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Predictors of C-reactive protein in Tsimane' 2 to 15 year-olds in lowland Bolivia
T W McDade1, W R Leonard, J Burhop
1Laboratory for Human Biology Research, Department of Anthropology, Northwestern University, Evanston, Illinois 60208, USA. t-mcdade@northwestern.edu
Insights
Childhood immune activation, measured by C-reactive protein (CRP), is high in a Bolivian population. Younger age, pathogen exposure, and socioeconomic factors influence CRP levels, impacting child health and development.
Area of Science:
- Human biology
- Immunology
- Anthropology
Background:
- Infectious diseases significantly impact child morbidity and mortality globally.
- Immune system investment is a critical life-history trait affecting child growth and development.
- Understanding immune activation in children is crucial for public health interventions.
Purpose of the Study:
- To determine the distribution of C-reactive protein (CRP) levels by age and gender in Tsimane' children.
- To identify predictors of elevated CRP, including pathogen exposure, economic status, and acculturation.
- To assess CRP as a biomarker for immune activation and its relation to child health.
Main Methods:
- Cross-sectional study of 536 Tsimane' children aged 2-15 years in lowland Bolivia.
- Measurement of blood-spot C-reactive protein (CRP) concentrations.
- Statistical analysis to explore associations between CRP and demographic, environmental, and socioeconomic variables.
Main Results:
- Median CRP was 0.73 mg/L, with 12.9% exceeding 5 mg/L, indicating substantial immune activation.
- Younger age was the strongest predictor of higher CRP levels.
- Increased CRP correlated with higher pathogen exposure, lower economic resources, and greater maternal education.
Conclusions:
- C-reactive protein (CRP) serves as an objective biomarker for immune activation in children.
- Environmental factors and socioeconomic status significantly influence immune activation in this population.
- Immune activation pathways are critical for understanding child growth and health outcomes.
Abstract:
Infectious disease is a major global determinant of child morbidity and mortality, and energetic investment in immune defenses (even in the absence of overt disease) is an important life-history variable, with implications for human growth and development. This study uses a biomarker of immune activation (C-reactive protein) to investigate an important aspect of child health among the Tsimane', a relatively isolated Amerindian population in lowland Bolivia. Our objectives are twofold: 1) to describe the distribution of CRP by age and gender in a cross-sectional sample of 536 2-15-year-olds; and 2) to explore multiple measures of pathogen exposure, economic resources, and acculturation as predictors of increased CRP. The median blood-spot CRP concentration was 0.73 mg/l, with 12.9% of the sample having concentrations greater than 5 mg/L, indicating a relatively high degree of immune activation in this population. Age was the strongest predictor of CRP, with the highest concentrations found among younger individuals. Increased CRP was also associated with higher pathogen exposure, lower household economic resources, and increased maternal education and literacy. The measurement of CRP offers a direct, objective indicator of immune activation, and provides insights into a potentially important pathway through which environmental quality may shape child growth and health.
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