This Article Full Text Full Text (PDF) All Versions of this Article: 107/3/391    most recent 01.CIR.0000055014.62083.05v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ridker, P. M Articles by Rifai, N. Search for Related Content PubMed PubMed Citation Articles by Ridker, P. M Articles by Rifai, N. Related Collections Primary prevention Risk Factors Thrombosis risk factors Type 2 diabetes Acute myocardial infarction Epidemiology

(Circulation. 2003;107:391.)
© 2003 American Heart Association, Inc.

Clinical Investigation and Reports

C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events

An 8-Year Follow-Up of 14 719 Initially Healthy American Women

From the Center for Cardiovascular Disease Prevention (P.M.R., J.E.B., N.R.C., N.R.), the Divisions of Preventive Medicine (P.M.R., J.E.B., N.R.C.) and Cardiology (P.M.R.), and the LeDucq Center for Cardiovascular Research (P.M.R., N.R.), Brigham and Women’s Hospital, and the Department of Laboratory Medicine, Children’s Hospital (N.R.), Harvard Medical School, Boston, Mass.

Correspondence to Paul M Ridker, MD, Center for Cardiovascular Disease Prevention, 900 Commonwealth Ave E, Boston, MA 02215. E-mail pridker{at}partners.org

Background— The metabolic syndrome describes a high-risk population having 3 or more of the following clinical characteristics: upper-body obesity, hypertriglyceridemia, low HDL, hypertension, and abnormal glucose. All of these attributes, however, are associated with increased levels of C-reactive protein (CRP).

Methods and Results— We evaluated interrelationships between CRP, the metabolic syndrome, and incident cardiovascular events among 14 719 apparently healthy women who were followed up for an 8-year period for myocardial infarction, stroke, coronary revascularization, or cardiovascular death; 24% of the cohort had the metabolic syndrome at study entry. At baseline, median CRP levels for those with 0, 1, 2, 3, 4, or 5 characteristics of the metabolic syndrome were 0.68, 1.09, 1.93, 3.01, 3.88, and 5.75 mg/L, respectively (P_trend <0.0001). Over the 8-year follow-up, cardiovascular event-free survival rates based on CRP levels above or below 3.0 mg/L were similar to survival rates based on having 3 or more characteristics of the metabolic syndrome. At all levels of severity of the metabolic syndrome, however, CRP added prognostic information on subsequent risk. For example, among those with the metabolic syndrome at study entry, age-adjusted incidence rates of future cardiovascular events were 3.4 and 5.9 per 1000 person-years of exposure for those with baseline CRP levels less than or greater than 3.0 mg/L, respectively. Additive effects for CRP were also observed for those with 4 or 5 characteristics of the metabolic syndrome. The use of different definitions of the metabolic syndrome had minimal impact on these findings.

Conclusions— These prospective data suggest that measurement of CRP adds clinically important prognostic information to the metabolic syndrome.

Key Words: protein, C-reactive • risk factors • prognosis • diabetes mellitus • inflammation

This article has been cited by other articles:

				A. Mahajan, R. Tabassum, S. Chavali, O. P. Dwivedi, M. Bharadwaj, N. Tandon, and D. Bharadwaj High-Sensitivity C-Reactive Protein Levels and Type 2 Diabetes in Urban North Indians J. Clin. Endocrinol. Metab., June 1, 2009; 94(6): 2123 - 2127. [Abstract] [Full Text] [PDF]

				A. W Fogarty, S. A Lewis, T. M McKeever, and J. R Britton Is higher sodium intake associated with elevated systemic inflammation? A population-based study Am. J. Clinical Nutrition, June 1, 2009; 89(6): 1901 - 1904. [Abstract] [Full Text] [PDF]

				T. W McDade, J. N Rutherford, L. Adair, and C. Kuzawa Population differences in associations between C-reactive protein concentration and adiposity: comparison of young adults in the Philippines and the United States Am. J. Clinical Nutrition, April 1, 2009; 89(4): 1237 - 1245. [Abstract] [Full Text] [PDF]

