C-Reactive Protein as a Risk Predictor

Albert, Michelle A.; Ridker, Paul M.

doi:10.1161/circulationaha.106.613570

Cited by 65 publications

(27 citation statements)

References 63 publications

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“…The subjects of the current study were all patients with RA who experienced chronic inflammation, whereas the previous study subjects were either physically healthy adults (6,7) or subjects randomized from the general population (8). In addition, significant racial/ethnic differences in the distribution of CRP have been known to exist as well (48). Future studies should confirm the differences related to the background of the study population.…”

Section: Discussionmentioning

confidence: 98%

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

Kojima

Suzuki

et al. 2014

Arthritis Care & Research

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Objective. We previously reported that depression and inflammation have independent effects on pain severity in patients with rheumatoid arthritis (RA). Alexithymia is a personality trait characterized by deficits in cognitive processing and regulation of emotions. A broad association between alexithymia and various health problems has been suggested, including depression, inflammation, and pain. The objective of this study was to examine the independent influence of alexithymia on pain perception and its relationship to depression and inflammation. Methods. We evaluated 213 RA outpatients who completed self-administered questionnaires, including the Beck Depression Inventory-II (BDI-II) to measure depression severity, the 20-item Toronto Alexithymia Scale (TAS-20) to measure degree of alexithymia, and a visual analog scale to quantify perceived pain. Serum C-reactive protein (CRP) levels were measured to quantify inflammation severity.Results. An initial significant positive association between the TAS-20 score and pain severity (P ‫؍‬ 0.01) lost significance after controlling for BDI-II score and CRP level using regression analysis. An interaction was observed among alexithymia, depression, and inflammation with regard to perceived pain. Among those without alexithymia, pain severity increased linearly with the CRP tertile levels regardless of the presence of depression (P < 0.001 for trend). No linear association between pain severity and CRP level was observed among those with alexithymia. Moreover, depressed patients with alexithymia (BDI-II score >14 and TAS-20 score >61) reported severe pain even at low CRP levels. Conclusion. Alexithymia might have a substantial role in pain perception as well as depression in patients with RA. A biopsychosocial approach is essential to achieve better pain control. INTRODUCTIONRheumatoid arthritis (RA) is a chronic disease in which an autoimmune disorder causes inflammation of the joints and surrounding tissues. Patients with RA experience persistent pain, arising from inflammation. This pain is also known to possess a strong emotional component and is affected by mood and psychosocial factors (1). We previously reported the independent influences of depression severity and inflammation on perceived pain in patients with RA (2). Both the depression score and the serum levels of C-reactive protein (CRP), a biomarker of inflammation, were significantly associated with pain, even after controlling for each other and for clinical covariates by regression analysis. Alexithymia is defined as a personality construct with difficulties in affective self-regulation (3). It has been proposed to be a cluster of cognitive and affective characteristics that are commonly observed among classic psychosomatic patients for whom therapy has been unsuccessful (4). Individuals with alexithymia tend to experience difficulties in identifying and describing their inner feelings and have a limited imaginary capacity and a preference for externally oriented thinking rather than introspection (3)....

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Section: Discussionmentioning

confidence: 98%

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

Kojima

Suzuki

et al. 2014

Arthritis Care & Research

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“…These prior data suggest that women generally have higher CRP levels than men and that African Americans, particularly AfricanAmerican women and south Asians generally have higher levels than white adults (34). In the Women's Health Study, African-American women had the highest CRP levels, Asian women had the lowest, and white and Hispanic women had levels in the intermediate range (37).…”

Section: Discussionmentioning

confidence: 98%

Obesity and C-reactive Protein Levels Among White, Black, and Hispanic US Adults

Wee¹,

Mukamal²,

Huang³

et al. 2008

Obesity

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Objective-Studies suggest that obesity's adverse impact on cardiovascular mortality may be reduced in African Americans relative to white Americans. We examined whether obesity's association with novel cardiovascular risk factors such as C-reactive protein (CRP) also varies by race and ethnicity.Methods and Procedures-We analyzed data from 10,492 white, African-American, and Hispanic-American participants of the 1999-2004 National Health and Nutrition Examination Survey, who were aged 20 years and older, with a BMI ≥18.5 kg/m 2 and CRP ≤10 mg/l. We fit sexspecific multivariable models of the association of BMI or waist circumference with log CRP levels and tested for interactions of BMI or waist circumference with race/ethnicity.Results-Higher BMI was significantly associated with higher CRP in all racial/ethnic groups for both men and women (P > 0.05 for BMI-race/ethnicity interaction) before and after adjustment for age, education, and health behaviors. Larger waist circumference was also associated with higher CRP levels in all racial/ethnic groups before and after adjustment; among women, the relationship was strongest for Mexican Hispanics (P < 0.01 for waist circumference-race/ethnicity interaction). Results were similar after additional adjustment for medications that might affect CRP levels.

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“…It is shown that the consumption of a high-fat food is associated with an elevation of plasma IL-6 concentrations that is greater in women than in men (Payette et al 2009). Data from healthy middle-aged postmenopausal women show that CRP and interleukin-6 predict cardiovascular disease risk in women and are of added value in the Framingham risk score for general cardiovascular disease (Albert and Ridker 2006). To date, we are unaware of any study demonstrating the impact of gender and diabetes on markers of oxidative stress such as serum HSP70 and ox-LDL level.…”

Section: Discussionmentioning

confidence: 99%

Serum heat shock protein 70 and oxidized LDL in patients with type 2 diabetes: does sex matter?

Nakhjavani

Morteza

Meysamie

et al. 2011

Cell Stress and Chaperones

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Several studies suggest that the response to various stressors differs between the sexes. We aimed to study serum HSP70 and levels of oxidized-LDL (ox-LDL) as markers of oxidative stress in men and women with type 2 diabetes. We quantified serum HSP70 and levels of ox-LDL in three cohorts; patients with newly diagnosed diabetes, patients with long-standing diabetes and normal controls. The cohort of patients with newly diagnosed diabetes was followed up for 3 months under glucoselowering therapy with metformin. Our findings showed that serum HSP70 level was increased in women with long-standing diabetes in comparison with men. HSP70 did not decrease after glucose lowering therapy in women with newly diagnosed diabetes, but it did decrease in men. There was no significant difference on ox-LDL between men and women in any of the studied cohorts. It decreased significantly in the cohort of patients with newly diagnosed diabetes after treatment, regardless of sex. There was no significant correlation between HSP70 and ox-LDL in any of the studied cohorts except among normal women. We suggest that diabetes induces an immune response and impairs cellular defense mechanisms against oxidative stress more commonly in women with type 2 diabetes than in men.

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C-Reactive Protein as a Risk Predictor

Cited by 65 publications

References 63 publications

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

Alexithymia, Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis

Obesity and C-reactive Protein Levels Among White, Black, and Hispanic US Adults

Serum heat shock protein 70 and oxidized LDL in patients with type 2 diabetes: does sex matter?

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