C-Reactive Protein as a Risk Factor for Coronary Heart Disease: A Systematic Review and Meta-analyses for the U.S. Preventive Services Task Force

Buckley, David I; Fu, Rongwei; Freeman, Michele; Rogers, Kevin; Helfand, Mark

doi:10.7326/0003-4819-151-7-200910060-00009

Cited by 476 publications

(371 citation statements)

References 98 publications

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“…Serum CRP levels are well studied as sensitive circulating markers of inflammation, as CRP is independently associated with an increased risk of cardiovascular disease and diabetes (18)(19)(20)(21)(22). In addition to these previous associations, our study identifies new information regarding CRP and disease outcomes.…”

Section: Discussionmentioning

confidence: 67%

Serum High-Sensitivity C-Reactive Protein Levels Are Associated With High Risk of Development, Not Progression, of Diabetic Nephropathy Among Japanese Type 2 Diabetic Patients: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT7])

et al. 2014

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OBJECTIVETo assess the prospective association between baseline serum hs-CRP concentration and the subsequent risk of development or progression of diabetic nephropathy. RESEARCH DESIGN AND METHODSLongitudinal data were obtained from 2,518 patients with type 2 diabetes registered in a Japanese diabetes registry. To assess the independent correlations between serum baseline hs-CRP and either the development or progression of diabetic nephropathy 1 year later, the Cox proportional hazards model was used and adjusted for potential confounders. RESULTSThe mean patient age, BMI, and HbA 1c level were 66.1 years, 24.6 kg/m 2 , and 7.5% (57.6 mmol/mol), respectively. Baseline serum hs-CRP levels were significantly associated with the urinary albumin-to-creatinine ratio at baseline (P < 0.001). Multivariable adjusted hazard ratio for the development from normoalbuminuria to microalbuminuria was 1.31 (95% CI 0.80-2.17; P = 0.286), 1.55 (1.16-2.08; P = 0.003), and 1.57 (1.22-2.03; P = 0.001), respectively, for the second, third, and fourth quartiles of serum hs-CRP levels, showing a statistically significant linear trend across categories (P < 0.001). We did not observe a significant association between hs-CRP levels and the subsequent risk of diabetic nephropathy progression (P for trend = 0.575). CONCLUSIONSSerum hs-CRP levels, independent of possible confounders, were associated with a subsequent risk of developing, not progressing, diabetic nephropathy in type 2 diabetic patients. Serum hs-CRP may be useful for predicting the future risk of developing diabetic nephropathy.

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Section: Discussionmentioning

confidence: 67%

Serum High-Sensitivity C-Reactive Protein Levels Are Associated With High Risk of Development, Not Progression, of Diabetic Nephropathy Among Japanese Type 2 Diabetic Patients: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT7])

et al. 2014

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“…The participants categorised into the Low PA group according to the IPAQ-E had a mean hs-CRP .3 mg/l. In clinical practice, hs-CRP .3 mg/l is classified as indicating a high risk for a cardiac event (28,29) . This suggests that the IPAQ-E was able to indicate participants having this risk factor.…”

Section: Discussionmentioning

confidence: 99%

The International Physical Activity Questionnaire modified for the elderly: aspects of validity and feasibility

Hurtig-Wennlöf

Hagströmer

Olsson

2010

Public Health Nutr.

193

175

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Objective: To modify the self-administered, short version of the International Physical Activity Questionnaire (IPAQ) for adults to be used in the elderly (aged 65 years and above), and to validate this modified IPAQ for the elderly (IPAQ-E). Design: A direct validity study using accelerometer-measured physical activity (PA) as the criterion measure, and an indirect criterion validity study using highsensitivity C-reactive protein (hs-CRP) as a biological marker of activity. Setting: Organisations for retired persons in Sweden. Subjects: The direct validity study consisted of fifty-four participants and the indirect criterion validity study consisted of 359 participants. All participants were retired persons (66-91 years) living independently. Results: All self-reported activity domains (sitting, walking, moderate and vigorous) were positively correlated with the corresponding variable objectively assessed by an accelerometer (r 5 0?277-0?471), but a systematic error was observed. The specificity of IPAQ-E to identify low-active participants was 85 %, and the sensitivity to identify the more active participants was 81 %. A main effect of IPAQ-E category (Low, Moderate or High) was observed for hs-CRP (P 5 0?041). Conclusions: We found this modified version of IPAQ, the IPAQ-E, to be well accepted by our sample of socially active elderly. It provided acceptable estimates of PA, well in line with other questionnaires, even though it had a systematic error. The IPAQ-E was able to identify an expected response of a biomarker (hs-CRP) to PA. We recommend the use of the IPAQ-E to classify participants aged 65 years and above into PA categories, to rank individuals or to identify individuals meeting certain PA criteria. Keywords AccelerometryElderly International Physical Activity Questionnaire Physical activityTo promote and maintain health, regular physical activity (PA) is essential. In both men and women, individuals with a high level of PA have been shown to have a longer life expectancy than more sedentary individuals (1,2) . More recently, positive effects of PA have also been reported on cognitive functions (3,4) as well as on depression and anxiety disorders (5) . The level and pattern of PA and various health markers have been extensively studied in young and middle-aged groups, but not to the same extent in older adults (6) . The elderly (aged 65 years and above) are a rapidly growing age group in many countries, and therefore merit special attention with regard to PA behaviour and its effect on health.Most PA assessment methods have been developed for young-to-middle-aged participants, and just a few activity questionnaires have been developed specifically for the elderly participants (7) . This holds true also for the International Physical Activity Questionnaire (IPAQ, available at www.ipaq.ki.se (8) ), which was developed by an international consensus group in 1998, primarily for international surveillance studies of PA in adults aged 18-65 years (9) . The short-format IPAQ (10) and the long-form...

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“…While it is clear that minor CRP level elevation is associated with a moderately increased relative risk of future myocardial infarction (18,19), many studies have shown that CRP determination adds little to a thorough evaluation of known risk factors (12,20,21). Risk factors are merely epidemiologically determined associations.…”

Section: Why Does Minor Crp Level Elevation Predict Coronary Events?mentioning

confidence: 99%

A unifying biologic explanation for “high‐sensitivity” C‐reactive protein and “low‐grade” inflammation

Kushner¹,

Samols²,

Magrey³

2010

Arthritis Care & Research

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C-Reactive Protein as a Risk Factor for Coronary Heart Disease: A Systematic Review and Meta-analyses for the U.S. Preventive Services Task Force

Cited by 476 publications

References 98 publications

Serum High-Sensitivity C-Reactive Protein Levels Are Associated With High Risk of Development, Not Progression, of Diabetic Nephropathy Among Japanese Type 2 Diabetic Patients: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT7])

Serum High-Sensitivity C-Reactive Protein Levels Are Associated With High Risk of Development, Not Progression, of Diabetic Nephropathy Among Japanese Type 2 Diabetic Patients: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT7])

The International Physical Activity Questionnaire modified for the elderly: aspects of validity and feasibility

A unifying biologic explanation for “high‐sensitivity” C‐reactive protein and “low‐grade” inflammation

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