				A. G. Pittas, S. S. Harris, M. Eliades, P. Stark, and B. Dawson-Hughes Association between Serum Osteocalcin and Markers of Metabolic Phenotype J. Clin. Endocrinol. Metab., March 1, 2009; 94(3): 827 - 832. [Abstract] [Full Text] [PDF]

				J. Steinberger, S. R. Daniels, R. H. Eckel, L. Hayman, R. H. Lustig, B. McCrindle, and M. L. Mietus-Snyder Progress and Challenges in Metabolic Syndrome in Children and Adolescents: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism Circulation, February 3, 2009; 119(4): 628 - 647. [Full Text] [PDF]

				B. W. J. H. Penninx, B. J. Nicklas, A. B. Newman, T. B. Harris, B. H. Goodpaster, S. Satterfield, N. de Rekeneire, K. Yaffe, M. Pahor, S. B. Kritchevsky, et al. Metabolic Syndrome and Physical Decline in Older Persons: Results from the Health, Aging and Body Composition Study J Gerontol A Biol Sci Med Sci, January 27, 2009; (2009) gln005v2. [Abstract] [Full Text] [PDF]

				R Iijima, R A Byrne, G Ndrepepa, S Braun, J Mehilli, P B Berger, A Schomig, and A Kastrati Pre-procedural C-reactive protein levels and clinical outcomes after percutaneous coronary interventions with and without abciximab: pooled analysis of four ISAR trials Heart, January 15, 2009; 95(2): 107 - 112. [Abstract] [Full Text] [PDF]

				M. H. SHISHEHBOR and S. L. HAZEN JUPITER to Earth: A statin helps people with normal LDL-C and high hs-CRP, but what does it mean? Cleveland Clinic Journal of Medicine, January 1, 2009; 76(1): 37 - 44. [Abstract] [Full Text] [PDF]

				T. Sathyapalan, E. S. Kilpatrick, A.-M. Coady, and S. L. Atkin The Effect of Atorvastatin in Patients with Polycystic Ovary Syndrome: A Randomized Double-Blind Placebo-Controlled Study J. Clin. Endocrinol. Metab., January 1, 2009; 94(1): 103 - 108. [Abstract] [Full Text] [PDF]

				Y. Handelsman Metabolic Syndrome Pathophysiology and Clinical Presentation Toxicol Pathol, January 1, 2009; 37(1): 18 - 20. [Abstract] [Full Text] [PDF]

				R. L. Pande, T. S. Perlstein, J. A. Beckman, and M. A. Creager Association of Insulin Resistance and Inflammation With Peripheral Arterial Disease: The National Health and Nutrition Examination Survey, 1999 to 2004 Circulation, July 1, 2008; 118(1): 33 - 41. [Abstract] [Full Text] [PDF]

				K. Chen, J. B Lindsey, A. Khera, J. A. D. Lemos, C. R Ayers, A. Goyal, G. L Vega, S. A Murphy, S. M Grundy, and D. K Mcguire Independent associations between metabolic syndrome, diabetes mellitus and atherosclerosis: observations from the Dallas Heart Study Diabetes and Vascular Disease Research, June 1, 2008; 5(2): 96 - 101. [Abstract] [PDF]

				M K Baum, C Rafie, S Sales, S Lai, R Duan, D T Jayaweera, J B Page, and A Campa C-reactive protein: a poor marker of cardiovascular disease risk in HIV+ populations with a high prevalence of elevated serum transaminases Int J STD AIDS, June 1, 2008; 19(6): 410 - 413. [Abstract] [Full Text] [PDF]

				V. M. Miller and S. P. Duckles Vascular Actions of Estrogens: Functional Implications Pharmacol. Rev., June 1, 2008; 60(2): 210 - 241. [Abstract] [Full Text] [PDF]

				A. Kelley-Hedgepeth, D. M. Lloyd-Jones, A. Colvin, K. A. Matthews, J. Johnston, M. R. Sowers, B. Sternfeld, R. C. Pasternak, C. U. Chae, and for the SWAN Investigators Ethnic Differences in C-Reactive Protein Concentrations Clin. Chem., June 1, 2008; 54(6): 1027 - 1037. [Abstract] [Full Text] [PDF]

