STATE-OF-THE-ART PAPER
Inflammatory Markers and the Metabolic Syndrome
Insights From Therapeutic Interventions
Kwang Kon Koh, MD, PhD, FACC*,*,
Seung Hwan Han, MD* and
Michael J. Quon, MD, PhD
* Division of Cardiology, Gil Heart Center, Gachon Medical School, Incheon, Korea
Diabetes Unit, Laboratory of Clinical Investigation, National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland
Manuscript received April 16, 2005;
revised manuscript received June 22, 2005,
accepted June 27, 2005.
* Reprint requests and correspondence: Dr. Kwang Kon Koh, Vascular Medicine and Atherosclerosis Unit, Division of Cardiology, Gil Heart Center, Gachon Medical School, 1198 Kuwol-dong, Namdong-gu, Incheon, South Korea 405-760 (Email: kwangk{at}ghil.com).
Inflammation in the vasculature might be an important pathogenic link between cardiovascular diseases and the metabolic syndrome. Inflammation can be reduced by a variety of approaches including diet, exercise, cardiovascular drugs, and insulin sensitizers. Importantly, these different measures improve vascular function and reduce inflammation by distinct mechanisms. Therefore, combination therapy including lifestyle modifications and multiple drugs from separate classes might produce additive beneficial outcomes. We review plausible mechanisms for effects of combination therapy to reduce inflammation, improve endothelial dysfunction, and decrease insulin resistance in atherosclerosis, coronary heart disease, and hypertension in the context of insulin-resistant states including diabetes, obesity, and the metabolic syndrome.
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Abbreviations and Acronyms
| | ACE = angiotensin-converting enzyme | | CAMs = cell adhesion molecules | | CRP = C-reactive protein | | ICAM = intercellular adhesion molecule | | IL = interleukin | | LDL = low-density lipoprotein | | MCP = monocyte chemoattractant protein | | NF = nuclear factor | | NO = nitric oxide | | PPAR = peroxisome proliferator-activated receptor | | sCD40L = soluble CD40 ligand | | TNF = tumor necrosis factor | | VCAM = vascular cell adhesion molecule |
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