건강한 성인에서 대사증후군 예측을 위한 호모시스테인과 고감도 C 반응성 단백의 조합 = The Effectiveness of Using a Combination of Serum Homocysteine and High Sensitivity C-Reactive Protein for Predicting Metabolic Syndrome in Healthy Adult

다국어 초록 (Multilingual Abstract)

High sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) are associated with vascular inflammatory responses and confirmed to be associated with cardiovascular disease and metabolic syndrome. However, it is still unclear whether the combination of hs-CRP and Hcy predicts the development of metabolic syndrome. This study evaluated the combination of hs-CRP and Hcy as a predictor of metabolic syndrome in healthy adults. From January 2017 to August 2019, this study was conducted on healthy adults who were over 20 years old. They underwent a general health examination at a general hospital in the Seoul metropolitan area. High hs-CRP and Hcy levels were defined as outcome values corresponding to the 75th percentile of all the subjects. The diagnosis of metabolic syndrome applied the NCEP-ATP III criteria. hs-CRP increased the risk of developing metabolic syndrome in the fourth quartile more than in the first quartile. The probability of developing metabolic syndrome in the group with only high hs-CRP levels was 2.38 for men and 3.50 for women. The incidence of metabolic syndrome with a combination of both high hs-CRP and Hcy levels was 3.42 for men and 6.55 for women. In conclusion, this study demonstrated that the combination of high levels of serum hs-CRP and Hcy can be a predicting factor for a patient’s risk of developing metabolic syndrome.

참고문헌 (Reference)

• 1 신경아, "복부비만 고령여성의 대사증후군 위험요인과 고감도 C-반응성 단백의 관련성" 대한임상검사과학회 49 (49): 121-127, 2017
• 2 신경아, "대사증후군 위험요인으로서 호모시스테인 평가" 한국웰니스학회 11 (11): 389-400, 2016
• 3 Murakami, S., "The physiological and pathophysiological roles of taurine in adipose tissue in relation to obesity" 186 : 80-86, 2017
• 4 Kumar, A., "The metabolism and significance of homocysteine in nutrition and health" 14 : 78-, 2017
• 5 Ford, E. S., "The metabolic syndrome and C-reactive protein, fibrinogen, and leukocyte count: findings from the Third National Health and Nutrition Examination Survey" 168 : 351-358, 2003
• 6 Moretti, R., "The controversial role of homocysteine in neurology:from labs to clinical practice" 20 : 2019
• 7 Kim, J., "The co-existence of elevated high sensitivity C-reactive protein and homocysteine levels is associated with increased risk of metabolic syndrome: A 6-year follow-up study" 13 : e0206157-, 2018
• 8 World Health Organization, "The Asia-Pacific Perspective: redefining obesity and its treatment" Health Communications Australia Pty Ltd 19-20, 2000
• 9 Ganguly, P., "Role of homocysteine in the development of cardiovascular disease" 14 : 6-, 2015
• 10 Gong, X., "Prognostic value of inflammatory mediators in 1-year outcome of acute ischemic stroke with middle cerebral artery stenosis" 2013 : 850714-, 2013
• 11 Hu, G., "Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women" 164 : 1066-1076, 2004
• 12 Youssef, M. Y., "Plasma concentrations of C-reactive protein and total homocysteine in relation to the severity and risk factors for cerebrovascular disease" 150 : 158-163, 2007
• 13 Mayer, O., "Mild hyperhomocysteinaemia is associated with increased aortic stiffness in general population" 20 : 267-271, 2006
• 14 Gami, A. S., "Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies" 49 : 403-414, 2007
• 15 Wang, K., "Joint association of serum homocysteine and high-sensitivity C-reactive protein with arterial stiffness in Chinese population : A 12-year longitudinal study" 144 : 27-35, 2019
• 16 Yudkin, J. S., "Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link?" 148 : 209-214, 2000
• 17 Nishida, K., "Inflammation and metabolic cardiomyopathy" 113 : 389-398, 2017
• 18 Oron-Herman, M., "Hyperhomocysteinemia as a component of syndrome X" 52 : 1491-1495, 2003
• 19 Federico Cacciapuoti, "Hyper-homocysteinemia Inducing Hyperuricemia: What are the Mechanisms?" 대한류마티스학회 24 (24): 127-130, 2017
• 20 Silverman, M. D., "Homocysteine upregulates vascular cell adhesion molecule-1 expression in cultured human aortic endothelial cells and enhances monocyte adhesion" 22 : 587-592, 2002
• 21 Doronzo, G., "Homocysteine rapidly increases matrix metalloproteinase-2 expression and activity in cultured human vascular smooth muscle cells. Role of phosphatidyl inositol 3-kinase and mitogen activated protein kinase pathways" 94 : 1285-1293, 2005
• 22 Pang, X., "Homocysteine induces the expression of C-reactive protein via NMDAr-ROS-MAPK-NF- B signal pathway in rat vascular smooth muscle cells" 236 : 73-81, 2014
• 23 Koga, T., "Homocysteine increases monocyte and T-cell adhesion to human aortic endothelial cells" 161 : 365-374, 2002
• 24 Welch, G. N., "Homocysteine and atherothrombosis" 338 : 1042-1050, 1998
• 25 Chuang, C. H., "Homocysteine and C-reactive protein as useful surrogate markers for evaluating CKD risk in adults" 37 : 402-413, 2013
• 26 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, "Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)" 285 : 2486-2497, 2001
• 27 Pang, X., "Emodin inhibits homocysteineinduced C-reactive protein generation in vascular smooth muscle cells by regulating PPAR expression and ROS-ERK1/2/p38 signal pathway" 10 : e0131295-, 2015
• 28 Helfand, M., "Emerging risk factors for coronary heart disease: a summary of systematic reviews conducted for the U.S. Preventive Services Task Force" 151 : 496-507, 2009
• 29 Li, S., "Determination of serum homocysteine and hypersensitive C-reactive protein and their correlation with premature coronary heart disease" 22 : E215-E217, 2019
• 30 Tu, W. J., "Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke" 35 : 912-921, 2013
• 31 Cho, D. Y., "Combination of high-sensitivity C-reactive protein and homocysteine may predict an increased risk of coronary artery disease in Korean population" 125 : 569-573, 2012
• 32 Isomaa, B., "Cardiovascular morbidity and mortality associated with the metabolic syndrome" 24 : 683-689, 2001
• 33 Ridker, P. M., "C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events : an 8-year followup of 14, 719 initially healthy American women" 107 : 391-397, 2003
• 34 Reaven, G. M., "Banting lecture 1988. Role of insulin resistance in human disease" 37 : 1595-1607, 1988
• 35 Maury, E., "Adipokine dysregulation, adipose tissue inflammation and metabolic syndrome" 314 : 1-16, 2010