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Confounders in Identification and Analysis of Inflammatory Biomarkers in Cardiovascular Diseases

Qurrat Ul Ain1, Mehak Sarfraz2, Gayuk Kalih Prasesti1

  • 1Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Bandung Institute of Technology, Bandung 40132, Indonesia.

Biomolecules
|October 23, 2021
PubMed

Insights

Systemic inflammation, measured by biomarkers like C-reactive protein (CRP) and interleukins (IL), is linked to cardiovascular disease. This review examines how demographic, lifestyle, and analytical factors affect these key inflammatory biomarker levels.

Area of Science:

  • Biomedical Science
  • Epidemiology
  • Immunology

Background:

  • Proinflammatory biomarkers are crucial for studying systemic inflammation and cardiovascular diseases (CVD).
  • While elevated inflammatory biomarkers correlate with CVD pathology, underlying mechanisms remain unclear.
  • Identifying biomarkers like cytokines, chemokines, and acute-phase proteins aids early disease diagnosis.

Purpose of the Study:

  • To review and summarize the impact of demographic, epidemiological, medication, and analytical factors on serum inflammatory biomarker concentrations.
  • To investigate variations in key biomarkers including C-reactive protein (CRP), Interleukin-1 beta (IL-1b), Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNFa), and soluble TNF receptors.
  • To understand how confounding variables influence the measurement and interpretation of inflammatory biomarkers in research.

Main Methods:

  • Systematic review of studies investigating inflammatory biomarkers and CVD.
  • Analysis of factors influencing biomarker concentrations: age, sex, BMI, medication use, lifestyle, and medical history.
  • Examination of pre-analytical (sample collection, storage) and analytical (assay methods, data processing) variations.
  • Focus on specific biomarkers: CRP, IL-1b, IL-6, TNFa, and soluble TNF receptors.

Main Results:

  • Demographic factors (age, sex) and lifestyle (BMI, substance use) significantly influence biomarker levels.
  • Medication use and co-existing medical conditions introduce variability in inflammatory marker concentrations.
  • Pre-analytical and analytical inconsistencies can lead to significant variations in reported biomarker results.
  • Specific patterns of variation were observed for CRP, IL-1b, IL-6, TNFa, and soluble TNF receptors.

Conclusions:

  • Confounding factors, including demographic, epidemiological, and analytical variables, critically affect inflammatory biomarker concentrations.
  • Standardization of methodologies is essential to reduce variability and improve the reliability of biomarker studies in CVD research.
  • Further research is needed to elucidate the precise mechanisms linking inflammation and CVD, accounting for these influential factors.

Keywords:
acute-phase proteinschemokinesconfounding factorscytokinesdemographic factorsepidemiological factorsinflammationpre-analytical factorspro-inflammatory biomarkers

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