				F. Tabassum, M. Kumari, A. Rumley, G. Lowe, C. Power, and D. P. Strachan Effects of Socioeconomic Position on Inflammatory and Hemostatic Markers: A Life-Course Analysis in the 1958 British Birth Cohort Am. J. Epidemiol., June 1, 2008; 167(11): 1332 - 1341. [Abstract] [Full Text] [PDF]

				T. You, B. J. Nicklas, J. Ding, B. W. J. H. Penninx, B. H. Goodpaster, D. C. Bauer, F. A. Tylavsky, T. B. Harris, S. B. Kritchevsky, and for the Health, Aging and Body Composition Study The Metabolic Syndrome Is Associated With Circulating Adipokines in Older Adults Across a Wide Range of Adiposity J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2008; 63(4): 414 - 419. [Abstract] [Full Text] [PDF]

				D. Conen, P. M. Ridker, S. Mora, J. E. Buring, and R. J. Glynn Risk of type 2 diabetes mellitus in those with hypertension: reply Eur. Heart J., April 1, 2008; 29(7): 953 - 954. [Full Text] [PDF]

				H. Watanabe, N. Tanabe, T. Watanabe, D. Darbar, D. M. Roden, S. Sasaki, and Y. Aizawa Metabolic Syndrome and Risk of Development of Atrial Fibrillation: The Niigata Preventive Medicine Study Circulation, March 11, 2008; 117(10): 1255 - 1260. [Abstract] [Full Text] [PDF]

				V. Stangl, V. Witzel, G. Baumann, and K. Stangl Current diagnostic concepts to detect coronary artery disease in women Eur. Heart J., March 2, 2008; 29(6): 707 - 717. [Abstract] [Full Text] [PDF]

				D. E. King, A. G. Mainous III, B. M. Egan, R. F. Woolson, and M. E. Geesey Effect of Psyllium Fiber Supplementation on C-Reactive Protein: The Trial to Reduce Inflammatory Markers (TRIM) Ann. Fam. Med, March 1, 2008; 6(2): 100 - 106. [Abstract] [Full Text] [PDF]

				C. Cuaz-Perolin, L. Billiet, E. Bauge, C. Copin, D. Scott-Algara, F. Genze, B. Buchele, T. Syrovets, T. Simmet, and M. Rouis Antiinflammatory and Antiatherogenic Effects of the NF-{kappa}B Inhibitor Acetyl-11-Keto-{beta}-Boswellic Acid in LPS-Challenged ApoE-/- Mice Arterioscler. Thromb. Vasc. Biol., February 1, 2008; 28(2): 272 - 277. [Abstract] [Full Text] [PDF]

				C. Marsik, L. Kazemi-Shirazi, T. Schickbauer, S. Winkler, C. Joukhadar, O. F. Wagner, and G. Endler C-Reactive Protein and All-Cause Mortality in a Large Hospital-Based Cohort Clin. Chem., February 1, 2008; 54(2): 343 - 349. [Abstract] [Full Text] [PDF]

				J. M. Moreno-Navarrete, F. J. Ortega, J. Bassols, A. Castro, W. Ricart, and J. M. Fernandez-Real Association of Circulating Lactoferrin Concentration and 2 Nonsynonymous LTF Gene Polymorphisms with Dyslipidemia in Men Depends on Glucose-Tolerance Status Clin. Chem., February 1, 2008; 54(2): 301 - 309. [Abstract] [Full Text] [PDF]

				R. R. S. Packard and P. Libby Inflammation in Atherosclerosis: From Vascular Biology to Biomarker Discovery and Risk Prediction Clin. Chem., January 1, 2008; 54(1): 24 - 38. [Abstract] [Full Text] [PDF]

				Y Yamada, S Ichihara, K Kato, T Yoshida, K Yokoi, H Matsuo, S Watanabe, N Metoki, H Yoshida, K Satoh, et al. Genetic risk for metabolic syndrome: examination of candidate gene polymorphisms related to lipid metabolism in Japanese people J. Med. Genet., January 1, 2008; 45(1): 22 - 28. [Abstract] [Full Text] [PDF]

