C-reactive protein and the metabolic syndrome correlate differently with carotid atherosclerosis between men and women in a Taiwanese community

Little is known about the role of C-reactive protein (CRP) and metabolic syndrome (MetS) in carotid atherosclerosis among Chinese. In the present cross-sectional study, we examined this relationship and emphasized the sex differences in 456 men and 354 women aged 39 years and older who participated in a community-based cohort study in Taiwan. These participants received measurements for high-sensitivity CRP and ultrasound examinations for common carotid artery intima-media thickness (IMT) and extracranial carotid artery plaques. Metabolic syndrome was defined by the US National Cholesterol Education Program Adult Treatment Panel III criteria. The women had higher median CRP (1.3 vs 1.1 mg/L) and MetS prevalence than the men (58.8 vs 34.2%). Thicker IMT was associated with MetS in women (multivariate-adjusted odds ratio [OR], 2.07; 95% confidence interval, 1.04-4.11) but not in men. Compared with participants with CRP <1 mg/L, men with CRP >3 mg/L had an elevated OR with the presence of plaque (OR, 1.99; 95% confidence interval, 1.10-3.61), but not women. Compared with men with CRP <1 mg/L and no MetS, individuals with MetS and CRP level >3 mg/L were 2.2 times (P = .046) more likely to have artery plaque. In conclusion, thicker IMT is related to MetS in women, whereas the presence of plaque is associated with elevated CRP in men, and this association is enhanced by MetS.