Elevated High-Sensitivity C-Reactive Protein in Metabolic Syndrome: A Cross-Sectional Analytical Study at Islamabad.

Background Metabolic syndrome (MetS) is frequently accompanied by chronic low-grade inflammation, but population-specific evidence remains limited in Pakistan. This study assessed the frequency of elevated high-sensitivity C-reactive protein (hs-CRP) among adults with MetS in Islamabad and examined associated cardiometabolic characteristics. Methods In a cross-sectional study at a tertiary care hospital in Islamabad, adults aged 30–60 years with MetS (ATP III–based criteria) were enrolled consecutively (n = 267). Elevated hs-CRP was defined as > 3 mg/L. Participants were compared by hs-CRP category (≤ 3 vs > 3 mg/L). Multivariable logistic regression evaluated independent predictors of elevated hs-CRP (predictors standardized per 1 SD). Model discrimination was assessed using AUC. Results The cohort included 139 women (52.1%) with mean age 45.5 ± 7.6 years. Median hs-CRP was 3.07 mg/L (IQR 2.08–4.53), and elevated hs-CRP (> 3 mg/L) was present in 140/267 participants (52.4%; 95% CI 46.5%–58.3). Compared with hs-CRP ≤ 3 mg/L, participants with hs-CRP > 3 mg/L had higher waist circumference (100.8 ± 9.5 vs 97.3 ± 10.3 cm; p = 0.005), higher fasting glucose (132.4 ± 17.4 vs 124.8 ± 20.2 mg/dL; p = 0.001), and higher MetS component count (4.0 ± 0.7 vs 3.7 ± 0.7; p = 0.006). In multivariable analysis, elevated hs-CRP was independently associated with waist circumference (aOR 1.48; 95% CI 1.12–1.95; p = 0.005), triglycerides (aOR 1.39; 95% CI 1.06–1.82; p = 0.018), and fasting glucose (aOR 1.60; 95% CI 1.22–2.09; p < 0.001); model discrimination was moderate (AUC = 0.695). Conclusion Elevated hs-CRP is common among adults with MetS in Islamabad and is independently associated with central adiposity, triglycerides, and fasting glucose. These findings support the inflammatory-metabolic phenotype of MetS and justify prospective evaluation of hs-CRP for risk refinement in Pakistani populations.