In some cases, there are significant differences in the strengths of association. Also, each marker may participate in the CVD process in a different way. In a side-by-side comparison, CRP had the strongest risk prediction, but a meta-analysis observed no real difference between CRP and fibrinogen in risk prediction.
Inflammation and the Metabolic Syndrome: an Important Relationship
It has been observed that markers of inflammation are associated with the components of the metabolic syn-drome; this finding is in addition to the known association of inflammation markers, as well as markers of coagulant activity, with diabetes status. there
For example, CRP values increase with the number of components of the metabolic syndrome present, and fibrinogen levels are correlated with albumin excretion, even in those patients without demonstrable impaired glucose tolerance (N. Jenny, PhD; unpublished data). Despite these strong relationships, as mentioned before, factor analysis indicates that inflammation represents a distinct underlying pathophysiologic pathway.
To help better understand the metabolic pathways associated with inflammation, we and others have studied the correlates of CRP. The major correlates are adiposity and insulin sensitivity status. CRP is also associated with coagulation activity status, as estimated by markers such as d-dimer (a fibrin degradation product [FDP] that reflects first the formation of fibrin and then fibrinolysis) and plasmin-antiplasmin complex (a marker reflecting plasmin formation rate, itself depending on the stimulation of fibrin formation, as well as the levels of tissue plasminogen activator and PAI-1)A> Increases in coagulation status in the metabolic syndrome and diabetes have been well documented.”