Systematic review: Inflammatory biomarkers and residual cardiovascular risk in patients with metabolic syndrome
DOI:
https://doi.org/10.33448/rsd-v15i5.51098Keywords:
Metabolic Syndrome, Inflammation, Biomarkers, Cardiovascular Risk, Atherosclerosis, Preventive Medicine.Abstract
Metabolic syndrome is a significant public health problem, characterized by the association between central obesity, insulin resistance, hypertension, dyslipidemia, and alterations in glucose metabolism—factors that significantly increase the risk of cardiovascular events. Recent evidence demonstrates that chronic low-grade inflammation plays a fundamental role in the pathophysiology of metabolic syndrome and the progression of atherosclerosis, highlighting the relevance of inflammatory biomarkers, such as high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor alpha, and adiponectin, in the stratification of residual cardiovascular risk. In this context, the present study aims to critically analyze the scientific evidence regarding the association between inflammatory biomarkers and cardiovascular risk in patients with metabolic syndrome, through an integrative literature review conducted in the PubMed, SciELO, and Embase databases. It is expected that a correlation will be identified between elevated levels of these biomarkers and a higher occurrence of adverse cardiovascular outcomes, reinforcing the potential for their incorporation into clinical practice for a more accurate assessment of cardiovascular risk and for the development of more individualized therapeutic strategies.
References
Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., et al. (2009). Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120(16), 1640–1645
Baek, J. H., Park, S. Y., Choi, H. J., et al. (2024). Association of inflammatory status with metabolically unhealthy phenotypes in adults. International Journal of Molecular Sciences, 25(21), 11540
Blaha, M. J., Budoff, M. J., DeFilippis, A. P., et al. (2011). Associations between C-reactive protein, coronary artery calcium, and cardiovascular events. Journal of the American College of Cardiology, 57(1), 37–45
Dallmeier, D., Larson, M. G., Vasan, R. S., Keaney, J. F., Fontes, J. D., & Benjamin, E. J. (2012). Multiple biomarkers and the metabolic syndrome: The Framingham Offspring Study. Metabolism: Clinical and Experimental, 61(4), 463–470
Esser, N., Legrand-Poels, S., Piette, J., et al. (2014). Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Research and Clinical Practice, 105(2), 141–150
Grundy, S. M. (2016). Metabolic syndrome update. Trends in Cardiovascular Medicine, 26(4), 364–373
Hansson, G. K. (2005). Inflammation, atherosclerosis, and coronary artery disease. New England Journal of Medicine, 352(16), 1685–1695.
Kwaśniewska, M., Kozińska, J., Dziankowska, M., et al. (2015). The association between inflammatory biomarkers, endothelial dysfunction and metabolic syndrome. Diabetology & Metabolic Syndrome, 7(81), 1–9
Libby, P. (2021). The changing landscape of atherosclerosis. Nature, 592(7855), 524–533
Libby, P., Ridker, P. M., & Hansson, G. K. (2009). Inflammation in atherosclerosis: From pathophysiology to practice. Journal of the American College of Cardiology, 54(23), 2129–2138
Lim, J. H., Kim, S. Y., Lee, M. K., et al. (2024). C-reactive protein-to-albumin ratio and incident metabolic syndrome in adults: A longitudinal cohort study. Cardiovascular Diabetology, 23(114), 1–13
LURIC Study Group. (2025). Inflammatory biomarkers and residual cardiovascular risk in patients with metabolic dysfunction. International Journal of Molecular Sciences, 26(15), 7335
Page, M. J. et al. (2022). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Rev Panam Salud Publica. 46:e112. doi: 10.26633/RPSP.2022.112.
Pearson, T. A., Mensah, G. A., Alexander, R. W., et al. (2003). Markers of inflammation and cardiovascular disease: Application to clinical and public health practice. Circulation, 107(3), 499–511
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [Free ebook]. Santa Maria. Editora da UFSM.
Ridker, P. M. (2016). From C-reactive protein to interleukin-6 to interleukin-1: Moving upstream to identify novel targets for atheroprotection. Circulation Research, 118(1), 145–156
Ridker, P. M., Danielson, E., Fonseca, F. A. H., et al. (2008). Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. New England Journal of Medicine, 359(21), 2195–2207
Ridker, P. M., Everett, B. M., Thuren, T., et al. (2017). Antiinflammatory therapy with canakinumab for atherosclerotic disease. New England Journal of Medicine, 377(12), 1119–1131
Risemberg, R. I. C. et al. (2026). A importância da metodologia científica no desenvolvimento de artigos científicos. E-Acadêmica, 7(1), e0171675. https://eacademica.org/eacademica/article/view/675
Ross, R. (1999). Atherosclerosis—An inflammatory disease. New England Journal of Medicine, 340(2), 115–126
Wei, L., Liu, X., Chen, Y., et al. (2025). Systemic inflammation and metabolic syndrome across different age groups: A population-based analysis. The Journal of Clinical Endocrinology & Metabolism, 110(3), 634–645
Xue, J., Zhang, Y., Wang, H., et al. (2022). Association between high-sensitivity C-reactive protein and metabolic syndrome: A systematic review and meta-analysis. Nutrition & Metabolism, 19(12), 1–14
Ying, Z., Xu, H., Zhao, L., et al. (2025). Predictive value of inflammation-metabolic indices for cardiovascular mortality in metabolic syndrome. Diabetology & Metabolic Syndrome, 17(47), 1–12
Yudkin, J. S., Stehouwer, C. D. A., Emeis, J. J., & Coppack, S. W. (1999). C-reactive protein in healthy subjects: Associations with obesity, insulin resistance, and endothelial dysfunction. Atherosclerosis, 148(1), 197–204
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Cintia Luciana Alves Santos, Marcus Vinicius da Silva, Lillian dos Santos Rodrigues, Wallace Peyroton do Couto, Yan do Rosario Nunes, Luiz Sergio Costa Fernandes Filho, João Victor de Souza Maciel, Lucas Galhardo Jagl de Mello, Livia Thurler de Mendonça, Rafael Guerra dos Santos
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
