The prevalence of metabolic syndrome increases with serum hs-CRP concentration in individuals without a history of cardiovascular disease: a report from a large Persian cohort

BACKGROUND: Metabolic syndrome (MetS) is defined by a clustering of cardiovascular (CV) risk factors and is associated with a heightened inflammatory state. A raised serum high-sensitivity C-reactive protein (hs-CRP), a marker of inflammation, is also known to associate with CV risk. We have investigated the relationship between the presence of MetS and serum hs-CRP concentration in a large representative Persian population cohort without a history of cardiovascular disease (CVD). METHODS: The MASHAD study population cohort comprised 9 778 subjects, who were recruited from the city of Mashhad, Iran, between 2007 and 2008. Several cardiovascular risk factors were measured in this population without CVD. Individuals were categorized into quartiles of serum hs-CRP concentration: 1st quartile - 0.72 (0.59-0.85) [median (range)] mg/L, 2nd quartile - 1.30 (1.14-1.4) mg/L, 3rd quartile - 2.29 (1.92-2.81) mg/L and 4th quartile - 6.63 (4.61-11.95) mg/L respectively. The prevalence of MetS in each quartile was determined using either International Diabetes Federation (IDF) or Adult Treatment Panel III (ATPIII) criteria. RESULTS: The prevalence of MetS was highest in the 4th quartile for serum hs-CRP [1220 subjects (50.0%)], and significantly higher than that in the 1st quartile (reference group) [634 subjects (25.9%)] (p<0.001). A positive smoking habit [OR, 1.47 (1.26-1.70), p<0.001] and the presence of either MetS-IDF [OR, 1.35 (1.18-1.55), p<0.001] or Mets-ATPIII [OR, 1.40 (1.18-1.50), p<0.001] were strong predictors of a 4th quartile for serum hs-CRP concentration. CONCLUSIONS: There was a significant association between high levels of serum hs-CRP and the presence of MetS among individuals without a history of CVD in our Persian cohort

Serum high sensitive C reactive protein is associated with dietary intakes in diabetic patients with and without hypertension: a cross-sectional study

Background: Serum C reactive protein (CRP) concentrations independently predict the development of diabetes, metabolic syndrome and cardiovascular disease. However, the impact of dietary factors on serum CRP concentrations in diabetic patients has received limited attention. We aimed to investigate the association between dietary factors and serum CRP, measured using a high sensitivity (hs-)assay, among diabetic patients with and without hypertension and healthy subjects. Methods: In this cross-sectional study, diabetics with (n=325) and without hypertension (n=599) and healthy individuals (n=1220) were recruited in Mashhad, Iran. Dietary intake was assessed by 24-hour recall. Biochemical parameters including serum hs-CRP were measured using standard protocols. Stepwise multiple regression analysis was used to predict whether serum hs-CRP concentration was associated with dietary constituents. Results: hs-CRP was significantly higher among hypertensive and non-hypertensive diabetic patients compared to healthy subjects (p<0.001). The dietary intake of zinc +6.4% and calcium -3.4%, and BMI +3.9% explained approximately 13.7% of the variation in serum hs-CRP among diabetic hypertensive patients. Approximately, 9.7% of the variation in serum hs-CRP in diabetic non-hypertensive patients could be explained by BMI, and intake of sodium, iron and cholesterol. In the healthy subjects approximately 4.4% of the total variation in serum hs-CRP concentration could be explained by cholesterol consumption and waist circumference. Conclusion: Serum hs-CRP concentrations were found to be a significant predictor for hypertensive and non-hypertensive diabetic subjects. There was a significant association between dietary factors include zinc, iron, sodium and cholesterol and serum hs-CRP whilst there was an inverse association between dietary calcium and serum hs-CRP in diabetic hypertensive individuals

Hookah smoking is strongly associated with diabetes mellitus, metabolic syndrome and obesity: a population-based study

