The metabolic syndrome is associated with inflammatory cytokines, including TNF-alpha, IL-6 and CRP. The role of these inflammatory markers in the etiology of cardiovascular disease is unclear, although investigators have speculated that anti-inflammatory therapy may have a role in the prevention of cardiovascular disease in this population. The purpose of the study is to examine the role of TNF-alpha blockade on other inflammatory markers predictive of CAD and on adiponectin, a newly recognized adipokine that may be protective against atherosclerosis. Although little is known about adiponectin's regulation, in vitro data from both animals and humans, suggest that TNF-alpha may cause suppression of adiponectin, thus worsening insulin sensitivity and dampening adiponectin's anti-inflammatory and antiatherosclerotic effects. The study will be a randomized double blind placebo controlled trial in metabolic syndrome subjects using Etanercept, a TNF-alpha antagonist, to evaluate the effect of TNF-alpha blockade on inflammatory cytokines, adiponectin levels, and insulin resistance. Insulin resistance will be evaluated with an insulin modified IV glucose tolerance test. Inflammatory cytokines, adiponectin, and insulin resistance will be measured before, during and after Etancercept treatment.
| Bernstein, L Elizabeth; Berry, Jacqueline; Kim, Sunnie et al. (2006) Effects of etanercept in patients with the metabolic syndrome. Arch Intern Med 166:902-8 |
