Increased C-Reactive Protein in Brazilian Children: Association with Cardiometabolic Risk and Metabolic Syndrome Components (PASE Study)

Abstract

C-reactive protein (CRP) is a marker of subclinical inflammation that has been found to be associated with cardiovascular disease risk. However, few studies have investigated the relationship between CRP and cardiometabolic markers in a representative sample of prepubescent children. The objective was to evaluate the high-sensitive CRP (hs-CRP) and its association with traditional and nontraditional cardiometabolic risk factors, as well as metabolic syndrome (MetS) components in Brazilian children. This is a cross-sectional representative study, with participants of the Schoolchildren Health Assessment Survey (PASE). Children from 8 to 9 years old (n=350) enrolled in public and private schools in the municipality of Viçosa, Minas Gerais, Brazil, were evaluated. Sociodemographic evaluation was performed through a semistructured questionnaire. Anthropometric, body composition, clinical, and biochemical measures were analyzed for cardiometabolic risk assessment. The total mean of serum hs-CRP concentration was 0.62 (±1.44) mg/L. hs-CRP was significantly correlated with several anthropometric, biochemical, and clinical parameters in this population (P<0.05). hs-CRP was positively associated with the accumulation of cardiometabolic risk factors and MetS components (P<0.05). Children with excessive weight; abdominal obesity; increased gynoid and android body fat; low HDL-c; hyperglycemia; and elevated uric acid, homocysteine, and apoB had higher chances of presenting increased hs-CRP (P<0.05). In this study, Brazilian children with cardiometabolic risk already presented elevated serum hs-CRP concentration. hs-CRP was associated with the increase of traditional and nontraditional cardiometabolic risk factors, as well as the accumulation of MetS components.

Neutrophil: lymphocyte ratio is positively associated with subclinical diabetic cardiomyopathy

“…Furthermore, chronic low-grade inflammation may also lead to cardiometabolic disease by inducing insulin resistance, a major contributor to DCM development [16,17]. Dysregulation of immune inflammatory factors, including elevated levels of acute-phase reactants [18], IL-6 [18], CRP [19], and cortisol [20], were also well associated with the cardiometabolic-risk profile. Chronic inflammation is therefore hypothesized to underlie the constellation of DCM risk factors [14].…”

<p>High-Sensitivity C-Reactive Protein Leads to Increased Incident Metabolic Syndrome in Women but Not in Men: A Five-Year Follow-Up Study in a Chinese Population</p>

“…The positive association between hs-CRP and MetS observed in the current study was largely consistent with the positive correlations that have been reported from cross-sectional studies. [7][8][9][10][11][12][13][14][15] Among the few prospective cohort studies conducted in Finland, 22,23 Mexico, 24 and Korea, 25 the results have not been entirely consistent. Among the three prospective studies conducted in men only, 22,24,25 two studies observed a positive association between CRP and MetS, 22,24 while the other study found no association.…”

“…5 Furthermore, high-sensitivity C-reactive protein (hs-CRP), a known biomarker for acute and chronic inflammation, 6 has been shown to be correlated with MetS in various cross-sectional studies. [7][8][9][10][11][12][13][14][15] However, the temporal association between hs-CRP and MetS cannot be inferred from cross-sectional studies, and prospective cohort studies are warranted. Although numerous prospective studies and meta-analyses have been conducted to evaluate the associations between hs-CRP and type 2 diabetes [16][17][18][19] and cardiovascular disease, 14,15,20,21 only a few studies have assessed the association between hs-CRP and incident MetS in Finland, 22,23 Mexico, 24 and Korea; 25 to date, no prospective study has evaluated the association among a Chinese population.…”

Ultrasensitive C-reactive protein as biomarker of cardiometabolic risk in a group of obese children and adolescents

“…In a study conducted by Konstantinos Kitsios et al 18 , the levels of CRP-us were significantly higher in overweight and obese groups compared to control groups. Suhet et al 19 , when evaluating 350 children, reported a significant association between CRP-us and overweight, believing that the increase of CRP-us may be a potential mediator between obesity and the beginning of atherosclerosis during childhood. A relevant fact in our study was the utilization of the case-control method, pairing both sexes with chronologic age, according to the International Diabetes Federation.…”

“…This fact is of great importance to the metabolic bias, for children and adolescents with these lipidic profiles may already exhibit fatty streaks in a coronary and carotid level, associated with the increase in CRP-us levels 25 . Suhet et al 19 observed the connection between CRP-us and low HDL. In a research conducted with 124 children, Muramoto et al 26 reported that for every increase of 1 mg/L in CRP serum concentration, a reduction of 0.072 mg/dL in HDL occurs, regardless of the individual nutritional state.…”