Objectives The adverse effects of cigarette smoking have been widely studied before, whilst the effects of hookah smoking has received less attention, although it is a common habit in the Middle East. Here we have investigated the effects of cigarette and hookah smoking on biochemical characteristics in a representative population sample derived from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study, from Northeastern Iran. Study design A total of 9840 subjects from the MASHAD population study were allocated to five groups; non-smokers (6742), ex-smokers (976), cigarette smokers (864), hookah smokers (1067), concomitant cigarette and hookah smokers (41). Methods Baseline characteristics were recorded in a questionnaire. Biochemical characteristics were measured by routine methods. Data were analyzed using SPSS software and p < 0.05 was considered significant. Results After adjustment for age and sex; the presence of CVD, obesity, metabolic syndrome, DM and dyslipidemia were significantly (p < 0.001) related to smoking status. After multivariate analysis, HDL (p < 0.001), WBC (p < 0.001), MCV (p < 0.05), PLT (p < 0.01) and RDW (p < 0.001), and the presence of CVD (p < 0.01), obesity (p < 0.001), metabolic syndrome (p < 0.05) and DM (p < 0.01) remained significant between cigarette smokers and non-smokers. Between hookah smokers and non-smokers; uric acid (p < 0.001), PLT (p < 0.05) and RDW (p < 0.05), and the presence of obesity (p < 0.01), metabolic syndrome (p < 0.001), diabetes (p < 0.01) and dyslipidemia (p < 0.01) remained significant after logistic regression. Conclusion There was a positive association between hookah smoking and metabolic syndrome, diabetes, obesity and dyslipidemia which was not established in cigarette smoking

Changes in plasma level of heat shock protein 27 after acute coronary syndrome

We assessed the association between serum heat shock protein 27 (Hsp-27)concentrations in patients with acute coronary syndrome (ACS) and compared them with healthy participants. Patients with ACS (n = 75) were recruited and their biochemical parameters were compared with 75 healthy participants. Heat shock protein 27 concentrations were measured from blood samples taken on admission and 12 hours after the onset of chest pain. In the patient group, Hsp-27 concentrations (31.62 [20.12-38.51] ng/mL) in the first blood samples were significantly (P < .001) higher than in control samples (20.12 [16.67-28.17] ng/mL). In patients, serum Hsp-27 levels on admission were significantly (P < .001) higher than for the samples collected 12 hours after the onset of chest pain (25.87 [15.52-31.62]); the latter did not differ significantly from samples of healthy controls. In conclusion, serum Hsp-27 concentrations are elevated in the early hours following ACS, but fall to levels near to those in healthy individuals after about 12 hours from the onset of chest pain

Cardiovascular Risk Factors and Nutritional Intake are not Associated with Ultrasound-defined Increased Carotid Intima Media Thickness in Individuals Without a History of Cardiovascular Events

Background: Carotid ultrasound appears to be useful in the assessment of cardiovascular risk. In this study, we have assessed the carotid intima-media thickness (CIMT) in a group of individuals without a history of cardiovascular events. Methods: A sample of 431subjects (189 [43.9%] males and 242 [56.1%] females) was obtained from an urban population using a stratified-cluster method in Mashhad stroke and heart atherosclerosis disorder study. None of the subjects had a history of the cardiovascular event. Carotid artery duplex ultrasound was used to determine the CIMT in all subjects, and to identify those with an abnormal value (CIMT [+]; i.e., CIMT ≥ 0.8 mm). Dietary intake of participants was assessed using a questionnaire for 24-h dietary recall. The relationship between anthropometric, biochemical and dietary data and CIMT were assessed. Results: The mean age of subjects was 48.7 ± 8.0 years. Of the 431 patients, 118 (27.4%) were found to be CIMT (+). Of the cardiovascular parameters assessed, only age (odds ratio [OR] [95% confidence interval (CI)], 1.11 [0.56-4.34]; P < 0.01) and male gender (OR [95% CI], 1.14 [0.63-2.23]; P < 0.05) were significant independent predictors of ultrasound defined CIMT. Crude and total energy adjusted intake were not associated with the presence of CIMT (+). Conclusions: It appears that within a relatively young Iranian population of individuals without a history of cardiovascular event, the presence of CIMT (+) defined by duplex ultrasound cut-off value of ≥0.8 mm, did not associate with several modifiable cardiovascular risk factors or measures of dietary intake