Effects of Statins on Serum Inflammatory Markers: The U.S. National Health and Nutrition Examination Survey 1999-2004

Yoon, Sung Sug; Dillon, Charles; Carroll, Margaret D.; Illoh, Kachi; Ostchega, Yechiam

doi:10.5551/jat.5652

Cited by 30 publications

(28 citation statements)

References 32 publications

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“…Importantly, our study consistently showed that the use of statins is associated with decreased levels of CRP in the general population, as previously described in population-based studies and clinical trials [33,56-60]. Essentially, by confirming this well-known association between statin use and decreased levels of CRP, it demonstrates that we have used appropriate methods for patient selection.…”

Section: Discussionsupporting

confidence: 87%

Statin Use and Markers of Immunity in the Doetinchem Cohort Study

et al. 2013

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It has been suggested that statins can both stimulate and suppress the immune system, and thereby, may influence autoimmune diseases. Therefore, we studied effects of statins on innate and adaptive immunity, and self-tolerance by measuring serological levels of C-reactive protein (CRP), neopterin, immunoglobulin E (IgE) antibodies and the presence of autoantibodies (antinuclear antibodies (ANA) and IgM rheumatoid factor (RF)) in the general population. We conducted a nested case-control study within the population-based Doetinchem cohort. Data from health questionnaires, serological measurements and information on medication from linkage to pharmacy-dispensing records were available. We selected 332 statin users (cases) and 331 non-users (controls), matched by age, sex, date of serum collection, history of cardiovascular diseases, diabetes mellitus type II and stroke. Multivariate regression analyses were performed to estimate effect of statins on the immune system. The median level of CRP in statin users (1.28 mg/L, interquartile range (IQR): 0.59-2.79) was lower than in non-users (1.62 mg/L, IQR: 0.79-3.35), which after adjustment was estimated to be a 28% lower level. We observed an inverse association between duration of statin use and CRP levels. Elevated levels of IgE (>100 IU/mL) were more prevalent in statin users compared to non-users. A trend towards increased levels of IgE antibodies in statin users was observed, whereas no associations were found between statin use and levels of neopterin or the presence of autoantibodies. In this general population sub-sample, we observed an anti-inflammatory effect of statin use and a trend towards an increase of IgE levels, an surrogate marker for Th (helper) 2 responses without a decrease in neopterin levels, a surrogate marker for Th1 response and/or self-tolerance. We postulate that the observed decreased inflammatory response during statin therapy may be important but is insufficient to induce loss of self-tolerance.

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Section: Discussionsupporting

confidence: 87%

Statin Use and Markers of Immunity in the Doetinchem Cohort Study

et al. 2013

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“…In clinical trials, statin use has been associated with decreasing CRP levels over the short and long term . Cross‐sectional population‐based studies, in which statin use was associated with lower CRP levels, have supported these results . Given the increasing prevalence of statin drug usage, population‐wide CRP levels may be decreasing along with decreasing cholesterol levels .…”

Section: Discussionmentioning

confidence: 91%

Long‐Term Variability of Inflammatory Markers and Associated Factors in a Population‐Based Cohort

