Synergistic role of inflammation and insulin resistance as coronary artery disease risk factors in African Americans and Caucasians

Anuurad Erdembileg, Russell P. Tracy, Thomas A. Pearson, Kyoungmi Kim, Lars Berglund

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The separate roles of inflammation and insulin resistance (IR) in the pathogenesis of cardiovascular disease (CVD) are well recognized. We investigated whether presence of inflammation would modify coronary artery disease (CAD) risk prediction in subjects with or without IR. Insulin, glucose, CRP and fibrinogen levels were determined in 317 Caucasians and 222 African Americans undergoing diagnostic coronary angiography. Extent of CAD was defined by a composite score (0-75). The overall prevalence of IR (HOMA-IR ≥ 3.0) in Caucasians and African Americans was 32.5% and 22.9%, respectively (P < 0.05). The degree of CAD (composite score) was higher in subjects with IR (20.7 vs. 14.5, P = 0.014 and 20.1 vs. 13.1, P = 0.031 for Caucasians and African Americans, respectively), and in a multiple regression model IR was an independent predictor for CAD in both groups. In both ethnic groups, subjects with a combination of IR and high CRP (≥3 mg/l) had significantly higher composite score compared to those with no IR and low CRP (<3 mg/l) (21.2 vs. 13.9, P < 0.05 and 20.9 vs. 10.2, P < 0.05 for Caucasians and African Americans, respectively). Similarly, the composite score was significantly higher in subjects with IR and high fibrinogen (≥340 mg/dl) compared to those with no IR and low fibrinogen. In conclusion, elevated levels of inflammatory markers were positively associated with IR. Further, a combination of IR and inflammation resulted in a higher degree of CAD in both Caucasians and African Americans. The results suggest that inflammation may potentiate the cardiovascular risk factor role of IR.

Original languageEnglish (US)
Pages (from-to)290-295
Number of pages6
JournalAtherosclerosis
Volume205
Issue number1
DOIs
StatePublished - Jul 2009

Fingerprint

African Americans
Insulin Resistance
Coronary Artery Disease
Inflammation
Fibrinogen
Coronary Angiography
Ethnic Groups
Cardiovascular Diseases
Insulin
Glucose

Keywords

  • CRP
  • Ethnicity
  • Fibrinogen
  • Inflammation
  • Insulin resistance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Synergistic role of inflammation and insulin resistance as coronary artery disease risk factors in African Americans and Caucasians. / Erdembileg, Anuurad; Tracy, Russell P.; Pearson, Thomas A.; Kim, Kyoungmi; Berglund, Lars.

In: Atherosclerosis, Vol. 205, No. 1, 07.2009, p. 290-295.

Research output: Contribution to journalArticle

@article{4d0cb798b39d481c886c57eecfc3cc57,
title = "Synergistic role of inflammation and insulin resistance as coronary artery disease risk factors in African Americans and Caucasians",
abstract = "The separate roles of inflammation and insulin resistance (IR) in the pathogenesis of cardiovascular disease (CVD) are well recognized. We investigated whether presence of inflammation would modify coronary artery disease (CAD) risk prediction in subjects with or without IR. Insulin, glucose, CRP and fibrinogen levels were determined in 317 Caucasians and 222 African Americans undergoing diagnostic coronary angiography. Extent of CAD was defined by a composite score (0-75). The overall prevalence of IR (HOMA-IR ≥ 3.0) in Caucasians and African Americans was 32.5{\%} and 22.9{\%}, respectively (P < 0.05). The degree of CAD (composite score) was higher in subjects with IR (20.7 vs. 14.5, P = 0.014 and 20.1 vs. 13.1, P = 0.031 for Caucasians and African Americans, respectively), and in a multiple regression model IR was an independent predictor for CAD in both groups. In both ethnic groups, subjects with a combination of IR and high CRP (≥3 mg/l) had significantly higher composite score compared to those with no IR and low CRP (<3 mg/l) (21.2 vs. 13.9, P < 0.05 and 20.9 vs. 10.2, P < 0.05 for Caucasians and African Americans, respectively). Similarly, the composite score was significantly higher in subjects with IR and high fibrinogen (≥340 mg/dl) compared to those with no IR and low fibrinogen. In conclusion, elevated levels of inflammatory markers were positively associated with IR. Further, a combination of IR and inflammation resulted in a higher degree of CAD in both Caucasians and African Americans. The results suggest that inflammation may potentiate the cardiovascular risk factor role of IR.",
keywords = "CRP, Ethnicity, Fibrinogen, Inflammation, Insulin resistance",
author = "Anuurad Erdembileg and Tracy, {Russell P.} and Pearson, {Thomas A.} and Kyoungmi Kim and Lars Berglund",
year = "2009",
month = "7",
doi = "10.1016/j.atherosclerosis.2008.11.028",
language = "English (US)",
volume = "205",
pages = "290--295",
journal = "Atherosclerosis",
issn = "0021-9150",
publisher = "Elsevier Ireland Ltd",
number = "1",

}

TY - JOUR

T1 - Synergistic role of inflammation and insulin resistance as coronary artery disease risk factors in African Americans and Caucasians

AU - Erdembileg, Anuurad

AU - Tracy, Russell P.