				D. Conen, P. M. Ridker, S. Mora, J. E. Buring, and R. J. Glynn Blood pressure and risk of developing type 2 diabetes mellitus: The Women's Health Study Eur. Heart J., December 1, 2007; 28(23): 2937 - 2943. [Abstract] [Full Text] [PDF]

				C A Daly, P Hildebrandt, M Bertrand, R Ferrari, W Remme, M Simoons, K M Fox, and on behalf of the EUROPA investigators Adverse prognosis associated with the metabolic syndrome in established coronary artery disease: data from the EUROPA trial Heart, November 1, 2007; 93(11): 1406 - 1411. [Abstract] [Full Text] [PDF]

				D. H St-Pierre, J.-P. Bastard, L. Coderre, M. Brochu, A. D Karelis, M.-E. Lavoie, F. Malita, J. Fontaine, D. Mignault, K. Cianflone, et al. Association of acylated ghrelin profiles with chronic inflammatory markers in overweight and obese postmenopausal women: a MONET study Eur. J. Endocrinol., October 1, 2007; 157(4): 419 - 426. [Abstract] [Full Text] [PDF]

				A. Kotronen, J. Westerbacka, R. Bergholm, K. H. Pietilainen, and H. Yki-Jarvinen Liver Fat in the Metabolic Syndrome J. Clin. Endocrinol. Metab., September 1, 2007; 92(9): 3490 - 3497. [Abstract] [Full Text] [PDF]

				A. Muscari, S. Antonelli, G. Bianchi, G. Cavrini, S. Dapporto, A. Ligabue, C. Ludovico, D. Magalotti, G. Poggiopollini, M. Zoli, et al. Serum C3 Is a Stronger Inflammatory Marker of Insulin Resistance Than C-Reactive Protein, Leukocyte Count, and Erythrocyte Sedimentation Rate: Comparison study in an elderly population Diabetes Care, September 1, 2007; 30(9): 2362 - 2368. [Abstract] [Full Text] [PDF]

				E. Ingelsson, M. J. Pencina, G. H. Tofler, E. J. Benjamin, K. J. Lanier, P. F. Jacques, C. S. Fox, J. B. Meigs, D. Levy, M. G. Larson, et al. Multimarker Approach to Evaluate the Incidence of the Metabolic Syndrome and Longitudinal Changes in Metabolic Risk Factors: The Framingham Offspring Study Circulation, August 28, 2007; 116(9): 984 - 992. [Abstract] [Full Text] [PDF]

				S. Liu, L. Tinker, Y. Song, N. Rifai, D. E. Bonds, N. R. Cook, G. Heiss, B. V. Howard, G. S. Hotamisligil, F. B. Hu, et al. A Prospective Study of Inflammatory Cytokines and Diabetes Mellitus in a Multiethnic Cohort of Postmenopausal Women Arch Intern Med, August 13, 2007; 167(15): 1676 - 1685. [Abstract] [Full Text] [PDF]

				S. Cicala, G. de Simone, M. J. Roman, L. G. Best, E. T. Lee, W. Wang, T. K. Welty, J. M. Galloway, B. V. Howard, and R. B. Devereux Prevalence and Prognostic Significance of Wall-Motion Abnormalities in Adults Without Clinically Recognized Cardiovascular Disease: The Strong Heart Study Circulation, July 10, 2007; 116(2): 143 - 150. [Abstract] [Full Text] [PDF]

				D.-F. Dai, J.-W. Lin, J.-H. Kao, C.-N. Hsu, F.-T. Chiang, J.-L. Lin, Y.-H. Chou, K.-L. Hsu, C.-D. Tseng, Y.-Z. Tseng, et al. The Effects of Metabolic Syndrome Versus Infectious Burden on Inflammation, Severity of Coronary Atherosclerosis, and Major Adverse Cardiovascular Events J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2532 - 2537. [Abstract] [Full Text] [PDF]

				Authors/Task Force Members:, G. Mancia, G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano, G. Grassi, A. M. Heagerty, S. E. Kjeldsen, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) Eur. Heart J., June 11, 2007; (2007) ehm236v1. [Full Text] [PDF]

				Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74. [Full Text] [PDF]

