cited by 2,465
Chronic Subclinical Inflammation as Part of the Insulin Resistance Syndrome
Festa, A., D’Agostino, R., Howard, G., Mykkänen, L., Tracy, R. P., & Haffner, S. M. (2000) · Circulation · doi:10.1161/01.cir.102.1.42 · Cited by 2,366
Self-citationRidker, P. M., Buring, J. E., Cook, N. R., & Rifai, N. (2003) · Circulation · doi:10.1161/01.cir.0000055014.62083.05 · Cited by 2,292
Sattar, N., Gaw, A., Scherbakova, O., Ford, I., O’Reilly, D. S. J., Haffner, S. M., Isles, C., Macfarlane, P. W., Packard, C. J., Cobbe, S. M., et al. (2003) · Circulation · doi:10.1161/01.cir.0000080897.52664.94 · Cited by 1,506
Schmidt, M. I., Duncan, B. B., Sharrett, A. R., Lindberg, G., Savage, P. J., Offenbacher, S., Azambuja, M. I. R., Tracy, R. P., & HEISS, G. M. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01046-6 · Cited by 1,080
Festa, A., D’Agostino, R., Tracy, R. P., & Haffner, S. M. (2002) · Diabetes · doi:10.2337/diabetes.51.4.1131 · Cited by 1,057
Self-citationIs Type II diabetes mellitus a disease of the innate immune system?
Pickup, J. C., & Crook, M. A. (1998) · Diabetologia · doi:10.1007/s001250051058 · Cited by 1,042
Reciprocal Association of C-Reactive Protein With Adiponectin in Blood Stream and Adipose Tissue
Ouchi, N., Kihara, S., Funahashi, T., Nakamura, T., Nishida, M., Kumada, M., Okamoto, Y., Ohashi, K., Nagaretani, H., Kishida, K., et al. (2003) · Circulation · doi:10.1161/01.cir.0000055188.83694.b3 · Cited by 853
Mendall, M. A., Patel, P., Ballam, L., Strachan, D. P., & Northfield, T. C. (1996) · BMJ · doi:10.1136/bmj.312.7038.1061 · Cited by 851
Hotamisligil, G. S., Budavari, A., Murray, D., & Spiegelman, B. M. (1994) · Journal of Clinical Investigation · doi:10.1172/jci117495 · Cited by 819
Rost, N. S., Wolf, P. A., Kase, C. S., Kelly‐Hayes, M., Silbershatz, H., Massaro, J. M., D’Agostino, R. B., Franzblau, C., & Wilson, P. W. F. (2001) · Stroke · doi:10.1161/hs1101.098151 · Cited by 806
Self-citationFröhlich, M., Imhof, A., Berg‐Beckhoff, G., Hutchinson, W. L., Pepys, M. B., Boeing, H., Muche, R., Brenner, H., & Köenig, W. (2000) · Diabetes Care · doi:10.2337/diacare.23.12.1835 · Cited by 690
Barrett-Connor, E. L. (1991) · JAMA · doi:10.1001/jama.265.5.627 · Cited by 679
A Comparison of the Prevalence of the Metabolic Syndrome Using Two Proposed Definitions
Ford, E. S., & Giles, W. H. (2003) · Diabetes Care · doi:10.2337/diacare.26.3.575 · Cited by 616
Brunner, E. J., Hemingway, H., Walker, B. R., Page, M., Clarke, P., Juneja, M., Shipley, M. J., Kumari, M., Andrew, R., Seckl, J. R., et al. (2002) · Circulation · doi:10.1161/01.cir.0000038364.26310.bd · Cited by 539
Han, T. S., Sattar, N. A., Williams, K., González‐Villalpando, C., Lean, M. E. J., & Haffner, S. M. (2002) · Diabetes Care · doi:10.2337/diacare.25.11.2016 · Cited by 512
Resnick, H. E., Jones, K. L., Ruotolo, G., Jain, A. K., Henderson, J. A., Lu, W., & Howard, B. V. (2003) · Diabetes Care · doi:10.2337/diacare.26.3.861 · Cited by 426
Role of Cytokines in Inducing Hyperlipidemia
Feingold, K. R., & Grünfeld, C. (1992) · Diabetes · doi:10.2337/diab.41.2.s97 · Cited by 380
Onat, A., Ceyhan, K., Başar, O., Erer, B., Toprak, S., & Sansoy, V. (2002) · Atherosclerosis · doi:10.1016/s0021-9150(02)00236-8 · Cited by 349
Ford, E. S. (2003) · Atherosclerosis · doi:10.1016/s0021-9150(03)00134-5 · Cited by 315
Regulation of the Acute Phase Response by Cytokines
Kushner, I. (1993) · Perspectives in biology and medicine · doi:10.1353/pbm.1993.0004 · Cited by 295
Wang, T. J., Nam, B., Wilson, P. W. F., Wolf, P. A., Levy, D. A., Polak, J. F., D’Agostino, R. B., & O’Donnell, C. J. (2002) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.0000034543.78801.69 · Cited by 236
Self-citationTamakoshi, K., Yatsuya, H., Kondo, T., Hori, Y., Ishikawa, M., Zhang, H., Murata, C., Otsuka, R., Zhu, S., & Toyoshima, H. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802260 · Cited by 232
