.: ORİJİNAL ARAŞTIRMA
Relationship Between C-Reactive Protein, Uric Acid and Fibrinogen Levels and Insulin Resistance in Different Body Mass Indexes: Descriptive Research
Farklı Beden Kitle İndekslerinde C-Reaktif Protein, Ürik Asit ve Fibrinojen Düzeyleri ile İnsülin Direnci Arasındaki İlişki: Tanımlayıcı Araştırma
Turkiye Klinikleri J Cardiovasc Sci. 2023;35(1):21-6
doi: 10.5336/cardiosci.2022-94122
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Chronic inflammation in obesity is the main factor that increases insulin resistance by causing changes in insulin sensitivity. Our study aimed to investigate the relationship between insulin resistance and C-reactive protein (CRP), uric acid, and fibrinogen levels in different body mass indexes (BMI). Material and Methods: In our study, patients who applied to our hospital with the complaint of overweight in 2021-2022 were retrospectively analyzed, and 149 women aged 20 and over were included in the study. Glucose, uric acid, total cholesterol, high-density lipoprotein cholesterol, lowdensity lipoprotein cholesterol, triglyceride (TG), CRP, insulin, fibrinogen results, which were measured simultaneously with the height and weight measurements of the patients, were obtained from the laboratory information system. Results: The patients included in the study were 25 normal weight, 56 overweight, 53 obese and 15 morbidly obese according to BMI. The uric acid and TG levels of the overweight group were found to be significantly higher than the normal group (respectively; p=0.012, p=0.031), the CRP level of the morbidly obese group was found to be significantly higher than the normal, overweight, and obese groups (respectively; p<0.001, p<0.001, p=0.006). A significant positive correlation was found between Homeostatic Model Assessment for Insulin Resistance and CRP and uric acid (respectively; r=0.219, p=0.009; r=0.353, p<0,001). Conclusion: We think that uric acid levels in the early stage of obesity and CRP levels in the advanced stage may be a guide for insulin resistance and obesity-related diseases.
Keywords: Fibrinogen; uric acid; C-reaktive protein; obesity; insulin resistance
Objective: Chronic inflammation in obesity is the main factor that increases insulin resistance by causing changes in insulin sensitivity. Our study aimed to investigate the relationship between insulin resistance and C-reactive protein (CRP), uric acid, and fibrinogen levels in different body mass indexes (BMI). Material and Methods: In our study, patients who applied to our hospital with the complaint of overweight in 2021-2022 were retrospectively analyzed, and 149 women aged 20 and over were included in the study. Glucose, uric acid, total cholesterol, high-density lipoprotein cholesterol, lowdensity lipoprotein cholesterol, triglyceride (TG), CRP, insulin, fibrinogen results, which were measured simultaneously with the height and weight measurements of the patients, were obtained from the laboratory information system. Results: The patients included in the study were 25 normal weight, 56 overweight, 53 obese and 15 morbidly obese according to BMI. The uric acid and TG levels of the overweight group were found to be significantly higher than the normal group (respectively; p=0.012, p=0.031), the CRP level of the morbidly obese group was found to be significantly higher than the normal, overweight, and obese groups (respectively; p<0.001, p<0.001, p=0.006). A significant positive correlation was found between Homeostatic Model Assessment for Insulin Resistance and CRP and uric acid (respectively; r=0.219, p=0.009; r=0.353, p<0,001). Conclusion: We think that uric acid levels in the early stage of obesity and CRP levels in the advanced stage may be a guide for insulin resistance and obesity-related diseases.
