C-reactive protein and heart risk

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Hi All,

Previously, the risk for atherosclerosis in CRers was examined, and C-reactive

proteins was among the risks examined, as documented in:

Fontana L, Meyer TE, Klein S, Holloszy JO.

Long-term calorie restriction is highly effective in reducing the risk for

atherosclerosis in humans.

Proc Natl Acad Sci U S A. 2004 Apr 27;101(17):6659-63. Epub 2004 Apr 19.

PMID: 15096581

http://www.pnas.org/cgi/content/full/101/17/6659

Table 2. Risk factors for atherosclerosis

====================

Value Parameter CR (n = 18) Controls (n = 18) P

====================

Tchol, mg/dl 158±39 205±40 0.001

LDL-C, mg/dl 86±28 127±35 0.0001

HDL-C, mg/dl 63±19 48±11 0.006

Tchol/HDL-C ratio 2.6±0.5 4.5±1.3 0.0001

TG, mg/dl 48±15 147±89 0.0001

TG/HDL-C ratio 0.8±0.3 3.5±2.8 0.0001

Systolic BP, mmHg 99±10 129±13 0.0001

Diastolic BP, mmHg 61±6 79±7 0.0001

Fasting glucose, mg/dl 81±7 95±8 0.0001

Fasting insulin, mIU/ml 1.4±0.8 5.1±2 0.0001

Hs-CRP, µg/ml 0.3±0.2 1.6±2.2 0.001

====================

Values are means±SD. IU, international unit; Hs-CRP, high-sensitivity CRP; 1

mmHg =

133 Pa.

How does the risk for atherosclerosis in controls used above compare relative to

the

typical risk for atherosclerosis in other populations, and where do CRers fall

with

regard to percentiles for C-reactive protein levels.

See the below excerpts from a new paper that may address such questions.

Raitakari M, Mansikkaniemi K, Marniemi J, Viikari JS, Raitakari OT.

Distribution and determinants of serum high-sensitive C-reactive protein in a

population of young adults. The Cardiovascular Risk in Young Finns Study.

J Intern Med. 2005 Nov;258(5):428-34.

PMID: 16238678

Objectives. Elevated C-reactive protein (CRP) is a suggested risk marker for

cardiovascular disease. We aimed at investigating the distribution and

determinants

of CRP levels in young adults.

Design. Population-based study.

Subjects. A total of 2120 participants aged 24-39 years.

Main outcome measures. Distribution of CRP, and the relationship between CRP and

risk factors.

Results. CRP concentration (mean +/- SD) was 1.43 +/- 3.26 mg L(-1) in men, 1.36

+/-

2.36 mg L(-1) in women who did not use oral contraceptives (OC) and 3.69 +/-

6.01 mg

L(-1) in women who used OCs. In total, 8.8% of men, 10.3% of non-OC user women

and

35.3% of OC user women had CRP concentration >3 mg L(-1) (recommended cut-off

point

of high risk for cardiovascular disease). In univariate analysis, CRP was

associated

with obesity indices and physical activity amongst both sexes. In men, the

multivariate correlates of CRP included waist circumference (P < 0.0001),

smoking

(<0.0001) and HDL cholesterol (P = 0.024) (inverse association). These three

variables explained 21.9% (model R(2)) of the total variation in CRP, waist

circumference having the greatest influence (partial R(2) = 19.6%). In women,

the

multivariate correlates of CRP included OC use (P < 0.0001), body mass index

(BMI)

(P < 0.0001), triglycerides (<0.0001) and physical activity (P = 0.025) (inverse

association). These four variables explained 38.2% (model R(2)) of the total

variation in CRP, with OC use (partial R(2) = 18.4%) and BMI (partial R(2) =

18.0%)

having the greatest influence.

Conclusions. The determinants of CRP level include obesity and smoking in men,

and

obesity, OC use and physical activity in women. About one in three of healthy

women

who use OCs have CRP concentration exceeding 3 mg L(-1).

Table 1 Characteristics of the study subjects [mean (SD)]

=================

Men (n = 975) Women (n = 1046)

=================

Age (years) 31.7 (5.1) 31.7 (5.1)

CRP (mg L )1) 1.43 (3.26) 2.01 (3.90)

CRP (mg L )1) median (interquartile range) 0.59 (0.29–1.38) 0.81 (0.34–2.17)

BMI (kg m )2) 25.7 (4.1) 24.4 (4.7)

Waist circumference (cm) 89.6 (10.7) 78.8 (11.4)

Waist-to-hip ratio 0.90 (0.06) 0.79 (0.06)

Systolic blood pressure (mmHg) 121 (12) 113 (13)

Diastolic blood pressure (mmHg) 73 (11) 69 (10)

Total cholesterol (mM) 5.3 (1.0) 5.0 (0.9)

LDL cholesterol (mM) 3.4 (0.9) 3.1 (0.8)

HDL cholesterol (mM) 1.17 (0.28) 1.39 (0.30)

Triglycerides (mM) 1.5 (0.1) 1.4 (0.3)

Physical activity index (%) (range)a 16 (0–113) 17 (0–76)

Daily smoking (%) 30 20.4

Oral contraceptive use (%) 28.2

=================

CRP, C-reactive protein.

a Data available: men, n = 839; women, n = 806.