Hak, A. E., Pols, H. A. P., Stehouwer, C. D. A., Meijer, J., Kiliaan, A. J., Albert Hofman, D., Breteler, M. M. B., & Witteman, J. C. M. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.86.9.4398 · Cited by 185
Campos, S. P., & Baumann, H. (1992) · Molecular and Cellular Biology · doi:10.1128/mcb.12.4.1789 · Cited by 183
Youd, J. M., Rattigan, S., & Clark, M. G. (2000) · Diabetes · doi:10.2337/diabetes.49.11.1904 · Cited by 180
Temelkova-Kurktschiev, T. S., Siegert, G., Bergmann, S., Henkel, E., Koehler, C., Jaroszlig, W., & Markolf Hanefeld, E. (2002) · Metabolism · doi:10.1053/meta.2002.32804 · Cited by 155
Diabesity: An Inflammatory Metabolic Condition
Schmidt, M. I., & Duncan, B. B. (2003) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.2003.174 · Cited by 140
Haffner, S. M., Miettinen, H., & Stern, M. P. (1997) · Diabetologia · doi:10.1007/s001250050738 · Cited by 103
Alpizar, E., & SPICER, L. J. (1994) · Biology of Reproduction · doi:10.1095/biolreprod50.1.38 · Cited by 85
Laakso, M., R�nnemaa, T., Lehto, S., Puukka, P. J., Kallio, V., & Py�r�l�, K. (1995) · Diabetologia · doi:10.1007/bf00410288 · Cited by 68
Guerrero‐Romero, F., & Rodríguez‐Morán, M. (2003) · Diabetes & Metabolism · doi:10.1016/s1262-3636(07)70009-5 · Cited by 35
Cited by
Sorted by citations
Eckel, R. H., Alberti, K., Grundy, S. M., & Zimmet, P. (2010) · The Lancet · doi:10.1016/s0140-6736(09)61794-3 · Cited by 6,317
Eckel, R. H., Grundy, S. M., & Zimmet, P. (2005) · The Lancet · doi:10.1016/s0140-6736(05)66378-7 · Cited by 5,755
The Metabolic Syndrome: Time for a Critical Appraisal
Kahn, R., Buse, J. B., Ferrannini, E., & Stern, M. P. (2005) · Diabetes Care · doi:10.2337/diacare.28.9.2289 · Cited by 2,400
“(74) also found that CRP and the metabolic syndrome were independent risk factors, but in contrast to the two other reports, combining CRP and metabolic syndrome did not improve the predictive value of either used alone.”
Metabolic Syndrome and Risk of Incident Cardiovascular Events and Death
Gami, A. S., Witt, B. J., Howard, D. E., Erwin, P. J., Gami, L. A., Somers, V. K., & Montori, V. M. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.09.032 · Cited by 1,888
Ford, E. S. (2005) · Diabetes Care · doi:10.2337/diacare.28.7.1769 · Cited by 1,718
“For seven studies (13,15,18,19,21,23,24) with eight estimates of relative risk that excluded participants with diabetes or Figure 1—A: Associations between metabolic syndrome, using the NCEP definition, and all-cause mortality.”
Background
Metadata
- Authors
- Rutter, M. K., Meigs, J. B., Sullivan, L. M., D’Agostino, R. B., & Wilson, P. W. F.
- Affiliations
- Boston University (US)
- Venue
- Circulation
- Published
- 2004-07-27
- Volume
- 110
- Issue
- 4
- Pages
- 380-385
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1983997573
- Cited by
- 664
- References
- 36
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 9 · 2023: 15 · 2022: 19 · 2021: 9 · 2020: 8 · 2019: 11 · 2018: 15 · 2017: 13 · 2016: 19 · 2015: 20 · 2014: 36 · 2013: 36 · 2012: 26
- FWCI
- 48.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (R01HL073272, N01‐HC25195, R01-HL 073272-01)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- C-reactive protein, metabolic syndrome, cardiovascular risk prediction, inflammation, insulin resistance, sex differences, Framingham Offspring Study, cardiovascular events, risk discrimination, cardiovascular risk in women, NCEP ATP III criteria, Framingham risk score, Framingham risk equation
- MeSH terms
- Adult, Aged, Aged, 80 and over, C-Reactive Protein, Cardiovascular Diseases, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Inflammation, Insulin Resistance, Male, Middle Aged, Predictive Value of Tests, Risk, Sex Factors, Cohort Studies, Metabolic Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
