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Department of Epidemiology & Biostatistics (A.E.H., H.A.P.P., A.H., M.M.B.B., J.C.M.W.), Erasmus Medical Center Rotterdam, 3000 DR Rotterdam, The Netherlands; Department of Internal Medicine (A.E.H., H.A.P.P.), Erasmus Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; Department of Internal Medicine (C.D.A.S.), University Hospital Vrije Universiteit and Institute for Cardiovascular Research Vrije Universiteit, 1007 MB Amsterdam, The Netherlands; and Numico Research (J.M., A.J.K.), 6700 CA Wageningen, The Netherlands
Address all correspondence and requests for reprints to: J. C. M. Witteman, Department of Epidemiology & Biostatistics, Erasmus Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. E-mail: witteman{at}epib.fgg.eur.nl
Abstract
Insulin resistance, which is highly prevalent in the elderly, is suggested to be accompanied by an increased acute phase response. Until now, it is unclear whether cellular adhesion molecules are involved in the clustering of insulin resistance.
In the present study, we examined the relationship of insulin resistance (measured by postload insulin) with levels of markers of inflammation and cellular adhesion molecules in a random sample of 574 nondiabetic elderly men and women participating in the Rotterdam Study. Associations were assessed by regression analysis, with ln-insulin as the dependent variable [regression coefficient (95% confidence interval)].
In our population, insulin was strongly and significantly
(P < 0.001) associated with the markers of
inflammation C-reactive protein [1.52 (0.96–2.08)],
-1-antichymotrypsin [1.25 (0.82–1.69)], and IL-6 [2.60
(1.69–3.52)], adjusted for age and gender. Associations weakened, to
some extent, after additional adjustment for measures of obesity,
smoking, and cardiovascular disease. Insulin was associated with the
soluble intercellular adhesion molecule 1 [2.22 (1.29–3.16;
P < 0.001)], whereas no association with the
soluble vascular cell adhesion molecule 1 was found. The strength of
the associations of insulin with C-reactive protein,
-1-antichymotrypsin, IL-6, and soluble intercellular adhesion
molecule 1, as assessed by standardized regression coefficients, was
comparable with the strength of the associations of insulin with
high-density lipoprotein cholesterol, body mass index, and waist-to-hip
ratio.
The results of this population-based study indicate that low-grade inflammation and the cellular adhesion molecule soluble intercellular adhesion molecule 1 are an integral part of insulin resistance in nondiabetic elderly. These factors may contribute to the well-known relationship between insulin resistance and cardiovascular disease risk and might potentially become therapeutic targets in insulin resistant subjects.
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