Keywords: Fibrinogen; uric acid; C-reaktive protein; obesity; insulin resistance
ÖZET
Amaç: Obezitede görülen kronik inflamasyon, insülin duyarlılığında değişikliğe neden olarak insülin direncini artıran temel faktördür. Çalışmamızda, farklı beden kitle indekslerinde (BKİ) insülin direnci ile C-reaktif protein (CRP), ürik asit ve fibrinojen düzeyleri arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamızda, 2021-2022 yıllarında fazla kilo şikâyeti ile hastanemize başvuran hastalar retrospektif olarak incelendi ve 20 yaş ve üzeri 149 kadın çalışmaya dâhil edildi. Hastaların boy ve kilo ölçümleri ile eş zamanlı olarak ölçülen glukoz, ürik asit, total kolesterol, yüksek dansiteli lipoprotein kolesterol, düşük dansiteli lipoprotein kolesterol, trigliserid (TG), CRP, insülin ve fibrinojen sonuçları laboratuvar bilgi sisteminden alındı. Bulgular: Çalışmaya dâhil edilen hastalar BKİ'ye göre 25 normal kilolu, 56 kilolu, 53 obez ve 15 morbid obezdi. Aşırı kilolu grubun ürik asit ve TG düzeyleri normal kilolu gruba göre anlamlı olarak yüksek (sırasıyla; p=0,012, p=0,031), morbid obez grubun CRP düzeyi normal, fazla kilolu ve obez gruplara göre anlamlı yüksek bulundu (sırasıyla p<0,001, p<0,001, p=0,006). İnsülin Direncinin Homeostatik Modeli Değerlendirmesi ile CRP ve ürik asit arasında anlamlı pozitif korelasyon saptandı (sırasıyla; r=0,219, p=0,009; r=0,353, p<0,001). Sonuç: Obezitenin erken evresinde ürik asit, ileri evresinde ise CRP düzeylerinin, insülin direnci ve obezite ile ilişkili hastalıklar için yol gösterici olabileceğini düşünüyoruz.
Anahtar Kelimeler: Fibrinojen; ürik asit; C-reaktif protein; obezite; insülin direnci
Amaç: Obezitede görülen kronik inflamasyon, insülin duyarlılığında değişikliğe neden olarak insülin direncini artıran temel faktördür. Çalışmamızda, farklı beden kitle indekslerinde (BKİ) insülin direnci ile C-reaktif protein (CRP), ürik asit ve fibrinojen düzeyleri arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamızda, 2021-2022 yıllarında fazla kilo şikâyeti ile hastanemize başvuran hastalar retrospektif olarak incelendi ve 20 yaş ve üzeri 149 kadın çalışmaya dâhil edildi. Hastaların boy ve kilo ölçümleri ile eş zamanlı olarak ölçülen glukoz, ürik asit, total kolesterol, yüksek dansiteli lipoprotein kolesterol, düşük dansiteli lipoprotein kolesterol, trigliserid (TG), CRP, insülin ve fibrinojen sonuçları laboratuvar bilgi sisteminden alındı. Bulgular: Çalışmaya dâhil edilen hastalar BKİ'ye göre 25 normal kilolu, 56 kilolu, 53 obez ve 15 morbid obezdi. Aşırı kilolu grubun ürik asit ve TG düzeyleri normal kilolu gruba göre anlamlı olarak yüksek (sırasıyla; p=0,012, p=0,031), morbid obez grubun CRP düzeyi normal, fazla kilolu ve obez gruplara göre anlamlı yüksek bulundu (sırasıyla p<0,001, p<0,001, p=0,006). İnsülin Direncinin Homeostatik Modeli Değerlendirmesi ile CRP ve ürik asit arasında anlamlı pozitif korelasyon saptandı (sırasıyla; r=0,219, p=0,009; r=0,353, p<0,001). Sonuç: Obezitenin erken evresinde ürik asit, ileri evresinde ise CRP düzeylerinin, insülin direnci ve obezite ile ilişkili hastalıklar için yol gösterici olabileceğini düşünüyoruz.
