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.