Multimodal determinants of high-sensitivity c-reactive protein in older adults

Background High-sensitivity C-reactive protein (hsCRP) serves as a crucial biomarker for systemic inflammation and cardiovascular risk. Although prior studies have linked individual physiological domains to hsCRP levels, comprehensive evaluations that integrate multiple modalities remain scarce, especially among older adults. Purpose This study aimed to identify key physiological contributors to hsCRP by analyzing multi-modal data from a community-based cohort of adults aged 50 to 85 years, providing a holistic view of inflammation in aging. Methods A total of 88 participants underwent extensive phenotyping across several domains. Cardiac assessments were performed using Magnetic Resonance Imaging to evaluate left ventricular structure, systolic function, and myocardial tissue characteristics. Vascular function was measured through central blood pressure, augmentation index, pulse wave velocity, endothelial function, and reactive hyperemia. The metabolic profile included circulating biomarkers such as cholesterol, glucose, and lipids, along with measurements of visceral adiposity and hepatic fat content. Musculoskeletal evaluations encompassed muscle mass, intramuscular fat fraction, grip strength, performance on the short physical performance battery, and gait speed. Functional capacity was assessed using the six-minute walk test. Participants were grouped according to hsCRP > 3 mg/L or < 3 mg/L, and compared using independent t-tests (Table 1). Results Among study participants, 27 individuals (31%) had elevated hsCRP. Those with elevated hsCRP had increased total body fat, subcutaneous and visceral fat, liver fat, higher central blood pressures, and increased vascular stiffness. Additionally, the high hsCRP group had lower thigh muscle mass (relative to total body mass), lower grip strength and covered less distance during the six-minute walk test. Conclusion In this multimodal analysis, metabolic dysfunction, vascular stiffness, and musculoskeletal decline emerged as the primary characteristics to systemic inflammation, as indicated by hsCRP levels. These findings highlight the interconnected nature of physiological aging and suggest potential targets for anti-inflammatory interventions.