AU - Pearson, Thomas A.

AU - Kim, Kyoungmi

AU - Berglund, Lars

PY - 2009/7

Y1 - 2009/7

N2 - The separate roles of inflammation and insulin resistance (IR) in the pathogenesis of cardiovascular disease (CVD) are well recognized. We investigated whether presence of inflammation would modify coronary artery disease (CAD) risk prediction in subjects with or without IR. Insulin, glucose, CRP and fibrinogen levels were determined in 317 Caucasians and 222 African Americans undergoing diagnostic coronary angiography. Extent of CAD was defined by a composite score (0-75). The overall prevalence of IR (HOMA-IR ≥ 3.0) in Caucasians and African Americans was 32.5% and 22.9%, respectively (P < 0.05). The degree of CAD (composite score) was higher in subjects with IR (20.7 vs. 14.5, P = 0.014 and 20.1 vs. 13.1, P = 0.031 for Caucasians and African Americans, respectively), and in a multiple regression model IR was an independent predictor for CAD in both groups. In both ethnic groups, subjects with a combination of IR and high CRP (≥3 mg/l) had significantly higher composite score compared to those with no IR and low CRP (<3 mg/l) (21.2 vs. 13.9, P < 0.05 and 20.9 vs. 10.2, P < 0.05 for Caucasians and African Americans, respectively). Similarly, the composite score was significantly higher in subjects with IR and high fibrinogen (≥340 mg/dl) compared to those with no IR and low fibrinogen. In conclusion, elevated levels of inflammatory markers were positively associated with IR. Further, a combination of IR and inflammation resulted in a higher degree of CAD in both Caucasians and African Americans. The results suggest that inflammation may potentiate the cardiovascular risk factor role of IR.

AB - The separate roles of inflammation and insulin resistance (IR) in the pathogenesis of cardiovascular disease (CVD) are well recognized. We investigated whether presence of inflammation would modify coronary artery disease (CAD) risk prediction in subjects with or without IR. Insulin, glucose, CRP and fibrinogen levels were determined in 317 Caucasians and 222 African Americans undergoing diagnostic coronary angiography. Extent of CAD was defined by a composite score (0-75). The overall prevalence of IR (HOMA-IR ≥ 3.0) in Caucasians and African Americans was 32.5% and 22.9%, respectively (P < 0.05). The degree of CAD (composite score) was higher in subjects with IR (20.7 vs. 14.5, P = 0.014 and 20.1 vs. 13.1, P = 0.031 for Caucasians and African Americans, respectively), and in a multiple regression model IR was an independent predictor for CAD in both groups. In both ethnic groups, subjects with a combination of IR and high CRP (≥3 mg/l) had significantly higher composite score compared to those with no IR and low CRP (<3 mg/l) (21.2 vs. 13.9, P < 0.05 and 20.9 vs. 10.2, P < 0.05 for Caucasians and African Americans, respectively). Similarly, the composite score was significantly higher in subjects with IR and high fibrinogen (≥340 mg/dl) compared to those with no IR and low fibrinogen. In conclusion, elevated levels of inflammatory markers were positively associated with IR. Further, a combination of IR and inflammation resulted in a higher degree of CAD in both Caucasians and African Americans. The results suggest that inflammation may potentiate the cardiovascular risk factor role of IR.

KW - CRP

KW - Ethnicity

KW - Fibrinogen

KW - Inflammation

KW - Insulin resistance

UR - http://www.scopus.com/inward/record.url?scp=67349132264&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67349132264&partnerID=8YFLogxK

U2 - 10.1016/j.atherosclerosis.2008.11.028

DO - 10.1016/j.atherosclerosis.2008.11.028

M3 - Article

C2 - 19135196

AN - SCOPUS:67349132264

VL - 205

SP - 290

EP - 295

JO - Atherosclerosis

JF - Atherosclerosis

SN - 0021-9150

IS - 1

ER -