Body Mass Index, High-Sensitivity C-Reactive Protein and Mortality in Chinese with Coronary Artery Disease

Abstract

BackgroundTo investigate single and joint associations of body mass index (BMI) and serum high-sensitivity C-reactive protein (hsCRP) with death.MethodsThe study included 1871 coronary artery disease (CAD) patients aged 40–85 year-old recruited from 2008 to 2011. Cox regression models were used to estimate the association of BMI and hsCRP with mortality. The data was analyzed in 2014.ResultsDuring 3.1 years follow-up, 141 deaths were recorded, 110 died of cardiovascular disease (CVD). After adjustment of major CVD risk factors, there was a J-shaped association between BMI and all-cause and CVD mortality, and a positive association between hsCRP and mortality. The J-shaped association of BMI with mortality was present among patients who never smoked or with elevated hsCRP (≥3.0 mg/L). Compared with overweight (BMI 24–27.9 kg/m2) patients with normal hsCRP (<3.0 mg/L), obese patients (BMI≥28 kg/m2) with elevated hsCRP had a 3.41-fold risk of all-cause mortality (95% CI 1.49–7.80) and a 3.50-fold risk of CVD mortality (1.40–8.75), lean patients (BMI<24 kg/m2) with elevated hsCRP concentration had a 2.54-fold risk of all-cause mortality (1.36–4.74) and a 2.36-fold risk of CVD mortality (1.19–4.70).ConclusionsThe association pattern between baseline BMI and mortality changed among different baseline hsCRP concentrations, indicating that low-grade inflammation may be related to BMI and secondary prognosis of CAD.

High Sensitivity C-Reactive Protein Predictive Value for Cardiovascular Disease: A Nested Case Control from Isfahan Cohort Study (ICS)

“…Although in several studies a positive relationship was observed between BMI status and hs-CRP levels, our findings were not significant [29][30][31][32][33]. Possible explanation for this strange result might be malnutrition-inflammation syndrome.…”

“…Due to inflammation responses in the body, and especially in acute phase responses, anorexia and promotion of catabolic process stimulating protein degradation would occur, which consequently declining BMI levels and CVDs risks. Furthermore, nature of the inflammation creates defense against injurious stimuli, therefore, mild elevation in inflammatory biomarkers specifically hs-CRP, which are mostly observed in overweight persons, have another explanation [32]. Several longstanding comprehensive studies are necessary to investigate the exact associations of body weight with hs-CRP values in order to predict the CVDs likelihood.…”

Lean body mass and creatine kinase are associated with reduced inflammation in obesity

“…This is reported in several cross‐sectional studies and meta‐analyses . Additionally, lost weight reduced C‐reactive protein (CRP) , and obesity‐related inflammation has been associated with increased risk of cardiovascular diseases (CVD), CVD‐mortality and overall mortality . Obesity stimulates production of a number of molecules including pro‐inflammatory metabolites (adipokines) in adipose tissue, and several of them are linked to overweight .…”

Interactions between C-reactive protein and traditional risk factors in predicting mortality of older adults

“…In our study the cut point was set at a BMI of 30 kg/m 2 , whereas in the third National Health and Nutrition Examination Survey the cut point was 25 kg/m 2 . Different results were seen in a Japanese study [23] that divided the cohort of 1,871 patients with coronary artery disease into three groups: BMI < 24 kg/m 2 , 24.0-27.9 kg/ m 2 and ≥ 28 kg/m 2 . Using the group with a BMI of 24.0-27.9 kg/m 2 and CRP < 3 mg/L as reference, the hazard ratio was 1.16 for the group with the same BMI but with CRP values of ≥ 3 mg/L.…”