Metabolic syndrome: obesity, hypertension, diabetes and now also inflammation

Metabolic syndrome is a combination of several individual metabolic problems that lead to high risk of atherosclerosis and heart problems. The disease has become a serious global problem in the last two decades with as much as 47 millions of cases in US and 25 million in Europe, and further understanding of its origin and mechanism is urgent. To that aim, in an article just published online in the International Journal of Obesity, a group of Portuguese scientists reports that patients suffering from severe metabolic syndrome show high levels of Protein-C reactive (CRP), an inflammatory marker, a result that suggests a role for inflammation in the disease. Additionally, it was also found that central obesity (found around the abdomen/organs) and high blood pressure, two of the metabolic problems associated with the syndrome, were directly associated with the increase in CRP levels making them into preferential targets for both therapy and prevention.

Metabolic syndrome was first described 80 years ago as a cluster of three or more specific health conditions in an individual that leads to high risk of cardiovascular disease. The health conditions associated with the syndrome (also called syndrome’s components) include obesity (especially central obesity, which is found around the viscera/abdomen), type 2 diabetes, insulin resistance, abnormal amounts of fat in the blood and high blood pressure (hypertension).

For most patients the origin of the syndrome seems to be related with poor nutrition, lack of physical activity and subsequent increase in body weight, and the raise in metabolic syndrome numbers is believed to be associated with the global epidemic of obesity and diabetes. The disease spreading has led to serious health concerns, especially in relation to the increased risk of cardiovascular problems observed in patients, and consequently to the realisation that better preventive and therapeutic measures were necessary.

CRP is a protein produced and released by the liver during inflammation that has recently been associated with increased risk for hypertension and heart disease. The amount of CRP produced in the body varies from person to person and is affected by the individual’s genetic makeup and lifestyle. Higher CRP levels tend to be found in individuals who smoke, have high blood pressure, are overweight and don’t exercise, whereas lean, athletic individuals tend to have lower CRP levels.

High CRP levels (although within the normal range/within the basal level) have also been associated with metabolic syndrome and, furthermore, with several of the syndrome’s individual components what led Ana-Cristina Santos, Henrique Barros and colleagues from the Department of Hygiene and Epidemiology, University of Porto Medical School, Portugal to decide to further investigate the relationship between the levels of this protein and metabolic syndrome.

The group of scientists studied 1022 individuals aged between 18 to 92 and found that, as previously proposed by others, metabolic syndrome patients present higher CRP levels than normal, healthy individuals. Additionally, it was observed that individuals with a higher number of syndrome’s components (and consequently a more severe disease/syndrome) would show higher CRP levels. These results support the view that inflammation is an important part of metabolic syndrome and led Santos, Barros and colleagues to propose that anti-inflammatory drugs, following further research, might be included in disease therapy.

Furthermore, the finding that central obesity and hypertension are the main syndrome’s components associated with high CRP levels further highlights the need to control these two metabolic problems and their importance as main targets for prevention and therapy measures.

Piece researched and written by: Catarina Amorim (catarina.amorim@linacre.ox.ac.uk)