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(Circulation. 2003;108:126.)
© 2003 American Heart Association, Inc.

Editorials

Inflammation, Metabolic Syndrome, and Diet Responsiveness

Scott M. Grundy, MD, PhD

From the Center for Human Nutrition and the Departments of Clinical Nutrition and Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Tex.

Correspondence to Scott M. Grundy, MD, PhD, Center for Human Nutrition and the Departments of Clinical Nutrition and Internal Medicine, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Y3.206, Dallas, TX 75390-9052.

Key Words: Editorials • inflammation • metabolism • C-reactive protein • diet

An extract of the first 250 words of the full text is provided, because this article has no abstract.

There has been a surge of interest in the role of inflammation in causation of atherosclerosis and acute coronary syndromes. This interest is spurred both by pathological studies showing that ruptured coronary plaques manifest inflammatory characteristics¹ and by the demonstration that inflammatory biomarkers in the plasma correlate with risk for acute coronary syndromes.^2,3 Among the biomarkers that correlate with acute coronary syndromes, the most robust is C-reactive protein (CRP).⁴ The liver is known to respond to high levels of cytokines in the circulation with an increased production of CRP. A recent report by the American Heart Association/Centers for Disease Control and Prevention (AHA/CDC)⁴ indicated that CRP measurements may provide incremental information for global risk assessment for coronary heart disease beyond that obtained from established risk factors. These measurements can be made at the discretion of physicians, provided that established risk factors are given priority in global risk assessment.

See p 150

Another recent observation of significance is that elevated CRP levels associate with the metabolic syndrome. The latter is a syndrome in which several metabolic risk factors cosegregate in one person. Risk factors of the metabolic syndrome include atherogenic dyslipidemia (raised triglycerides, elevated apolipoprotein B, small LDL particles, and low HDL cholesterol), elevated blood pressure, insulin resistance (±glucose intolerance), a proinflammatory state, and a prothrombotic state.⁵ Several studies^6–8 add support to the concept that a proinflammatory state is one component of the metabolic syndrome. Ridker et al⁹ have confirmed that elevated CRP associates strongly with metabolic syndrome risk factors; moreover, . . . [Full Text of this Article]

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