				M. Persson, B. Hedblad, J. J. Nelson, and G. Berglund Elevated Lp-PLA2 Levels Add Prognostic Information to the Metabolic Syndrome on Incidence of Cardiovascular Events Among Middle-Aged Nondiabetic Subjects Arterioscler. Thromb. Vasc. Biol., June 1, 2007; 27(6): 1411 - 1416. [Abstract] [Full Text] [PDF]

				A. W Fogarty, S. Jones, J. R Britton, S. A Lewis, and T. M McKeever Systemic inflammation and decline in lung function in a general population: a prospective study Thorax, June 1, 2007; 62(6): 515 - 520. [Abstract] [Full Text] [PDF]

				O. Ben-Yehuda High-Sensitivity C-Reactive Protein in Every Chart?: The Use of Biomarkers in Individual Patients J. Am. Coll. Cardiol., May 29, 2007; 49(21): 2139 - 2141. [Abstract] [Full Text] [PDF]

				P. M. Ridker C-Reactive Protein and the Prediction of Cardiovascular Events Among Those at Intermediate Risk: Moving an Inflammatory Hypothesis Toward Consensus J. Am. Coll. Cardiol., May 29, 2007; 49(21): 2129 - 2138. [Abstract] [Full Text] [PDF]

				P. E. Szmitko and S. Verma C-Reactive Protein and Reendothelialization: NO Involvement Circ. Res., May 25, 2007; 100(10): 1405 - 1407. [Full Text] [PDF]

				X. Ye, Z. Yu, H. Li, O. H. Franco, Y. Liu, and X. Lin Distributions of C-Reactive Protein and its Association With Metabolic Syndrome in Middle-Aged and Older Chinese People J. Am. Coll. Cardiol., May 1, 2007; 49(17): 1798 - 1805. [Abstract] [Full Text] [PDF]

				I. M. Wahba and R. H. Mak Obesity and Obesity-Initiated Metabolic Syndrome: Mechanistic Links to Chronic Kidney Disease Clin. J. Am. Soc. Nephrol., May 1, 2007; 2(3): 550 - 562. [Abstract] [Full Text] [PDF]

				A. Lopez-Bermejo, B. Chico-Julia, A. Castro, M. Recasens, E. Esteve, J. Biarnes, R. Casamitjana, W. Ricart, and J.-M. Fernandez-Real Alpha Defensins 1, 2, and 3: Potential Roles in Dyslipidemia and Vascular Dysfunction in Humans Arterioscler. Thromb. Vasc. Biol., May 1, 2007; 27(5): 1166 - 1171. [Abstract] [Full Text] [PDF]

				A. I. Kakafika, D. P. Mikhailidis, A. Karagiannis, and V. G. Athyros The Role of Endocannabinoid System Blockade in the Treatment of the Metabolic Syndrome J. Clin. Pharmacol., May 1, 2007; 47(5): 642 - 652. [Abstract] [Full Text] [PDF]

				C. Pitsavos, D. B. Panagiotakos, N. Tzima, Y. Lentzas, C. Chrysohoou, U. N. Das, and C. Stefanadis Diet, Exercise, and C-Reactive Protein Levels in People With Abdominal Obesity: The ATTICA Epidemiological Study Angiology, April 1, 2007; 58(2): 225 - 233. [Abstract] [PDF]

				J. Wang, S. Ruotsalainen, L. Moilanen, P. Lepisto, M. Laakso, and J. Kuusisto The metabolic syndrome predicts cardiovascular mortality: a 13-year follow-up study in elderly non-diabetic Finns Eur. Heart J., April 1, 2007; 28(7): 857 - 864. [Abstract] [Full Text] [PDF]

				O. Schlager, M. Exner, W. Mlekusch, S. Sabeti, J. Amighi, P. Dick, O. Wagner, R. Koppensteiner, E. Minar, and M. Schillinger C-Reactive Protein Predicts Future Cardiovascular Events in Patients With Carotid Stenosis Stroke, April 1, 2007; 38(4): 1263 - 1268. [Abstract] [Full Text] [PDF]

