[Inflammatory markers; C-reactive protein (CRP) and serum amyloid A (SAA)]

C-reactive protein (CRP) and serum amyloid A (SAA) are sensitive acute phase reactants. Both, but predominantly CRP in Japan, have long been used for monitoring inflammatory diseases. During the recent wave of measuring both at low concentration ranges and utilizing these values to clarity certain disorders involving low grade inflammation, we need to remain aware of factors other than apparent inflammation that can influence these values. These include age, obesity, hyperlipidemia, glucose intolerance, silent atherosclerosis, and therapeutic use of hypolipidemic agents or glucocorticoid. Genetic polymorphism may also be an influence; especially an allelic variant of SAA1 has been proposed to have a positive effect on SAA concentrations. Understanding this, these values should not be evaluated at a single sampling point but used kinetically in the individual.