Abstract:
Obesity, particularly abdominal obesity when associated with end-organ resistance to
insulin, raised blood sugar, deranged lipid profile and high blood pressure is collectively
called “Metabolic Syndrome”. Metabolic Syndrome increases the risk of developing type 2
diabetes mellitus(T2DM). Metabolic syndrome represents a range of disorders related to
blood pressure, lipid profile, blood sugar and obesity related inflammation. Screening for
Metabolic Syndrome is important because obesity related manifestations are associated
with the deranged values of five components of Metabolic Syndrome. C-Reactive Protein
(CRP) is a known biomarker associated with many metabolic disorders with underlying
acute and chronic inflammation. Its use as a potential biomarker of disease states such as
diabetes, hypertension and Metabolic Syndrome need to be investigated. Therefore,
association of Type 2 diabetes mellitus patients with metabolic syndrome with a
proinflammatory state can be confirmed by higher levels of CRP. To investigate the
association of serum CRP levels with obese and non-obese type 2 diabetes mellitus
patients with metabolic syndrome. A comparative cross-sectional study was performed in
120 subjects divided into 2 groups (60 obese >30kg/m2
and 60 non-obese <30kg/m2
) type
2 diabetes mellitus patients with Metabolic Syndrome. The participants were recruited
from Medical OPD National Medical Center, Karachi for a duration of six months period.
The 2005 revised NCEP-ATP III criteria were used to determine participants with
Metabolic Syndrome in type 2 diabetic patients. The conditions included in diagnostic
criteria for Metabolic Syndrome are high blood pressure, high blood sugar, abnormal
cholesterol levels (low HDL or high triglycerides), and increased fat deposits in the
abdominal area. After taking informed consent and an overnight fast, fasting venous
samples were sent for Fasting Blood Glucose (FBG), Triglycerides (TG), Total cholesterol
(TC), Low density Lipoprotein (LDL-C), High density Lipoprotein (HDL-C) and C Reactive Protein (CRP). 75% of type 2 diabetes mellitus patients had metabolic syndrome.
The association of Metabolic Syndrome with Marital status and Education was found
statistically significant with p<0.05. Independent sample t test gave significant mean
differences for waist circumference, systolic blood pressure, fasting blood sugar, and
triglycerides between metabolic syndrome and non-metabolic syndrome samples with
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p<0.05. The Multivariate linear regression analysis, results showed increase in WC giving
0.13-time positive impact on CRP (p<0.01). The difference in median CRP of obese and
non-obese samples of metabolic samples was also statistically significant with p=0.01
using Mann Whitney U test. Pearson Chi Square test did give a significant association of
metabolic syndrome with SBP, FBS, HbA1C, and TG with p<0.05. The laboratory
parameters showed higher SBP, DBP, FBG, TG and low HDL-C levels in subjects. CRP
levels were higher in obese than non-obese type 2 diabetic patients with Metabolic
Syndrome
