Distribution and Correlates of C-Reactive Protein Concentrations among Adult US Women

Ford, Earl S.; Giles, Wayne H.; Mokdad, Ali H.; Myers, Gary L.

doi:10.1373/clinchem.2003.027359

Cited by 170 publications

(166 citation statements)

References 39 publications

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“…CRP levels tended to be similar to some representative samples among comparable age groups from the USA (13,14) and New Zealand (15), but higher than those from Japan (16,17). Females tended to have higher levels than males in numerous population-based studies (18,19), although not all investigators observed a significant difference (20).…”

Section: Discussionmentioning

confidence: 64%

Correlates of C-reactive protein levels in young adults: a population-based cohort study of 3827 subjects in Brazil

Nazmi

Oliveira

Victora

2008

Braz J Med Biol Res

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The socio-demographic, behavioral and anthropometric correlates of C-reactive protein levels were examined in a representative young adult Brazilian population. The 1982 Pelotas Birth Cohort Study (Brazil) recruited over 99% of births in the city of Pelotas that year (N = 5914). Individuals belonging to the cohort have been prospectively followed up. In 2004up. In -2005.4% of the cohort was traced, members were interviewed and 3827 individuals donated blood. Analyses of the outcome were based on a conceptual model that differentiated confounders from potential mediators. The following independent variables were studied in relation to levels of C-reactive protein in sex-stratified analyses: skin color, age, family income, education, parity, body mass index, waist circumference, smoking, fat/fiber/alcohol intake, physical activity, and minor psychiatric disorder. Geometric mean (95% confidence interval) C-reactive protein levels for the 1919 males and 1908 females were 0.89 (0.84-0.94) and 1.96 mg/L (1.85-2.09), respectively. Pregnant women and those using oral contraceptive therapies presented the highest C-reactive protein levels and all sub-groups of women had higher levels than men (P < 0.001). Significant associations between C-reactive protein levels were observed with age, socioeconomic indicators, obesity status, smoking, fat and alcohol intake, and minor psychiatric disorder. Associations were stronger at higher levels of C-reactive protein and some associations were sex-specific. We conclude that both distal (socio-demographic) and proximal (anthropometric and behavioral) factors exert strong effects on C-reactive protein levels and that the former are mediated to some degree by the latter.

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Section: Discussionmentioning

confidence: 64%

Correlates of C-reactive protein levels in young adults: a population-based cohort study of 3827 subjects in Brazil

Nazmi

Oliveira

Victora

2008

Braz J Med Biol Res

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“…In addition, the smoking rate for Korean women is -5%, which is strikingly lower than for Korean men (12). Indeed, different ethnicity and lifestyle factors of Koreans may affect the inflammatory response in different ways (13)(14)(15) …”

Section: Introductionmentioning

confidence: 99%

Gender difference and determinants of C-reactive protein level in Korean adults

Lee

Shin

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: C-reactive protein (CRP) has emerged as an important predictor for cardiovascular disease (CVD). To facilitate clinical and public health interventions, CRP thresholds have been defined as follows: low-risk (-1.0 mg/L), average-risk (1.0-3.0 mg/L), and high-risk ()3.0 mg/L). However, these cut-off thresholds are based on distributions in Western populations, and do not distinguish between men and women. Methods: We examined CRP distribution, gender difference, and determinants of CRP concentrations ranging from 0.02 mg/L to 10.0 mg/L, in 4923 Korean adults (2248 men; 2675 women) who received health checkups at Gangnam Severance Hospital from March 2006 to May 2007. Results: The distribution of CRP was highly skewed toward lower concentrations. CRP was higher in men than women, and the cut-off thresholds for the highrisk tertile of CRP concentrations corresponded to 1.01 mg/L in men and 0.62 mg/L in women, based on the current study population. Age, male gender, cigarette smoking, physical activity, body mass index, total cholesterol, high density lipoprotein cholesterol, g-glutamyltransferase, and uric acid were independently associated with CRP concentrations. Conclusions: CRP distribution and gender difference in Korean adults were found to be different from previous Western studies, although similar risk factors influence CRP concentrations. Our results suggest that ethnicity and gender specific cut-off thresholds

