What other findings are suggestive of the Insulin Resistance Syndrome?
SW displays several indicators that have been associated with the Insulin Resistance Syndrome. First, he has an elevated high sensitivity C-reactive protein (hs CRP) level, a marker of inflammation that has been associated with insulin resistance and which may identify patients at high risk for the development of acute coronary syndromes.2 His elevated plasma uric acid concentration, although not a sensitive predictor of insulin resistance, does increase the likelihood that he is insulin resistant. SW is also overweight—his BMI is 30 and his waist measurement is >40 inches. His microalbumin/creatinine ratio is high-normal; it should be monitored for progression to overt microalbuminuria (>30 µg/mg creatinine). Elevated albumin excretion is believed to represent a functional endothelial abnormality related to his underlying vascular disease process.
