Summary
Insulin resistance and erythrocyte sedimentation rate (ESR, a non-specific marker
of inflammation) are known risk factors for cardiovascular disease. Although obesity
is associated with increased ESR, it is unclear whether insulin resistance is associated
with ESR in humans. The relationship between insulin resistance and ESR was studied
in a cross-sectional, health-area based study of 140 (89 men and 51 women) apparently
healthy Caucasians subjects. ESR, additional inflammatory markers [soluble tumor necrosis
alpha receptors 1 and 2 (sTNFR1 and sTNFR2); C-reactive protein (CRP)], and insulin
sensitivity ( S I, frequently sampled intravenous glucose tolerance test with minimal
model analysis) were assessed in all subjects. An interaction with sex was documented
in the relationship between ESR and both insulin resistance and obesity (p < 0.05),
as log ESR correlated with log S I in men (r= –0.29, p = 0.009), but not in women
(r= –0.14, p = 0.33), and correlated with body mass index (BMI) in women (r=0.49,
p= < 0.0001), but not in men (r=0.15, p = 0.16). On multivariate analyses, these associations
proved to be independent of known covariates, such as age, hematocrit, smoking and
additional inflammatory markers in both men and women. In a replication study, variables
independently associated with ESR were also insulin resistance (homeostasis model
assessment) in men and obesity markers (either BMI or fat mass) in women. In conclusion,
ESR is independently associated with either insulin resistance or obesity in a sex-specific
manner. These findings contribute to explain the known relationship of this inflammatory
marker with cardiovascular disease.
Keywords
Diabetes mellitus - obesity - inflammation - insulin sensitivity - erythrocyte sedimentation
rate