Elevated C-reactive protein levels in overweight and obese adults

Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 01/2000; 282(22):2131-5.
Source: PubMed


Human adipose tissue expresses and releases the proinflammatory cytokine interleukin 6, potentially inducing low-grade systemic inflammation in persons with excess body fat.
To test whether overweight and obesity are associated with low-grade systemic inflammation as measured by serum C-reactive protein (CRP) level.
The Third National Health and Nutrition Examination Survey, representative of the US population from 1988 to 1994.
A total of 16616 men and nonpregnant women aged 17 years or older.
Elevated CRP level of 0.22 mg/dL or more and a more stringent clinically raised CRP level of more than 1.00 mg/dL.
Elevated CRP levels and clinically raised CRP levels were present in 27.6% and 6.7% of the population, respectively. Both overweight (body mass index [BMI], 25-29.9 kg/m2) and obese (BMI, > or =30 kg/m2) persons were more likely to have elevated CRP levels than their normal-weight counterparts (BMI, <25 kg/m2). After adjustment for potential confounders, including smoking and health status, the odds ratio (OR) for elevated CRP was 2.13 (95% confidence interval [CI], 1.56-2.91) for obese men and 6.21 (95% CI, 4.94-7.81) for obese women. In addition, BMI was associated with clinically raised CRP levels in women, with an OR of 4.76 (95% CI, 3.42-6.61) for obese women. Waist-to-hip ratio was positively associated with both elevated and clinically raised CRP levels, independent of BMI. Restricting the analyses to young adults (aged 17-39 years) and excluding smokers, persons with inflammatory disease, cardiovascular disease, or diabetes mellitus and estrogen users did not change the main findings.
Higher BMI is associated with higher CRP concentrations, even among young adults aged 17 to 39 years. These findings suggest a state of low-grade systemic inflammation in overweight and obese persons.

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Available from: Lex Bouter, Jul 01, 2014
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    • "High-sensitivity C-reactive protein (hs-CRP), an acute phase reactant and a marker for systemic inflammation, has been found to be associated with future cardiovascular disease (CVD) events and mortality (Buckley et al., 2009; Kengne et al., 2012; Libby et al., 2002; Ridker, 2003; Ridker et al., 2000; Strandberg and Tilvis, 2000) as well as with single CVD risk factors (RFs), including obesity or body mass index (BMI) (Arena et al., 2006; Ganguli et al., 2011; Ishii et al., 2012; Khoo et al., 2011; Strandberg and Tilvis, 2000; Visser et al., 1999), smoking (Khoo et al., 2011; Strandberg and Tilvis, 2000), blood pressure (Khoo et al., 2011; Lakoski et al., 2005), serum cholesterol (Chiu et al., 2012; Ganguli et al., 2011), and diabetes (Chiu et al., 2012). However, no data are available on the associations between having a favorable level of all CVD RFs (i.e., low risk — LR) at younger ages and hs-CRP levels at older ages. "
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    ABSTRACT: Objectives: Examine associations of favorable levels of all cardiovascular disease (CVD) risk factors (RFs) [i.e., low risk (LR)] at younger ages with high sensitivity C-reactive protein (hs-CRP) at older ages. Methods: There were 1,324 participants ages 65-84 years with hs-CRP ≤ 10mg/l from the Chicago Healthy Aging Study (2007-2010), CVD RFs assessed at baseline (1967-73) and 39 years later. LR was defined as untreated blood pressure (BP) ≤120/≤80 mmHg, untreated serum total cholesterol <200 mg/dL, body mass index (BMI) <25 kg/m(2), not smoking, no diabetes. Hs-CRP was natural log-transformed or dichotomized as elevated (≥3 mg/l or ≥2 mg/l) vs. otherwise. Results: With multivariable adjustment, the odds ratios (95% confidence intervals) for follow-up hs-CRP ≥3 mg/ in participants with baseline 0RF, 1RF and 2+RFs compared to those with baseline LR were 1.35 (0.89-2.03), 1.61(1.08-2.40) and 1.69(1.04-2.75), respectively. There was also a graded, direct association across four categories of RF groups with follow-up hs-CRP levels (β coefficient/P-trend = 0.18/0.014). Associations were mainly due to baseline smoking and BMI, independent of 39-year change in BMI levels. Similar trends were observed in gender-specific analyses. Conclusions: Favorable levels of all CVD RFs in younger age are associated with lower hs-CRP level in older age.
    Full-text · Article · Dec 2015
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    • "C-reactive protein levels reflect inflammation of coronary vessels related to the formation and severity of the atherogenic plaque or inflammation related to myocardial ischemia or necrosis[20]. Also, it has been suggested that plasma CRP levels reflect the amount and activity of pro-inflammatory cytokines such as IL-1, tumor necrosis factor-a, and IL-6, which are implicated in the process oferosclerotic plaque formation and acute coronary syndromes[17,18,20,21]. Interleukin-6 is secreted in several sites including activated macrophages and lymphocytes but also in adipose tissue. "

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    • "Genetic deficiency of the pro-inflammatory cytokine TNF in mouse models for diet-induced obesity delayed the development of insulin resis- tance[11]. The importance of this finding was corroborated by the observation that DM2 patients have chronic systemic presence of pro-inflammatory mediators in their circulation121314. Roughly ten years later, two pivotal studies demonstrated that obesity is associated with the accumulation of pro-inflammatory macrophages in visceral adipose tissue (VAT)[15,16]. "
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    ABSTRACT: Adipose tissue provides the body with a storage depot of nutrients that is drained during times of starvation and replenished when food sources are abundant. As such, it is the primary sensor for nutrient availability in the milieu of an organism, which it communicates to the body through the excretion of hormones. Adipose tissue regulates a multitude of body functions associated with metabolism, such as gluconeogenesis, feeding and nutrient uptake. The immune system forms a vital layer of protection against micro-organisms that try to gain access to the nutrients contained in the body. Because infections need to be resolved as quickly as possible, speed is favored over energy-efficiency in an immune response. Especially when immune cells are activated, they switch to fast, but energy-inefficient anaerobic respiration to fulfill their energetic needs. Despite the necessity for an effective immune system, it is not given free rein in its energy expenditure. Signals derived from adipose tissue limit immune cell numbers and activity under conditions of nutrient shortage, whereas they allow proper immune cell activity when food sources are sufficiently available. When excessive fat accumulation occurs, such as in diet-induced obesity, adipose tissue becomes the site of pathological immune cell activation, causing chronic low-grade systemic inflammation. Obesity is therefore associated with a number of disorders in which the immune system plays a central role, such as atherosclerosis and non-alcoholic steatohepatitis. In this review, we will discuss the way in which adipose tissue regulates activity of the immune system under healthy and pathological conditions.
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