C-Reactive Protein and Features of the Metabolic Syndrome in a Population-Based Sample of Children and Adolescents

Abstract

Background: C-Reactive protein (CRP) is a risk marker for type 2 diabetes and cardiovascular diseases. In youth, limited data are available on the distribution of high-sensitivity CRP as well as on its association with components of the metabolic syndrome. Methods: In 1999, we conducted a school-based survey of a representative sample of youths 9, 13, and 16 years of age in the province of Quebec, Canada. Standardized clinical measurements and fasting plasma lipid, glucose, insulin, and CRP concentrations were available for 2224 individuals. Results: The distribution of CRP was positively skewed. The median and 95th percentile values by age and sex ranged from <0.2 to 0.56 mg/L and from 2.72 to 6.28 mg/L, respectively. A total of 7.7% of 9-year-olds, 5.5% of 13-year-olds, and 12.8% of 16-year-olds had CRP concentrations >3.0 mg/L, the threshold defining the adult high-risk category. We observed a strong relationship between CRP concentrations and both body mass index (BMI) and fasting insulin values. The association between CRP and insulin concentration was markedly attenuated after adjustment for BMI, whereas that between CRP and BMI remained unchanged after adjustment for insulin: a 1 SD increase in BMI was associated with a 52% increase in CRP concentration. An increased CRP concentration was independently associated with a worsening of the lipid profile, whereas the association between increased CRP values and high systolic blood

Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors

“…Finally, the present data confirmed that in children, unlike in adults, 33 CRP levels are not related to the MS 6,34,35 and that in children the only variable independently associated with CRP is the degree of obesity. 15,35 If CRP levels are Metabolic syndrome and nontraditional CVD risk factors in obese children C Invitti et al obesity-driven, MS might fail to influence CRP in the context of an all obesity cohort.…”

Dietary determinants of subclinical inflammation, dyslipidemia and components of the metabolic syndrome in overweight children: a review

“…Although data from younger children are scarce, and most studies measured only CRP, 11,49,50,57 these findings are consistent with earlier studies showing an increased subclinical inflammation in obese prepubertal children. 3 Some studies have found an increased circulating TNF-a in obese children, 58,59 whereas others have not.…”

“…In Quebec, CRP concentrations were higher in 9-and 16-year-old girls than in boys at the same age. 50 In UK children aged 9-11 years, CRP concentrations were 47% higher in girls than in boys. 49 In adolescents in the 1999-2000 US National Health and Nutrition Examination Survey, women had higher CRP concentrations than men only at 16-19 years of age.…”

“…3,49,50 Subclinical inflammation also correlates with markers of oxidative stress, 51 and may be a mechanism of obesity-associated insulin resistance and the metabolic syndrome. 52 Dietary antioxidants can influence the expression of proinflammatory cytokines and decreased antioxidant vitamin levels and reduced antioxidant capacity that are common in obese children.…”

“…94,95 In children, data are more limited, but CRP has also been correlated with components of the metabolic syndrome. 11,49,50,57,98 However, studies suggest that increases in CRP, independent of adiposity, are associated with dyslipidemia but are not strongly associated with other components of the metabolic syndrome in children.In adults, stronger associations between adiposity and CRP have been reported for women compared with men. 99 In children, the data are unclear.…”