The relationship of lipoprotein(a), C-reactive protein and homocysteine with metabolic syndrome in South Asians

Elevated serum lipoprotein(a) (Lp(a)), C-reactive protein (CRP), and homocysteine are associated with increased risk for cardiovascular disease (CVD). Metabolic syndrome is yet another known risk factor for cardiovascular disease. However, the relationship between metabolic syndrome and these three prevalent CVD biomarkers in South Asians is not known. We describe the relationships between the metabolic syndrome and Lp(a), CRP, and homocysteine in South Asians. This was a cross-sectional study of 1000 South Asian participants in a CVD risk reduction program in the San Francisco Bay Area. Metabolic syndrome was defined by the International Diabetes Federation definition. Metabolic syndrome was present in 25.3% (n = 253) of the cohort. A significantly higher proportion of participants with metabolic syndrome had elevated CRP (p < 0.05) and homocysteine (p < 0.05) but not Lp(a) (p = 0.16). We identified a trend between increasing CRP (p < 0.05) and homocysteine (p < 0.05) with number of component risk factors of metabolic syndrome. After adjustment for confounders, Lp(a) was 5.93 ± 2.4 mg/dL lower in individuals with versus without metabolic syndrome, homocysteine was 0.68 ± 0.28 μmol/mL higher, and CRP was 0.50 ± 0.22 mg/dL higher (p < 0.05 for all). We describe a positive association between homocysteine and metabolic syndrome in South Asians and confirm prior studies of other racial groups showing a positive relationship between CRP and metabolic syndrome. To our knowledge, this is the first study to identify the negative relationship between Lp(a) and metabolic syndrome in South Asian men.