Abstract 410: High Sensitive C-Reactive Protein Independently Predicts Insulin Resistance in Women in a South Asian Population, With a Stronger Association in Urban Areas
Objectives: Insulin resistance (IR), which plays a fundamental role in the pathogenesis of metabolic syndrome and type 2 diabetes mellitus, is associated with serum levels of inflammatory markers and abdominal obesity. Whether the association of inflammation with IR is independent of obesity remains unresolved; moreover, whether this association varies with gender and urban living is not known. We therefore conducted a cross-sectional study to investigate the gender specific association between IR and high sensitive C-reactive protein (HsCRP), independent of abdominal obesity, in urban and rural communities in a South Asian population.
Methods: We conducted a population-based cross-sectional survey in 8,080 South Indians above the age of 20 years in both urban and rural environments. The study assessed of waist circumference (WC), blood pressure (BP), socioeconomic status, family history, anxiety and stress levels, and fasting blood for plasma glucose, insulin, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and HsCRP. IR was calculated using the homeostasis model assessment (HOMA-IR). After the exclusion of individuals with diabetics, 6,309 subjects (mean age 42 years; 58% women) were eligible and constituted the study sample.
Results: The HOMA-IR level (mean ± SD) was higher in women (1.98 ± 1.62), when compared to men (1.71 ± 1.38), and HsCRP levels were 4.00 ± 5.14 and 3.42 ± 7.22 mg/dl in women and men, respectively. There was stronger correlation of HsCRP with HOMA-IR in women (r= 0.371) when compared to men (r= 0.203). In a multiple regression analysis, after adjusting for WC and other co-variants such as, BP, TC, LDL, TG, socioeconomic status, physical activity and family history of diabetes, HsCRP continued to be a significant predictor only in women (p<0.001). In women with elevated HsCRP levels (≥ 3 mg/dl), after multivariate adjustments, the odds ratio of elevated HOMA-IR (≥ 2.86) was 2.13 [CI: 1.66, 2.74; p <0.001] in urban women, when compared to odds ratio of 1.41 [CI: 1.02, 1.96; p=0.037] in rural women.
Conclusion: HsCRP is associated with IR independent of abdominal obesity in non-diabetic South Asian women, and at elevated HsCRP levels the association is stronger in urban women.
Author Disclosures: M. Thanikachalam: None. J. Sunderarajan: None. V. Harivanzan: None. R. Siegel: None. K.K.H. Chui: None. J.S.N. Murthy: None. S. Thanikachalam: None.
- © 2014 by American Heart Association, Inc.