In this presentation Prof. Niskanen talks about C-reactive protein (CRP) as a predictor of metabolic syndrome, type 2 diabetes and hypertension, and the role of mediating factors.

The metabolic syndrome is a cluster of abnormalities increasing the risk of diabetes and/or cardiovascular disease, and these in turn are hypothesized to develop from a “common soil” of genetic and environmental antecedents. Evidence shows that inflammation plays an important role in both disorders.

Levels of CRP, a marker of inflammation, were previously found to be closely related to features of the metabolic syndrome (1), and to predict the development of type 2 diabetes (2) and hypertension (3) in the Women's Health Study. In the KIHD study similar findings were observed in men, and it was further possible to ask whether these associations are explained by lifestyle factors or factors related to insulin resistance (4,5).
Prof. Niskanen discusses these findings and how they support the common soil hypothesis.

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After viewing this presentation the participant will be able to discuss:

- The “common soil” hypothesis for the development of diabetes and cardiovascular disease
- The value of CRP as a predictor of metabolic syndrome, hypertension and type 2 diabetes
- Analyses from the KIHD study on mediating factors

1. Paul M Ridker, MD; Julie E. Buring, ScD; Nancy R. Cook, ScD; Nader Rifai, PhDC-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women Circulation. 2003;107:391.

2. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM.C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001 Jul 18;286(3):327-34.

3. Howard D. Sesso, ScD, MPH; Julie E. Buring, ScD; Nader Rifai, PhD; Gavin J. Blake, MD, MPH; J. Michael Gaziano, MD, MPH; Paul M. Ridker, MD, MPH. C-Reactive Protein and the Risk of Developing Hypertension JAMA. 2003;290:2945-2951.

4. D. E. Laaksonen, L. Niskanen, K. Nyyssönen, K. Punnonen, T.-P. Tuomainen, V.-P. Valkonen, R. Salonen and J. T. Salonen. C-reactive protein and the development of the metabolic syndrome and diabetes in middle-aged men Diabetologia, Volume 47, Issue 8, Aug 2004, Pages 1403 - 1410.

5. Leo Niskanen; David E. Laaksonen; Kristiina Nyyssönen; Kari Punnonen; Veli-Pekka Valkonen; Ricardo Fuentes; Tomi-Pekka Tuomainen; Riitta Salonen; Jukka T. Salonen. Inflammation, Abdominal Obesity, and Smoking as Predictors of Hypertension Hypertension. 2004;44:859.