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“…Ordinarily, this process is an acute response resulting in rapid, major increases in inflammatory mediators released into the circulation. 1,2 In healthy, lean, non-elderly people, for example, blood concentrations of the acute-phase reactant C-reactive protein (CRP), which are normally less than 2 mg/L in men 3 and less than 2.5 mg/L in women, 4 can increase more than 1000-fold in response to infection or trauma. 2,5,6 Typically, a CRP value of 10 mg/L or more is considered indicative of clinically significant inflammation.…”

mentioning

confidence: 99%

Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training

Nicklas¹

2005

Canadian Medical Association Journal

217

146

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Review SynthèseT he biologic cascade of events that form the body's natural defenses against injury or infection is a vital part of the immune system. Ordinarily, this process is an acute response resulting in rapid, major increases in inflammatory mediators released into the circulation. 1,2 In healthy, lean, non-elderly people, for example, blood concentrations of the acute-phase reactant C-reactive protein (CRP), which are normally less than 2 mg/L in men 3 and less than 2.5 mg/L in women, 4 can increase more than 1000-fold in response to infection or trauma. 2,5,6 Typically, a CRP value of 10 mg/L or more is considered indicative of clinically significant inflammation. 7 However, recent evidence indicates that persistent elevations in circulating markers of inflammation, even when within the clinically normal range, are risk factors for cardiovascular disease in both middle-aged [8][9][10][11][12][13] and older [14][15][16][17][18][19] people. Recently, the US Centers for Disease Control and Prevention and the American Heart Association have stated that people with CRP values in the upper tertile of the adult population (> 3.0 mg/L) have a risk of cardiovascular disease that is double that of people whose CRP concentrations are less than 1.0 mg/L. 20In addition to CRP, interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), along with several other acutephase reactant proteins, cytokines and cytokine-soluble receptors, are strongly associated with increased risk for several chronic diseases, including cardiovascular disease, 12,17,21,22 diabetes mellitus 23,24 and disability. 25,26 IL-6 and TNF-α are both stimulators of CRP release from hepatocytes.27,28 It is not yet known which of these factors might be the most robust indicator of underlying inflammation, or whether the effects of these biomarkers are additive for risk prediction.As illustrated in Figure 1, behavioural factors are associated with chronic, low-grade states of inflammation (as measured by slightly elevated inflammatory biomarkers), and therefore with the several chronic diseases that are associated with inflammatory states. Since the risk estimates associated with elevated inflammation appear to be linear (e.g., the CRP category cut-offs for assessment of cardiovascular disease risk 20 are low risk < 1.0 mg/L, medium risk 1.0-3.0 mg/L and high risk > 3.0 mg/L), behavioural interventions that produce even slight reductions in inflammation may have clinically significant benefits. A few pharmacologic interventions such as use of angiotensin-converting-enzyme inhibitors and statins decrease inflammation, as evidenced by lowered CRP concentrations in prospective clinical trials. [29][30][31][32] Moreover, there are very promising data suggesting that decreasing body weight and increasing physical activity are just as effective as medication for reducing overall inflammation. The published effects of behavioural interventions involving weight loss and exercise training on inflammatory markers are reviewed here. Role of adiposity and weigh...

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Distribution and Correlates of C-Reactive Protein Concentrations among Adult US Women

Cited by 170 publications

References 39 publications

Correlates of C-reactive protein levels in young adults: a population-based cohort study of 3827 subjects in Brazil

Correlates of C-reactive protein levels in young adults: a population-based cohort study of 3827 subjects in Brazil

Gender difference and determinants of C-reactive protein level in Korean adults

Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training

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