Background: The C reactive protein (CRP) is one of the most accurate inflammatory
markers in acute appendicitis (AA). Obesity leads to a pro-inflammatory
state with increased CRP, which may interfere with the interpretation of
this laboratory test in AA. Aim: To assess sensitivity, specificity, positive predictive value (PPV), and
negative predictive value (NPV) of CRP in patients with AA and their
correlation to body mass index (BMI) and body fat composition. Method: This is a retrospective study based on clinical records and imaging studies
of 191 subjects with histopathologically confirmed AA compared to 249
controls who underwent abdominal computed tomography (CT). Clinical and
epidemiological data, BMI, and CRP values were extracted from medical
records. CT scans were assessed for AA findings and body composition
measurements. Results: CRP values increased according to patients’ BMI, with varying sensitivity
from 79.78% in subjects with normal or lean BMI, 87.87% in overweight, and
93.5% in individuals with obesity. A similar pattern was observed for NPV:
an increase with increasing BMI, 69.3% in individuals with normal or lean
BMI, 84.3% in overweight, and 91.3% in individuals with obesity. There was a
positive correlation between CRP and visceral fat area in patients with AA.
Conclusions: Variations exist for sensitivity, specificity, PPV, and NPV values of CRP in
patients with AA, stratified by BMI. An increase in visceral fat area is
associated with elevated CRP across the BMI spectrum.