The
metabolic syndrome (MS) is associated with a systemic inflammatory response that plays an important pathogenetic role in atherothrombotic disease. Increasing evidence indicates that CD40-CD40
ligand interactions constitute an important mediator for vascular
inflammation. The purpose of this study was to assess whether
high-sensitivity C-reactive protein (
hs-CRP) and soluble
CD40 ligand (sCD40L) levels were increased in patients with MS. During the study period from January 2004 to August 2004, 312 patients with MS and 98 control subjects were included. Anthropometric measurements, blood pressure assessment, electrocardiography, and blood measurements including fasting
blood glucose, postprandial
blood glucose, total
cholesterol,
low-density lipoprotein cholesterol,
high-density lipoprotein cholesterol,
triglyceride,
glycated hemoglobin, white blood cell (WBC), platelets,
hs-CRP, and sCD40L were performed. Patients with MS were divided into 3 groups based upon their
glucose tolerance (group 1, normal
glucose tolerance; group 2, prediabetic group; and group 3,
diabetes mellitus). Patients with MS showed a significant increase of WBC,
hs-CRP, and sCD40L levels compared with control subjects. The levels of both
hs-CRP and sCD40L were positively correlated with body mass index (BMI). High-sensitivity CRP levels were also positively correlated with waist circumferences, fasting
blood glucose, postprandial
blood glucose, and
glycated hemoglobin, and negatively correlated with
high-density lipoprotein cholesterol. In patients with MS, both
hs-CRP and sCD40L levels were positively correlated with WBC count. We found a positive correlation between sCD40L and platelets. Among the subgroups of patients with MS, the mean levels of WBC,
hs-CRP, and sCD40L did not show any significant differences. In conclusion, elevated levels of WBC,
hs-CRP, and sCD40L in MS patients provide further insight into the relationship between MS and
inflammation. In our study, positive correlations between BMI and both
hs-CRP and sCD40L levels suggest that BMI is an important determinant of a chronic inflammatory state in patients with MS. Moreover, this study reports significantly increased levels of WBC,
hs-CRP, and sCD40L not only in diabetic subjects with MS but also in prediabetic subjects and nondiabetic subjects with MS compared with control subjects. Our data suggest that MS patients have proinflammatory state independent of their
glucose tolerance status. In our study, the positive correlation between the levels of sCD40L and platelets in patients with MS supports previous reports indicating that sCD40L are derived predominantly from platelets.