Nash

Cruickshanks

Klein

et al. 2013

J American Geriatrics Society

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OBJECTIVES To investigate long-term variability in serum high sensitivity C-reactive protein (CRP) and interleukin-6 (IL-6) and to determine associated risk factors for high risk inflammatory profiles. DESIGN Prospective population-based cohort study. PARTICIPANTS Participants (N=1,443) of the Epidemiology of Hearing Loss Study and the Beaver Dam Eye Study, two population-based prospective studies of aging in the same cohort. MEASUREMENTS Among participants aged 43–79 years at the initial exam (1988–1990), serum high sensitivity CRP was measured from three time-points (1988–1990, 1998–2000, 2009–2010) and serum IL-6 was measured from two (1998–2000 and 2009–2010). RESULTS When IL-6 levels were categorized into tertiles, 50.8% of participants remained in the same group 10 years later (weighted Kappa(κ)=.34). When CRP was categorized into three risk groups, 53.4% of participants remained in the same group during 10 years (κ=.36), and 32.4% remained in the same group at all three examinations (κ=.27). Interleukin 6 increased from a geometric mean of 1.54 pg/L to 1.78 pg/L over 10 years, while CRP increased from a geometric mean of 1.67 mg/L to 2.25 mg/L over 10 years, and then decreased to 1.93 mg/L over the next 10 years. These 10-year decreases in CRP were not observed in those not reporting statin use. Factors associated with long-term higher levels of either IL-6 and CRP included older age (IL-6), obesity, smoking, lower physical activity (IL-6), lower HDL cholesterol (IL-6), and a history of statin (non)use (CRP). CONCLUSION Inflammatory marker levels tracked over the long-term into older age with within-person increases observed. Several potentially modifiable risk factors were associated with long-term higher levels of inflammatory markers.

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“…Representative population data show positive associations between adiposity and leukocyte counts (50). To our knowledge, our study is the first investigation reporting long-term (12 months) effects of a caloric restriction weight loss diet with and without exercise on leukocyte and neutrophil counts.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Caloric Restriction Weight Loss Diet and Exercise on Inflammatory Biomarkers in Overweight/Obese Postmenopausal Women: A Randomized Controlled Trial

et al. 2012

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Obese and sedentary persons have increased risk for cancer; inflammation is a hypothesized mechanism. We examined the effects of a caloric restriction weight loss diet and exercise on inflammatory biomarkers in 439 women. Overweight and obese postmenopausal women were randomized to 1-year: caloric restriction diet (goal of 10% weight loss, N=118), aerobic exercise (225 minutes/week of moderate-to-vigorous activity, N=117), combined diet+exercise (N=117) or control (N=87). Baseline and 1-year high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA), interleukin-6 (IL-6), leukocyte and neutrophil levels were measured by investigators blind to group. Inflammatory biomarker changes were compared using generalized estimating equations. Models were adjusted for baseline body mass index (BMI), race/ethnicity and age. 438 (N=1 in diet+exercise group was excluded) were analyzed. Relative to controls, hs-CRP decreased by geometric mean (95% confidence interval, p-value) 0.92mg/L (0.53–1.31, P<0.001) in the diet and 0.87mg/L (0.51–1.23, P<0.0001) in the diet+exercise groups. IL-6 decreased by 0.34pg/ml (0.13–0.55, P=0.001) in the diet and 0.32pg/ml (0.15–0.49, P<0.001) in the diet+exercise groups. Neutrophil counts decreased by 0.31×109/L (0.09–0.54, P=0.006) in the diet and 0.30×109/L (0.09–0.50, P=0.005) in the diet+exercise groups. Diet and diet+exercise participants with ≥5% weight loss reduced inflammatory biomarkers (hs-CRP, SAA, and IL-6) compared to controls. The diet and diet+exercise groups reduced hs-CRP in all subgroups of baseline BMI, waist circumference, CRP level, and fasting glucose. Our findings indicate that a caloric restriction weight loss diet with or without exercise reduces biomarkers of inflammation in postmenopausal women, with potential clinical significance for cancer risk reduction.

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Effects of Statins on Serum Inflammatory Markers: The U.S. National Health and Nutrition Examination Survey 1999-2004

Cited by 30 publications

References 32 publications

Statin Use and Markers of Immunity in the Doetinchem Cohort Study

Statin Use and Markers of Immunity in the Doetinchem Cohort Study

Long‐Term Variability of Inflammatory Markers and Associated Factors in a Population‐Based Cohort

Effects of a Caloric Restriction Weight Loss Diet and Exercise on Inflammatory Biomarkers in Overweight/Obese Postmenopausal Women: A Randomized Controlled Trial

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