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Gender, obesity and repeated elevation of C-reactive protein: data from the CARDIA cohort
Shinya Ishii1, Arun S Karlamangla, Marcos Bote
1Department of Geriatric Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan. sishii76@gmail.com
Insights
High C-reactive protein (CRP) levels over 10 mg/L may indicate chronic inflammation, especially in obese women. Repeated elevations suggest chronic conditions, not just acute inflammation.
Area of Science:
- Biomedical research
- Epidemiology
- Inflammation markers
Background:
- C-reactive protein (CRP) above 10 mg/L traditionally signifies acute inflammation.
- Emerging evidence indicates that elevated CRP can also reflect chronic inflammatory processes.
- This challenges conventional exclusion of high CRP from chronic inflammation studies.
Purpose of the Study:
- To examine factors linked to repeated CRP elevations above 10 mg/L.
- To identify high-risk subgroups for persistent CRP elevation.
- To assess how CRP thresholds affect the likelihood of one-time versus repeated elevations.
Main Methods:
- Analysis of CRP measurements from 3,300 participants in the Coronary Artery Risk Development in Young Adults study.
- Longitudinal assessment of CRP levels between 1992/3 and 2005/6.
- Statistical analysis to identify associations and risk factors for repeated CRP elevation.
Main Results:
- 6.8% of participants had one-time CRP elevation (>10 mg/L), while 3.1% had repeated elevations.
- Repeated CRP elevation was associated with obesity, female gender, low income, and sex hormone use.
- Obese women (BMI > 31 kg/m²) showed the lowest probability (51%) of a single elevation, suggesting chronic inflammation.
Conclusions:
- Elevated CRP (>10 mg/L) in obese women is likely indicative of chronic inflammation.
- Current CRP thresholds may need re-evaluation for distinguishing acute from chronic inflammation, particularly in specific demographics.
- Further research into CRP as a marker for chronic inflammation in at-risk populations is warranted.
Abstract:
C-reactive Protein (CRP) measurements above 10 mg/L have been conventionally treated as acute inflammation and excluded from epidemiologic studies of chronic inflammation. However, recent evidence suggest that such CRP elevations can be seen even with chronic inflammation. The authors assessed 3,300 participants in The Coronary Artery Risk Development in Young Adults study, who had two or more CRP measurements between 1992/3 and 2005/6 to a) investigate characteristics associated with repeated CRP elevation above 10 mg/L; b) identify subgroups at high risk of repeated elevation; and c) investigate the effect of different CRP thresholds on the probability of an elevation being one-time rather than repeated. 225 participants (6.8%) had one-time and 103 (3.1%) had repeated CRP elevation above 10 mg/L. Repeated elevation was associated with obesity, female gender, low income, and sex hormone use. The probability of an elevation above 10 mg/L being one-time rather than repeated was lowest (51%) in women with body mass index above 31 kg/m(2), compared to 82% in others. These findings suggest that CRP elevations above 10 mg/L in obese women are likely to be from chronic rather than acute inflammation, and that CRP thresholds above 10 mg/L may be warranted to distinguish acute from chronic inflammation in obese women.
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