Comparing The Ability Of Inflammatory Markers To Identify Metabolic Diseases

AimsThe aim of this study was to evaluate the associations between various inflammatory markers(complement component 3(C3),complement component 4(C4),high sensitivity C-reactive protein(hs-CRP),leukocyte,neutrophil,lymphocyte and neutrophil-to-lymphocyte ratio(NLR))and the prevalence of metabolic syndrome(MetS),type 2 diabetes mellitus(T2DM),hypertension and hyperlipemia.We also compared the ability of inflammatory markers to diagnose metabolic diseases,in order to identify the most accurate and useful markers.MethodsA cross-sectional study was conducted on participants recruited from Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort study.All participants voluntarily participated in this study and all subjects gave written informed consent.Data from 2013-2016 was used,there are 6312 participants in this study.Data of physical examination,questionnaire survey and blood biochemical indicators were collected by trained personnel using a standardized protocol.MetS was defined in accordance with the criteria of American Heart Association.T2DM was defined in accordance with the criteria of American Diabetes Association.Hypertension was defined according to 2010 Chinese guidelines for the management of hypertension.Hyperlipemia was defined according to 2016 Chinese guideline for the management of dyslipidemia in adults.For baseline characteristics analysis,analysis of covariance(ANCOVA)was used to compare the differences of continuous variables between groups with and without MetS and multiple logistic regression analysis for proportional variables after adjustment for age and sex.Adjusted logistic models were used to assess associations between inflammatory markers and metabolic diseases.Receiver operating characteristic(ROC)curves were performed to obtain the area under ROC curves(AUC)and optimal cut-off points(OCP)of inflammatory markers for diagnosing metabolic disease.ResultsThe prevalence of MetS was 36.3%.The adjusted odds ratio(95%confidence interval)of MetS for the highest inflammatory markers(C3,leukocyte,neutrophil,lymphocyte)quintile,when compared to the lowest quintile were 2.68(2.12,3.38),2.53(2.05,3.11),1.31(1.06,1.62)and 1.94(1.60,2.37),respectively.No significant association was observed between the other inflammatory markers and MetS.ROC analysis showed that the AUC and the OCP(sensitivity,specificity)were 0.68 and118.4mg/dl(65.4%,62.7%)for C3.The prevalence of T2DM was 9.6%.The adjusted odds ratio(95%confidence interval)of T2DM for the highest inflammatory markers(C3,leukocyte,neutrophil,lymphocyte)quintile,when compared to the lowest quintile were 1.74(1.23,2.47),1.90(1.40,2.60),1.42(1.04,1.96)and 1.69(1.27,2.28),respectively.No significant association was observed between the other inflammatory markers and T2DM.ROC analysis showed that the AUC and the OCP(sensitivity,specificity)were 0.68 and118.4mg/dl(65.4%,62.7%)for C3,0.61 and 5.94×10~9/L(54.9%,62.8%)for leukocyte.The prevalence of hypertension was 9.6%.The adjusted odds ratio(95%confidence interval)of hypertension for the highest inflammatory markers(C3,leukocyte,neutrophil,lymphocyte)quintile,when compared to the lowest quintile were 1.61(1.29,2.01),1.25(1.02,1.54)and 1.61(1.32,1.97),respectively.No significant association was observed between the other inflammatory markers and hypertension.ROC analysis showed that the AUC and the OCP(sensitivity,specificity)were 0.62 and 101.9 mg/dl(57.3%,61.4%)for C3,0.62 and 0.77 mg/L(64.5%,53.6%)for leukocyte.The prevalence of hyperlipemia was 29.8%.The adjusted odds ratio(95%confidence interval)of hyperlipemia for the highest inflammatory markers(C3,leukocyte,lymphocyte)quintile,when compared to the lowest quintile were 3.21(2.56,4.03),2.01(1.65,2.44)and 2.01(1.66,2.43),respectively.No significant association was observed between the other inflammatory markers and hyperlipemia.ROC analysis showed that the AUC and the OCP(sensitivity,specificity)were 0.66and 101.1mg/dl(63.4%,59.2%)for C3.ConclusionAmong the inflammatory markers discussed in this population,C3 are positively associated with the prevalence of MetS,T2DM,hypertension and hyperlipemia.Furthermore,C3 has the strongest diagnostic value in detecting MetS and hyperlipemia.C3 necessitate further evalution in risk prediction for metabolic diseases,and could also provide targets for further therapeutic interventions.