The relationship between simple anthropometric indices and c-reactive protein: ethnic and gender differences

doi:10.1016/j.metabol.2003.07.005

Metabolism

Volume 52, Issue 12, December 2003, Pages 1542-1546

https://doi.org/10.1016/j.metabol.2003.07.005 Get rights and content

Abstract

C-reactive protein (CRP) is an independent risk factor for cardiovascular disease (CVD) that is strongly associated with indicators of body fat, yet the effect of potential confounders, such as ethnic background and gender has not been characterized. Our purpose was to determine the effect ethnicity and gender has on the relationship between CRP, body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) in men and women of Chinese and European descent. BMI, WC, WHR, and CRP were measured in European (n = 91) and Chinese (n = 91) men and women recruited from local hospital staff. Pearson correlation coefficients were determined between CRP, age, and anthropometric measures for the entire cohort and stratified by ethnicity and gender. Multiple regression analyses were performed using interactions between BMI, WC, and WHR for each ethnicity and gender with CRP as the outcome. CRP levels were significantly lower in Chinese compared with Europeans, but this difference disappeared after correction for either BMI or WC. In women, BMI (r = .55, P < .01) and WC (r = .59, P < .01) correlated with CRP. Gender significantly interacted with WC to predict CRP after adjusting for age, smoking status, alcohol, and BMI (P < .05). There was a nonsignificant interaction between gender and BMI as a predictor of CRP. Differences in CRP remained significant after adjusting for WHR. The relationship between CRP levels and BMI or WC was similar between men and women of Chinese and European descent. Gender significantly modified the relationship between CRP and WC. At a WC beyond 70 cm, CRP levels increased at a greater rate in women than men.

Section snippets

Materials and methods

Apparently healthy men and women were recruited from hospital staff, students, volunteers, and their friends who answered posted study advertisements. Those over 18 years of age and either of European or Chinese descent (all known ancestors of either European or Chinese origin) were eligible. Individuals were excluded if they had increased abdominal girth not related to increased adiposity (ie, pregnancy, peritoneal dialysis, or ascites). A sample size of convenience was limited to 100

Results

Eleven participants were excluded as CRP levels were not available, 5 were taking either ASA or lipid-lowering therapy and 2 had pre-existing CVD resulting in 91 European (39 men and 52 women) and 91 Chinese (44 men and 47 women) participants. One participant had diagnosed diabetes and another had elevated blood glucose, as they were not taking hypoglycemic agents, they were included in the analysis. A total of 12 participants reported smoking and 113 reported drinking alcohol. There were no

Discussion

This is the first investigation comparing CRP levels in a group of healthy Chinese men and women to those of European origin. BMI and WC were strongly correlated with CRP levels in Chinese women, but not men. We found CRP levels to be significantly lower in Chinese than European men and women, however this difference was no longer significant after adjusting for either BMI or WC. After adjustment for WHR, CRP levels remained lower in the Chinese men and women independent of age, smoking status,

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A healthy lifestyle (smoking cessation, increased physical activity, and weight loss) is associated with a reduction in CRP concentrations [175,177]. CRP concentration is also dependent on body weight and adiposity [178–180]. In studies on the effect of coffee on inflammatory biomarkers, the body weight of participants varied, as indicated by Moua et al. [111].
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of premature death worldwide. Inflammation and its biomarkers, like C-reactive protein (CRP), among the risk factors, such as hypertension, lipid disorders, and diabetes, may be also responsible for the residual cardiovascular disease (CVD) risk. Modern lipid-lowering treatment with statins, ezetimibe, PCSK9 inhibitors, or bempedoic acid does not fully protect against inflammation. The recommendations of the International Lipid Expert Panel (ILEP) indicate selected nutraceuticals with anti-inflammatory properties. Diet may have a significant impact on inflammation. Especially interesting in the context of inflammation is the consumption of coffee and tea. These drinks in many observational studies significantly reduced cardiovascular risk and mortality. The question is whether the anti-inflammatory effects of these drinks contribute significantly to the observed clinical effects. Thus, in this narrative review, we primarily discuss the anti-inflammatory properties of consuming tea and coffee. Based on a comprehensive analysis of the studies and their meta-analyses, inconsistent results were obtained, which makes it impossible to conclusively state how clinically significant the potential anti-inflammatory properties of black and green tea and coffee are. A number of confounding factors can cause the inconsistency of the available results. Consumption of tea and coffee appears to increase adiponectin concentrations, decrease reactive oxygen species, decrease low density lipoprotein (LDL) cholesterol concentrations (effect of green tea, etc.). Despite the still uncertain anti-inflammatory effect of tea and coffee, we recommend their consumption as a part of the healthy diet.
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We found significantly higher levels of hs-CRP in 27 subjects who had recently attempted suicide compared to 27 age- and sex-matched healthy subjects. Moreover, the levels of hs-CRP in suicide attempters were not related to background or psychopathological characteristics, nor to the methods of suicide attempt. Our matched case-control study confirms previous observations of high levels of the inflammation marker hs-CRP in patients who have attempted suicide, irrespective of their underlying type and levels of psychopathology.
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Some research suggests that marijuana use facilitates an anti-inflammatory response, yet the relationship between marijuana use and inflammation, as measured by C-reactive protein (CRP), remains poorly understood. The present study examined the association between recency of marijuana use and serum C-reactive protein levels in a nationally representative sample of adults.
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The association between C-reactive protein (CRP) and cardiovascular (CV) mortality by gender has not been previously described using a data set that is representative of the US population.
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The final sample size included a total of 13,878 individuals (7,364 women and 6,514 men) with a median follow up of 18.2 years. All models controlled for race, age, smoking, high-density lipoprotein, hypertension, diabetes mellitus, waist circumference, and total cholesterol. Men with a CRP >3.0 mg/L relative to those with a CRP ≤3.0 mg/L had elevated CV mortality hazards (hazard ratio [HR] 1.79, 95% CI 1.23-2.60) and all-cause mortality hazards (HR 1.57, 95% CI 1.29-1.90). In women, elevated CRP was not significantly associated with either increased CV (HR 1.20, 95% CI 0.90-1.59) or all-cause mortality hazards (HR 1.09, CI 0.93-1.29).
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^☆: Supported by the Medical Research of Canada/Heart and Stroke Foundation of Canada partnership Doctoral Research Award (to S.A.L.). M.M.C. salary support provided by the University of British Columbia Faculty of Medicine’s Summer Student Research Award.

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The relationship between simple anthropometric indices and c-reactive protein: ethnic and gender differences☆

Abstract

Section snippets

Materials and methods

Results

Discussion

Am J Cardiol

Metabolism

Lancet

Body-mass index and mortality in a prospective cohort of U.S. adults

N Engl J Med

Elevated C-reactive protein levels in overweight and obese adults

JAMA

Body mass index, diabetes, and C-reactive protein among U.S. adults

Diabetes Care

Serum levels of C-reactive protein are associated with obesity, weight gain, and hormone replacement therapy in healthy postmenopausal women

Am J Epidemiol

The relation of body fat mass and distribution to markers of chronic inflammation

Int J Obes Relat Metab Disord

Gender differences in C-reactive protein concentrations—Confirmation with two sensitive methods

Clin Chem Lab Med

A comparison of proxy measures of abdominal obesity in Chinese, European and South Asian adults

Diabet Med

Body mass index, waist circumference, waist-hip ratio, and glucose intolerance in Chinese and Europid adults in Newcastle, UK

J Epidemiol Comm Health