				D. E. King, B. M. Egan, R. F. Woolson, A. G. Mainous III, Y. Al-Solaiman, and A. Jesri Effect of a High-Fiber Diet vs a Fiber-Supplemented Diet on C-Reactive Protein Level Arch Intern Med, March 12, 2007; 167(5): 502 - 506. [Abstract] [Full Text] [PDF]

				C. Ay, T. Tengler, R. Vormittag, R. Simanek, W. Dorda, T. Vukovich, and I. Pabinger Venous thromboembolism a manifestation of the metabolic syndrome Haematologica, March 1, 2007; 92(3): 374 - 380. [Abstract] [Full Text] [PDF]

				R. Kelishadi, M. Sharifi, A. Khosravi, and K. Adeli Relationship Between C-Reactive Protein and Atherosclerotic Risk Factors and Oxidative Stress Markers Among Young Persons 10-18 Years Old Clin. Chem., March 1, 2007; 53(3): 456 - 464. [Abstract] [Full Text] [PDF]

				V. Jeevanantham, N. Singh, K. Izuora, J. P. D'souza, and D. H. Hsi Correlation of High Sensitivity C-Reactive Protein and Calcific Aortic Valve Disease Mayo Clin. Proc., February 1, 2007; 82(2): 171 - 174. [Abstract] [Full Text] [PDF]

				H. Koyama, T. Shoji, S. Fukumoto, K. Shinohara, T. Shoji, M. Emoto, K. Mori, H. Tahara, E. Ishimura, R. Kakiya, et al. Low Circulating Endogenous Secretory Receptor for AGEs Predicts Cardiovascular Mortality in Patients With End-Stage Renal Disease Arterioscler. Thromb. Vasc. Biol., January 1, 2007; 27(1): 147 - 153. [Abstract] [Full Text] [PDF]

				E K Iliodromitis, S Kyrzopoulos, I A Paraskevaidis, K G Kolocassides, S Adamopoulos, G Karavolias, and D T Kremastinos Increased C reactive protein and cardiac enzyme levels after coronary stent implantation. Is there protection by remote ischaemic preconditioning? Heart, December 1, 2006; 92(12): 1821 - 1826. [Abstract] [Full Text] [PDF]

				S. Bo, M. Durazzo, S. Guidi, M. Carello, C. Sacerdote, B. Silli, R. Rosato, M. Cassader, L. Gentile, and G. Pagano Dietary magnesium and fiber intakes and inflammatory and metabolic indicators in middle-aged subjects from a population-based cohort. Am. J. Clinical Nutrition, November 1, 2006; 84(5): 1062 - 1069. [Abstract] [Full Text] [PDF]

				S. Devaraj, E. Chan, and I. Jialal Direct Demonstration of an Antiinflammatory Effect of Simvastatin in Subjects with the Metabolic Syndrome J. Clin. Endocrinol. Metab., November 1, 2006; 91(11): 4489 - 4496. [Abstract] [Full Text] [PDF]

				P. Libby and P. M. Ridker Inflammation and Atherothrombosis: From Population Biology and Bench Research to Clinical Practice J. Am. Coll. Cardiol., October 27, 2006; 48(9_Suppl_A): A33 - A46. [Abstract] [Full Text] [PDF]

				J. V. Solis, J. L. Portero, J. Diaz, R. Garcia, J. M. Ligero, E. Vazquez, C. Lodeiro, and L. Ballesteros Iron Deficiency in the Acute-Phase Reaction After Open Aortic Surgery Vascular and Endovascular Surgery, October 1, 2006; 40(5): 392 - 398. [Abstract] [PDF]

				E Ingelsson, J Arnlov, L Lind, and J Sundstrom Metabolic syndrome and risk for heart failure in middle-aged men Heart, October 1, 2006; 92(10): 1409 - 1413. [Abstract] [Full Text] [PDF]

				S. Zarich, C. Luciano, J. Hulford, and A. Abdullah Prevalence of metabolic syndrome in young patients with acute MI: does the Framingham Risk Score underestimate cardiovascular risk in this population? Diabetes and Vascular Disease Research, September 1, 2006; 3(2): 103 - 107. [Abstract] [PDF]

