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High-Sensitivity C-Reactive Protein Leads to Increased Incident Metabolic Syndrome in Women but Not in Men: A Five-Year Follow-Up Study in a Chinese Population
The neutrophil-lymphocyte ratio (NLR) is often used as an inflammatory marker in chronic diseases such as cancer or cardiovascular diseases. However, there are few studies about the association between the NLR and diabetes mellitus (DM) or impaired fasting glucose (IFG) patients in Korea. This study investigated the association between the fasting plasma glucose (FPG) level and NLR in Koreans.
This cross-sectional retrospective study included 3,219 healthy subjects who visited Konyang University Hospital in South Korea for regular health examinations. Participants with a history of insulin administration, anti-diabetic drugs, anti-inflammatory drugs, or underlying diseases related to inflammation were excluded.
All statistical evaluation was performed by dividing participants into males and females. Based on FPG levels, the subjects were classified into three groups, with normal fasting glucose (n=1,969), IFG (n=1,138), and DM (n=122). The NLR had no significant mean differences among these groups for both sexes. Multiple linear regression analysis between FPG level and NLR showed an independent and significantly negative association (β±standard error, −0.67±0.24; P=0.006) in normal subjects after adjustment. Log(serum C-reactive protein [S-CRP]) showed an independently and significantly positive association with FPG in male IFG/DM patients. Total leukocyte (white blood cell [WBC]) showed an independently and significantly positive association with FPG in female IFG/DM patients.
In normal subjects, NLR shows an independently and significantly negative association with FPG. In IFG/DM patients, NLR was not significantly related to FPG. WBC count in female patients and S-CRP level in male patients were significantly positively associated with FPG only in IFG/DM.
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Inflammation is an important underlying mechanism in the pathogenesis of atherosclerosis, and an elevated resting heart rate underlies the process of atherosclerotic plaque formation. We hypothesized an association between resting heart rate and subclinical inflammation.
Resting heart rate was recorded at baseline in the KoGES-ARIRANG (Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population) cohort study, and was then divided into quartiles. Subclinical inflammation was measured by white blood cell count and high-sensitivity C-reactive protein. We used progressively adjusted regression models with terms for muscle mass, body fat proportion, and adiponectin in the fully adjusted models. We examined inflammatory markers as both continuous and categorical variables, using the clinical cut point of the highest quartile of white blood cell count (≥7,900/mm3) and ≥3 mg/dL for high-sensitivity C-reactive protein.
Participants had a mean age of 56.3±8.1 years and a mean resting heart rate of 71.4±10.7 beats/min; 39.1% were men. In a fully adjusted model, an increased resting heart rate was significantly associated with a higher white blood cell count and higher levels of high-sensitivity C-reactive protein in both continuous (P for trend <0.001) and categorical (P for trend <0.001) models.
An increased resting heart rate is associated with a higher level of subclinical inflammation among healthy Korean people.
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