Metabolic Syndrome is Strongly Associated With Chronic Subclinical Inflammation in Patients Achieving Optimal Low-Density Lipoprotein-Cholesterol Levels in Secondary Prevention of Cardiovascular Disease

BACKGROUND: The dual goals of low-density lipoprotein-cholesterol (LDL-C) and C-reactive protein (CRP) reduction are important for secondary prevention of cardiovascular disease. However, the relevant factors of subclinical inflammation in patients with optimal LDL-C were not clearly demonstrated. This study sought to test the hypothesis that the metabolic syndrome (MetS) is associated with subclinical inflammation in patients achieving optimal LDL-C. METHODS AND RESULTS: A total of 227 Japanese subjects with a prior history of ischemic heart disease and optimal LDL-C (LDL-C <100 mg/dl) were enrolled. When compared with patients with low CRP (<0.1 mg/dl), those with a high CRP (> or =0.1 mg/dl) had a significantly higher prevalence of visceral obesity, elevated triglyceride, lower high-density lipoprotein-cholesterol (HDL-C), hypertension, impaired fasting glucose, and a higher prevalence of MetS. A linear relationship between an increase in number of MetS components and CRP was observed (trend, p<0.001). In multivariate logistic analysis, visceral obesity (odds ratio 6.54; 95% confidence interval 2.99-14.3), low HDL-C (2.78; 1.09-7.12) and impaired fasting glucose (6.72; 3.30-13.7), and MetS (10.4; 5.18-20.7) were associated with higher CRP. CONCLUSIONS: MetS is well associated with higher CRP concentrations in patients who achieved optimal LDL-C levels.