				S. E. Kahn, B. Zinman, S. M. Haffner, M. C. O'Neill, B. G. Kravitz, D. Yu, M. I. Freed, W. H. Herman, R. R. Holman, N. P. Jones, et al. Obesity is a major determinant of the association of C-reactive protein levels and the metabolic syndrome in type 2 diabetes. Diabetes, August 1, 2006; 55(8): 2357 - 2364. [Abstract] [Full Text] [PDF]

				M. A. Mittleman A 39-year-old woman with hypercholesterolemia. JAMA, July 19, 2006; 296(3): 319 - 326. [Abstract] [Full Text] [PDF]

				N. R. Cook, J. E. Buring, and P. M Ridker The Effect of Including C-Reactive Protein in Cardiovascular Risk Prediction Models for Women Ann Intern Med, July 4, 2006; 145(1): 21 - 29. [Abstract] [Full Text] [PDF]

				S. D. de Ferranti, K. Gauvreau, D. S. Ludwig, J. W. Newburger, and N. Rifai Inflammation and Changes in Metabolic Syndrome Abnormalities in US Adolescents: Findings from the 1988-1994 and 1999-2000 National Health and Nutrition Examination Surveys Clin. Chem., July 1, 2006; 52(7): 1325 - 1330. [Abstract] [Full Text] [PDF]

				M. Briand, I. Lemieux, J. G. Dumesnil, P. Mathieu, A. Cartier, J.-P. Despres, M. Arsenault, J. Couet, and P. Pibarot Metabolic Syndrome Negatively Influences Disease Progression and Prognosis in Aortic Stenosis J. Am. Coll. Cardiol., June 6, 2006; 47(11): 2229 - 2236. [Abstract] [Full Text] [PDF]

				E. Diamanti-Kandarakis, T. Paterakis, K. Alexandraki, C. Piperi, A. Aessopos, I. Katsikis, N. Katsilambros, G. Kreatsas, and D. Panidis Indices of low-grade chronic inflammation in polycystic ovary syndrome and the beneficial effect of metformin Hum. Reprod., June 1, 2006; 21(6): 1426 - 1431. [Abstract] [Full Text] [PDF]

				G. Efstratiadis, G. Tsiaousis, V. G. Athyros, D. Karagianni, A. Pavlitou-Tsiontsi, A. Giannakou-Darda, and C. Manes Total Serum Insulin-like Growth Factor-1 and C-Reactive Protein in Metabolic Syndrome With or Without Diabetes Angiology, May 1, 2006; 57(3): 303 - 311. [Abstract] [PDF]

				K. Esposito, M. Ciotola, D. Carleo, B. Schisano, F. Saccomanno, F. C. Sasso, D. Cozzolino, R. Assaloni, D. Merante, A. Ceriello, et al. Effect of Rosiglitazone on Endothelial Function and Inflammatory Markers in Patients With the Metabolic Syndrome Diabetes Care, May 1, 2006; 29(5): 1071 - 1076. [Abstract] [Full Text] [PDF]

				J. S. Rana, A. C. Jansen, A. H. Zwinderman, M. Nieuwdorp, E. S. van Aalst-Cohen, J. W. Jukema, M. D. Trip, and J. J.P. Kastelein Metabolic Syndrome and Risk of Coronary, Cerebral, and Peripheral Vascular Disease in a Large Dutch Population With Familial Hypercholesterolemia Diabetes Care, May 1, 2006; 29(5): 1125 - 1127. [Full Text] [PDF]

				A. Zambon, P. Gervois, P. Pauletto, J.-C. Fruchart, and B. Staels Modulation of Hepatic Inflammatory Risk Markers of Cardiovascular Diseases by PPAR-{alpha} Activators: Clinical and Experimental Evidence Arterioscler. Thromb. Vasc. Biol., May 1, 2006; 26(5): 977 - 986. [Abstract] [Full Text] [PDF]

				L. E. Bernstein, J. Berry, S. Kim, B. Canavan, and S. K. Grinspoon Effects of Etanercept in Patients With the Metabolic Syndrome. Arch Intern Med, April 24, 2006; 166(8): 902 - 908. [Abstract] [Full Text] [PDF]

