454-P: Association between Insulin and C-Reactive Protein: Data from Athletes and Coronary Angiography Patients

A better understanding of the relationship between insulin and inflammation may have important implications for the treatment and prevention of diabetes. Chronic inflammation and diabetes are associated with coronary artery disease (CAD) . That said, many studies found no correlation between insulin and C-reactive protein (CRP) , the most common marker of chronic inflammation. We hypothesize here that the association of insulin and CRP may differ in different patient groups and may be masked by factors such as age, fitness or diseases, in particular established CAD. We thus evaluated the correlates of insulin and CRP among healthy professional athletes (Group 1, mean age = 24 years (ranging from 18-35 years) , n=59) , and patients undergoing coronary angiography (27-88 years, n=1574) who were further divided into younger (<60 years) patients without sign. CAD (Group 2, mean age = 52 years, n=258) , younger patients with sign. CAD (Group 3, mean age = 52, n=287) and older (≥60 years) patients without sign. CAD (Group 4, mean age 69, n=407) as well as older patients with sign. CAD (Group 5, mean age 70, n=622) . CRP and insulin were positively correlated in athletes (r₁=0.544, p<0.001) and in patients without sign. CAD (r₂=0.194, p=0.002 and r₄=0.134, p=0.007) but not in patients with sign. CAD (r₃=-0.001, p=0.981 and r₅=0.000, p=0.955) . In multivariate models including covariates BMI and age, CRP and insulin remained significantly associated in athletes (T₁=4.7, p<0.001) and in patients without sign. CAD (T₂₊₄=3.3, p=0.001) , but not in those with sign. CAD (T₃₊₅=0.0, p=0.997) . We conclude that CRP and insulin correlate in young and fit subjects but also in older subjects who do not have sign. CAD. The presence of CAD may abrogate the association between inflammation and insulin, potentially due to the inflammatory state of atherosclerosis. This appears worthwhile to be considered in future screening and treatment approaches.