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Adipocytokines and the metabolic syndrome among older persons with and without obesity: the InCHIANTI study


Sari Stenholm, Clinical Research Branch, National Institute on Aging, Harbor Hospital 5th Floor, 3001 S. Hanover Street, Baltimore, MD 21225, USA. Tel.: +1 410 3507333; Fax: +1 410 3507304; E-mail:


Objectives  Adipose tissue-derived inflammation may contribute to metabolic alterations and eventually to the metabolic syndrome (MetS). The purpose of this study was to: (1) examine the role of adipocytokines in the association between obesity and the MetS and (2) to determine whether the association is different in obese and non-obese persons.

Design  Cross-sectional population-based InCHIANTI study.

Subjects  A total of 944 community-dwelling adults aged 65 years and older living in Tuscany, Italy.

Measurements  Obesity was defined as body mass index ≥30 kg/m2 and MetS as ≥3 of the ATP-III criteria. Circulating levels of C-reactive protein, interleukin (IL)-6, IL-1 receptor antagonist (IL-1ra), IL-18, tumour necrosis factor (TNF)-α R1, adiponectin, resistin and leptin were measured. Additionally, insulin resistance was determined using the homeostasis model assessment (HOMA-IR).

Results  The prevalence of the MetS was 32%. Both overall and abdominal obesity were significantly associated with the MetS after adjusting for inflammatory cytokines, adipokines and lifestyle factors. After adjusting for multiple confounders and HOMA-IR, IL-1ra, TNF-α R1 and adiponectin (P < 0·05) remained significantly associated with the MetS. Having multiple cytokines in the highest tertile increased the likelihood of having the MetS in both obese (P for trend 0·002) and non-obese persons (P for trend 0·001) independent of insulin resistance.

Conclusions  Non-obese and obese individuals who develop an intense pro-inflammatory state may be more prone to develop the MetS than those with lower levels of inflammation.

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