				S. Tsimikas, J. T. Willerson, and P. M. Ridker C-reactive protein and other emerging blood biomarkers to optimize risk stratification of vulnerable patients. J. Am. Coll. Cardiol., April 18, 2006; 47(8 Suppl): C19 - C31. [Abstract] [Full Text] [PDF]

				J. Sundstrom, U. Riserus, L. Byberg, B. Zethelius, H. Lithell, and L. Lind Clinical value of the metabolic syndrome for long term prediction of total and cardiovascular mortality: prospective, population based cohort study BMJ, April 15, 2006; 332(7546): 878 - 882. [Abstract] [Full Text] [PDF]

				J. H. Ix, M. G. Shlipak, V. M. Brandenburg, S. Ali, M. Ketteler, and M. A. Whooley Association Between Human Fetuin-A and the Metabolic Syndrome: Data From the Heart and Soul Study Circulation, April 11, 2006; 113(14): 1760 - 1767. [Abstract] [Full Text] [PDF]

				C. H. Saely, L. Koch, F. Schmid, T. Marte, S. Aczel, P. Langer, G. Hoefle, and H. Drexel Adult Treatment Panel III 2001 but Not International Diabetes Federation 2005 Criteria of the Metabolic Syndrome Predict Clinical Cardiovascular Events in Subjects Who Underwent Coronary Angiography Diabetes Care, April 1, 2006; 29(4): 901 - 907. [Abstract] [Full Text] [PDF]

				L. Englund Ogge, G. Brohall, C. J. Behre, C. Schmidt, and B. Fagerberg Alcohol Consumption in Relation to Metabolic Regulation, Inflammation, and Adiponectin in 64-Year-Old Caucasian Women: A population-based study with a focus on impaired glucose regulation Diabetes Care, April 1, 2006; 29(4): 908 - 913. [Abstract] [Full Text] [PDF]

				K. Matsushita, H. Yatsuya, K. Tamakoshi, K. Wada, R. Otsuka, S. Takefuji, K. Sugiura, T. Kondo, T. Murohara, and H. Toyoshima Comparison of Circulating Adiponectin and Proinflammatory Markers Regarding Their Association With Metabolic Syndrome in Japanese Men Arterioscler. Thromb. Vasc. Biol., April 1, 2006; 26(4): 871 - 876. [Abstract] [Full Text] [PDF]

				H.-J. Chen, C.-H. Bai, W.-T. Yeh, H.-C. Chiu, and W.-H. Pan Influence of Metabolic Syndrome and General Obesity on the Risk of Ischemic Stroke Stroke, April 1, 2006; 37(4): 1060 - 1064. [Abstract] [Full Text] [PDF]

				F. Locatelli, P. Pozzoni, and L. Del Vecchio Renal Manifestations in the Metabolic Syndrome. J. Am. Soc. Nephrol., April 1, 2006; 17(4_suppl_2): S81 - S85. [Abstract] [Full Text] [PDF]

				S. H. Wild, C. D. Byrne, F. B. Smith, A. J. Lee, and F. G. R. Fowkes Low ankle-brachial pressure index predicts increased risk of cardiovascular disease independent of the metabolic syndrome and conventional cardiovascular risk factors in the edinburgh artery study. Diabetes Care, March 1, 2006; 29(3): 637 - 642. [Abstract] [Full Text] [PDF]

				L. J. Shaw, C. N. Bairey Merz, C. J. Pepine, S. E. Reis, V. Bittner, S. F. Kelsey, M. Olson, B. D. Johnson, S. Mankad, B. L. Sharaf, et al. Insights From the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part I: Gender Differences in Traditional and Novel Risk Factors, Symptom Evaluation, and Gender-Optimized Diagnostic Strategies J. Am. Coll. Cardiol., February 7, 2006; 47(3_Suppl_S): S4 - S20. [Abstract] [Full Text] [PDF]

				A. A. Quyyumi Women and Ischemic Heart Disease: Pathophysiologic Implications From the Women's Ischemia Syndrome Evaluation (WISE) Study and Future Research Steps J. Am. Coll. Cardiol., February 7, 2006; 47(3_Suppl_S): S66 - S71. [Abstract] [Full Text] [PDF]