Anahtar Kelimeler: Fibrinojen; ürik asit; C-reaktif protein; obezite; insülin direnci
REFERANSLAR:
- Raza Q, Doak CM, Khan A, Nicolaou M, Seidell JC. Obesity and cardiovascular disease risk factors among the indigenous and immigrant Pakistani population: a systematic review. Obes Facts. 2013;6(6):523-35. [Crossref] [PubMed] [PMC]
- Timmis A, Townsend N, Gale C, Grobbee R, Maniadakis N, Flather M, et al; ESC Scientific Document Group. European Society of Cardiology: Cardiovascular Disease Statistics 2017. Eur Heart J. 2018;39(7):508-79. [PubMed]
- Nomiyama T, Perez-Tilve D, Ogawa D, Gizard F, Zhao Y, Heywood EB, et al. Osteopontin mediates obesity-induced adipose tissue macrophage infiltration and insulin resistance in mice. J Clin Invest. 2007;117(10):2877-88. [Crossref] [PubMed] [PMC]
- Patel PS, Buras ED, Balasubramanyam A. The role of the immune system in obesity and insulin resistance. J Obes. 2013;2013:616193. [Crossref] [PubMed] [PMC]
- Kim J, Lee J. Role of obesity-induced inflammation in the development of insulin resistance and type 2 diabetes: history of the research and remaining questions. Ann Pediatr Endocrinol Metab. 2021;26(1):1-13. [Crossref] [PubMed] [PMC]
- Hortin GL. Amino acids, peptides, and proteins. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5th ed. St. Louis, USA: Elsevier Saunders; 2012. p.509-62. [Crossref]
- Stanimirovic J, Radovanovic J, Banjac K, Obradovic M, Essack M, Zafirovic S, et al. role of C-reactive protein in diabetic inflammation. Mediators Inflamm. 2022;2022:3706508. [Crossref] [PubMed] [PMC]
- Gherghina ME, Peride I, Tiglis M, Neagu TP, Niculae A, Checherita IA. Uric acid and oxidative stress-relationship with cardiovascular, metabolic, and renal impairment. Int J Mol Sci. 2022;23(6):3188. [Crossref] [PubMed] [PMC]
- Varesi A, Chirumbolo S, Campagnoli LIM, Pierella E, Piccini GB, Carrara A, et al. The role of antioxidants in the interplay between oxidative stress and senescence. Antioxidants (Basel). 2022;11(7):1224. [Crossref] [PubMed] [PMC]
- Kang DH, Ha SK. Uric acid puzzle: dual role as anti-oxidantand pro-oxidant. Electrolyte Blood Press. 2014;12(1):1-6. [Crossref] [PubMed] [PMC]
- Kim HK, Lee M, Lee YH, Lee BW, Cha BS, Kang ES. Uric acid variability as a predictive marker of newly developed cardiovascular events in type 2 diabetes. Front Cardiovasc Med. 2021;8:775753. [Crossref] [PubMed] [PMC]
- Ciarla S, Struglia M, Giorgini P, Striuli R, Necozione S, Properzi G, et al. Serum uric acid levels and metabolic syndrome. Arch Physiol Biochem. 2014;120(3):119-22. [Crossref] [PubMed]
- Liu SL, Wu NQ, Shi HW, Dong Q, Dong QT, Gao Y, et al. Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease. Cardiovasc Diabetol. 2020;19(1):36. [Crossref] [PubMed] [PMC]
- Mahjabeen S, Selim S, Mustari M, Rajib MH, Rahman AK, Fariduddin M, et al. Association of plasma fibrinogen and insulin resistance in women with gestational diabetes mellitus. Archives of Clinical and Biomedical Research. 2022;6(3):492-502. [Crossref]
- Türkiye Endokrinoloji ve Metabolizma Derneği. Obezite Tanı ve Tedavi Kılavuzu. 3. Baskı. Ankara: Miki Matbaacılık San ve Tic Ltd Şti; 2016. p.12-24.
- Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9. [Crossref] [PubMed]
- Rocha VZ, Libby P. Obesity, inflammation, and atherosclerosis. Nat Rev Cardiol. 2009;6(6):399-409. [Crossref] [PubMed]
- Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annu Rev Immunol. 2011;29:415-45. [Crossref] [PubMed]
- Abbasi F, Brown BW Jr, Lamendola C, McLaughlin T, Reaven GM. Relationship between obesity, insulin resistance, and coronary heart disease risk. J Am Coll Cardiol. 2002;40(5):937-43. [Crossref] [PubMed]
- Baskın Y, Yiğitbaşı T, Afacan G, Bağbozan Ş. İnsülin direnci olan erişkin kilolu ve obezlerde lipoprotein (a) ile lipid parametreleri [Lipoprotein (a) and lipid parameters in overweight and obese adults with insulin resistance]. Türk Klinik Biyokimya Derg. 2008;6(2):65-71. [Link]
- Hancı T, Türkön H, Çolak Aydoğdu A, Yıldız Ö, Karademirci İ, Çoker I. Yüksek duyarlıklı C-reaktif protein (HSCRP) ve obezite ilişkisi [Association of high sensitivity C-reactive protein (HSCRP) and obesity]. Türk Klinik Biyokimya Derg. 2012;10(1):1-7. [Link]
- Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA. 1999;282(22):2131-5. [Crossref] [PubMed]
- Bastard JP, Jardel C, Bruckert E, Blondy P, Capeau J, Laville M, et al. Elevated levels of interleukin 6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss. J Clin Endocrinol Metab. 2000;85(9):3338-42. [Crossref] [PubMed]
- Missel AL, Saslow LR, Griauzde DH, Marvicsin D, Sen A, Richardson CR, et al. Association between fasting insulin and C-reactive protein among adults without diabetes using a two-part model: NHANES 2005-2010. Diabetol Metab Syndr. 2021;13(1):29. [Crossref] [PubMed] [PMC]
- Çarlıoğlu A, Karakurt F, Maral S, Kasapoğlu B, Darcın T. Serum uric acid levels in obese women. The New Journal of Medicine. 2011;28:34-7. [Link]
- de Carvalho Vidigal F, de Lima Rosado LE, Paixão Rosado G, Lanes Ribeiro Rde C, Castro Franceschini Sdo C. Serum uric acid can predict higher C-reactive protein levels in apparently healthy men. Nutr Hosp. 2014;29(4):935-40. [PubMed]
- Lippi G, Montagnana M, Luca Salvagno G, Targher G, Cesare Guidi G. Epidemiological association between uric acid concentration in plasma, lipoprotein(a), and the traditional lipid profile. Clin Cardiol. 2010;33(2):E76-80. [Crossref] [PubMed] [PMC]
- Yu P, Huang L, Wang Z, Meng X, Yu X. The association of serum uric acid with beta-cell function and insulin resistance in nondiabetic individuals: a cross-sectional study. Diabetes Metab Syndr Obes. 2021;14:2673-82. [Crossref] [PubMed] [PMC]
- Li F, Chen S, Qiu X, Wu J, Tan M, Wang M. Serum uric acid levels and metabolic ındices in an obese population: a cross-sectional study. Diabetes Metab Syndr Obes. 2021;14:627-35. [Crossref] [PubMed] [PMC]
- Adnan E, Rahman IA, Faridin HP. Relationship between insulin resistance, metabolic syndrome components and serum uric acid. Diabetes Metab Syndr. 2019;13(3):2158-62. [Crossref] [PubMed]
- Koçak A, Kutlu R, Çivi S, Kılınç İ. Obezitede insülin direnci ile leptin, interlökin-6, hs-CRP ve fibrinojen ilişkisi [Relationship between insulin resistance and leptin, interleukin-6, hs-CRP and fibrinogen in obesity]. Turk J Biochem. 2014;39(3):373-82. [Link]
- Keskin S, Sayalı E, Temeloglu E, Ekizoglu E. Obezite ve inflamasyon [Obesity and inflammation]. Turkiye Klinikleri J Med Sci. 2005;25(2):636-41.
- Gómez-Ambrosi J, Salvador J, Silva C, Pastor C, Rotellar F, Gil MJ, et al. Increased cardiovascular risk markers in obesity are associated with body adiposity: role of leptin. Thromb Haemost. 2006;95(6):991-6. [Crossref] [PubMed]
.: İşlem Listesi