Key result
Higher body mass index and female gender were strongly associated with repeated CRP elevations above 10 mg/L, with obese women having only a 51% probability that an elevation was a one-time event compared to 82% in others.
Why the study?
What characteristics are associated with repeated CRP elevation above 10 mg/L, and does obesity and gender affect the probability of it being chronic rather than acute inflammation?
Cohort (n=3,300)
Yes
What characteristics are associated with repeated CRP elevation above 10 mg/L, and does obesity and gender affect the probability of it being chronic rather than acute inflammation?
Odds Ratio: 1.35 (95% CI 1.25–1.45)
p-value: p=<0.001
CRP elevations above 10 mg/L in obese women are likely indicative of chronic rather than acute inflammation, suggesting higher thresholds may be needed to distinguish acute from chronic inflammation in this subgroup.
Obesity and female sex link to repeated CRP >10 mg/L; leaves open whether exclusion thresholds warrant revision in epidemiologic studies.
C-reactive Protein (CRP) measurements above 10 mg/L have been conventionally treated as acute inflammation and excluded from epidemiologic studies of chronic inflammation. However, recent evidence suggest that such CRP elevations can be seen even with chronic inflammation. The authors assessed 3,300 participants in The Coronary Artery Risk Development in Young Adults study, who had two or more CRP measurements between 1992/3 and 2005/6 to a) investigate characteristics associated with repeated CRP elevation above 10 mg/L; b) identify subgroups at high risk of repeated elevation; and c) investigate the effect of different CRP thresholds on the probability of an elevation being one-time rather than repeated. 225 participants (6.8%) had one-time and 103 (3.1%) had repeated CRP elevation above 10 mg/L. Repeated elevation was associated with obesity, female gender, low income, and sex hormone use. The probability of an elevation above 10 mg/L being one-time rather than repeated was lowest (51%) in women with body mass index above 31 kg/m(2), compared to 82% in others. These findings suggest that CRP elevations above 10 mg/L in obese women are likely to be from chronic rather than acute inflammation, and that CRP thresholds above 10 mg/L may be warranted to distinguish acute from chronic inflammation in obese women.
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Ishii et al. (2012) conducted a cohort in Repeated elevation of C-Reactive Protein (CRP > 10 mg/L) (n=3,300). Body mass index (per kg/m2 increase) vs. Lower body mass index was evaluated on Repeated CRP elevation above 10 mg/L (at two or more visits) (OR 1.35, 95% CI 1.25-1.45, p=<0.001). Higher body mass index and female gender were strongly associated with repeated CRP elevations above 10 mg/L, with obese women having only a 51% probability that an elevation was a one-time event compared to 82% in others.
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