Table 2 Univariate associations between log10-transformed CRP and other study

variables

=================

Men (n = 975) Women (n = 1046)

Variable Regression coefficient SE P Regression coefficient SE P

=================

Age (years) 0.0090 0.0031 0.0036 )0.0116 0.0033 0.0004

BMI (kg m )2) 0.0505 0.0035 <0.0001 0.0498 0.0033 <0.0001

Waist (mm) 0.0020 0.0001 <0.0001 0.0019 0.0001 <0.0001

Waist-to-hip ratio 2.8674 0.2326 <0.0001 2.0162 0.2599 <0.0001

Systolic blood pressure (mmHg) 0.0065 0.0013 <0.0001 0.0072 0.0013 <0.0001

Diastolic blood pressure (mmHg) 0.0071 0.0014 <0.0001 0.0098 0.0016 <0.0001

Total cholesterol (mM) 0.0731 0.0149 <0.0001 0.1007 0.0189 <0.0001

LDL cholesterol (mM) 0.0702 0.0175 <0.0001 0.0447 0.0222 0.0444

HDL cholesterol (mM) )0.3122 0.0550 <0.0001 0.0362 0.0561 0.5190

Triglycerides (mM) 0.1046 0.0155 <0.0001 0.2460 0.0239 <0.0001

Smoking (daily) 0.1120 0.0342 0.0011 0.0069 0.0412 0.8987

Oral contraceptive use – – 0.4563 0.0345 <0.0001

Exercise ) 0.0020 0.0010 0.0393 )0.0027 0.0013 0.0402

Alcohol (no. drinks per week) 0.0022 0.0015 0.1534 )0.0013 0.0029 0.6413

===================

CRP, C-reactive protein; BMI, body mass index; SE, standard error of regression

coefficient.

Table 3 Mean CRP concentrations (mg/L) in young adults at selected percentile

cut-off points

==================

n Age (years) Mean±SD

Percentiles

0 15 102550759095 99 100

===================

Women (no OC use)

80 24 1.40±2.88 0.07 0.07 0.10 0.15 0.22 0.52 1.06 2.87 5.83 18.55 18.55

108 27 1.43±2.19 0.06 0.10 0.11 0.14 0.36 0.63 1.75 3.34 4.97 12.00 14.25

114 30 1.61±2.96 0.07 0.08 0.13 0.18 0.28 0.58 2.01 3.30 4.97 15.90 21.45

148 33 1.33±2.56 0.05 0.08 0.13 0.16 0.26 0.53 1.47 2.75 4.01 11.50 24.00

149 36 1.38±2.07 0.10 0.11 0.14 0.18 0.29 0.59 1.42 3.38 4.81 11.80 12.00

152 39 1.10±1.61 0.05 0.08 0.11 0.15 0.24 0.57 1.25 2.83 4.03 8.64 12.40

Women (OC users)

75 24 3.38±8.11 0.12 0.12 0.14 0.46 0.84 1.91 3.33 8.50 13.55 64.90 64.90

70 27 2.90±4.26 0.19 0.19 0.34 0.46 0.97 1.70 3.71 4.65 8.40 32.35 32.35

50 30 3.20±4.14 0.19 0.19 0.24 0.37 0.69 1.47 4.26 7.58 9.75 20.95 20.95

45 33 4.84±6.24 0.23 0.23 0.40 0.57 1.15 2.68 4.65 14.75 15.00 30.80 30.80

28 36 3.87±4.11 0.33 0.33 0.41 0.48 0.97 3.20 4.65 12.60 13.20 16.55 16.55

27 39 4.01±7.25 0.14 0.14 0.15 0.23 0.49 0.91 2.87 20.30 24.05 26.00 26.00

Men

155 24 1.33±3.13 0.07 0.07 0.10 0.14 0.26 0.53 1.19 2.32 4.05 20.50 28.05

140 27 1.45±3.18 0.03 0.07 0.13 0.16 0.27 0.52 1.21 2.88 5.72 19.50 23.50

177 30 1.24±2.49 0.05 0.07 0.13 0.15 0.27 0.55 1.25 2.36 3.09 15.50 24.70

164 33 1.49±3.58 0.07 0.07 0.15 0.18 0.30 0.72 1.34 2.45 3.75 29.00 30.75

178 36 1.59±4.51 0.07 0.11 0.13 0.20 0.31 0.57 1.38 3.50 4.68 10.65 56.40

161 39 1.46±2.04 0.06 0.07 0.13 0.20 0.37 0.78 1.69 3.38 4.24 12.60 13.70

====================

CRP, C-reactive protein; OC, oral contraceptives.

Subjects with diabetes, recent infection, rheumatic disease, as well as pregnant

women and

lactating women excluded.

Al Pater, PhD; email: old542000@...

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