Association of bronchial hyperresponsiveness and lung function with C-reactive protein (CRP): a population based study

Abstract

Background: C-reactive protein (CRP), a marker of systemic inflammation, is a powerful predictor of adverse cardiovascular events. Respiratory impairment is also associated with cardiovascular risk. Although some studies have found an inverse relationship between lung function and markers of systemic inflammation, only one study has reported a relationship between lung function and CRP levels. In contrast, little is known about the relationship between bronchial hyperresponsiveness (BHR) and systemic inflammation. The association between lung function and CRP and between BHR and CRP has been investigated. Methods: As part of the European Community Respiratory Health Survey follow up study serum CRP levels, forced expiratory volume in 1 second (FEV 1 ), and BHR to methacholine (>20% decrease in FEV 1 to ,4 mg methacholine) were measured in 259 adults aged 28-56 years free of cardiovascular disease or respiratory infection. Results: Mean (SD) FEV 1 (adjusted for age, sex, height, and smoking status) was lower in subjects with a high CRP level (high tertile) (3.29 (0.44) l/s v 3.50 (0.44) l/s; p,0.001) and BHR was more frequent (41.9% v 24.9%; p = 0.005) than in subjects with lower CRP levels (low+middle tertiles). Similar results were obtained when the potential confounding factors were taken into account. Similar patterns of results were found in non-smokers and in non-asthmatic subjects. Conclusions: Increased CRP levels are strongly and independently associated with respiratory impairment and more frequent BHR. These results suggest that both respiratory impairment and BHR are associated with a systemic inflammatory process.

High-sensitive C-reactive protein is associated with reduced lung function in young adults

“…The temporal relationship between systemic inflammation and poor lung function is also unclear. Although several studies have explored this association [1,[10][11][12][13][14][15], each of these studies had certain limitations. Some of these studies were cross sectional in nature and unable to assess the temporal relationships [10,11].…”

“…Although several studies have explored this association [1,[10][11][12][13][14][15], each of these studies had certain limitations. Some of these studies were cross sectional in nature and unable to assess the temporal relationships [10,11]. Longitudinal studies have found that lung function decline was associated with raised levels of CRP at follow-up, but found little or no evidence that high levels of CRP predicted a subsequent decline in lung function.…”

A review of the Hispanic paradox: time to spill the beans?

“…However, there is also evidence that systemic inflammation plays a primary role in the development (and possibly progression) of these diseases [15,16]. This conclusion comes from numerous prospective studies showing that markers of systemic inflammation, notably elevated interleukin (IL)-6 or C-reactive protein (CRP), are consistently associated with an increased risk of COPD and lung cancer in both population and cohort studies [17][18][19][20][21][22][23][24]. In several prospective studies, elevated markers of systemic inflammation have been repeatedly associated with a decline in lung function in young adults [17][18][19] and COPD in adults [20][21][22].…”

“…This conclusion comes from numerous prospective studies showing that markers of systemic inflammation, notably elevated interleukin (IL)-6 or C-reactive protein (CRP), are consistently associated with an increased risk of COPD and lung cancer in both population and cohort studies [17][18][19][20][21][22][23][24]. In several prospective studies, elevated markers of systemic inflammation have been repeatedly associated with a decline in lung function in young adults [17][18][19] and COPD in adults [20][21][22]. Similarly, in numerous prospective studies of cancer, elevated systemic markers have been associated with the development of lung cancer 5-15 years later [23][24][25][26][27].…”

“…4) [15][16][17][18][19][20][21][22][23][24][25][26][27]. Moreover, a reduction in IL-6-mediated systemic inflammation, through the use of HMGCoA reductase inhibitors (statins), has been closely linked to improved outcomes and reduced mortality in COPD, and to reduced mortality and prevalence of lung cancer [16,32].…”