Differential association of C-reactive protein with adiposity in men and women in an Aboriginal community in northeast Arnhem Land of Australia

Shemesh, Tomer; Rowley, Kevin; Jenkins, Alicia J.; Brimblecombe, Julie; Best, James D.; O’Dea, Kerin

doi:10.1038/sj.ijo.0803350

Cited by 40 publications

(43 citation statements)

References 40 publications

(37 reference statements)

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“…Waist circumference has been shown to be among the strongest correlates of CRP across a wide range of populations, consistent with the established importance of visceral adipose tissue as a source of proinflammatory cytokines (32,33). However, several studies have documented sex differences in patterns of association between CRP and waist circumference and other measures of adiposity (34)(35)(36). The Pelotas Birth Cohort Study in Brazil, for example, reported stronger associations between central obesity and CRP in young adult women than in young men (37).…”

Section: Discussionmentioning

confidence: 94%

Population differences in associations between C-reactive protein concentration and adiposity: comparison of young adults in the Philippines and the United States

McDade¹,

Rutherford²,

Adair³

et al. 2009

The American Journal of Clinical Nutrition

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Background: Inflammation may be an important mediator of the association between nutrition and cardiovascular diseases, but most studies have been conducted in Western populations with high rates of overweight and obesity and low levels of infectious disease. Objectives: This study sought to investigate the predictors of C-reactive protein (CRP) in young adults living in the Philippines and to examine patterns of association with adiposity compared with young adults in the United States. Design: Maximum likelihood logistic regression models were used to predict elevated high-sensitivity CRP (.3 mg/L) in relation to anthropometric measures of adiposity, symptoms of infectious disease, and proxy measures of pathogen exposure in men and women from the Philippines (n ¼ 1648; age: 20-22 y). Comparative data were drawn from a nationally representative sample in the United States (National Health and Nutrition Examination Survey; n ¼ 616; age: 19-24 y). Results: Median concentrations of CRP were substantially lower in the Philippines (0.2 mg/L) than in the United States (0.9 mg/L), and the likelihood of elevated CRP was lower in the Philippines than in the United States at the same level of waist circumference or skinfold thickness. In the Philippines, infectious symptoms and pathogen exposure predicted elevated CRP, independent of adiposity. Conclusions: Adiposity and infectious exposures are associated with elevated CRP in the Philippines; other populations undergoing comparable lifestyle and dietary changes associated with increasing rates of overweight and obesity are likely experiencing similar double burdens of inflammatory stimuli. Low concentrations of CRP in this Philippine sample raise the question of whether CRP cutoffs based on European or European-American reference populations are appropriate for predicting disease risk in populations undergoing the nutrition transition.

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Section: Discussionmentioning

confidence: 94%

Population differences in associations between C-reactive protein concentration and adiposity: comparison of young adults in the Philippines and the United States

McDade¹,

Rutherford²,

Adair³

et al. 2009

The American Journal of Clinical Nutrition

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“…Elevated CRP has been previously reported to be strongly associated with central obesity in remote Aboriginal populations (25), which in turn may be associated with hyperfiltration and thus eGFR decline. The potential role of central obesity is supported by a recent report that percentage body fat (rather than weight) was independently associated with eGFR decline in 615 healthy Koreans (26).…”

Section: Discussionmentioning

confidence: 99%

Progression of Kidney Disease in Indigenous Australians: The eGFR Follow-up Study

Maple-Brown¹,

Hughes²,

Ritte³

et al. 2016

CJASN

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Background and objectives Indigenous Australians experience a heavy burden of CKD. To address this burden, the eGFR Follow-Up Study recruited and followed an Indigenous Australian cohort from regions of Australia with the greatest ESRD burden. We sought to better understand factors contributing to the progression of kidney disease. Specific objectives were to assess rates of progression of eGFR in Indigenous Australians with and without CKD and identify factors associated with a decline in eGFR.Design, setting, participants, & measurements This observational longitudinal study of Indigenous Australian adults was conducted in .20 sites. The baseline cohort was recruited from community and primary care clinic sites across five strata of health, diabetes status, and kidney function. Participants were then invited to follow up at 2-4 years; if unavailable, vital status, progression to RRT, and serum creatinine were obtained from medical records. Primary outcomes were annual eGFR change and combined renal outcome (first of $30% eGFR decline with follow-up eGFR,60 ml/min per 1.73 m 2 , progression to RRT, or renal death).Results Participants (n=550) were followed for a median of 3.0 years. Baseline and follow-up eGFR (geometric mean [95% confidence interval], 83.9 (80.7 to 87.3) and 70.1 (65.9 to 74.5) ml/min per 1.73 m 2 , respectively. Overall mean annual eGFR change was 23.1 (23.6 to 22.5) ml/min per 1.73 m 2 . Stratified by baseline eGFR ($90, 60-89, ,60 ml/min per 1.73 m 2 ), annual eGFR changes were 23.0 (23.6 to 22.4), 21.9 (23.3 to 20.5), and 25.0 (26.5 to 23.6) ml/min per 1.73 m 2 . Across baseline eGFR categories, annual eGFR decline was greatest among adults with baseline albumin-to-creatinine ratio (ACR) .265 mg/g (30 mg/mmol). Baseline determinants of the combined renal outcome (experienced by 66 participants) were higher urine ACR, diabetes, lower measured GFR, and higher C-reactive protein.Conclusions The observed eGFR decline was three times higher than described in nonindigenous populations. ACR was confirmed as a powerful predictor for eGFR decline across diverse geographic regions.

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“…The research design and methods are reported in detail elsewhere (4 ). Briefly, we screened 70 participants living in an isolated coastal Aboriginal community in the northeast of Arnhem Land in 2 risk-factor screening programs between 2001 and 2004.…”

Section: Methodsmentioning

confidence: 99%

C-Reactive Protein Concentrations Are Very High and More Stable over Time Than the Traditional Vascular Risk Factors Total Cholesterol and Systolic Blood Pressure in an Australian Aboriginal Cohort

et al. 2009

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Background: Stability of circulating high-sensitivity C-reactive protein (hsCRP) concentrations has implications for its utility in assessing cardiovascular disease (CVD) risk. We sought to determine hsCRP reproducibility in an indigenous Australian cohort with a view to use hsCRP as a marker of future CVD in community-based risk-factor screenings.Methods: Seventy people living in a community on the northern coast of Australia participated in 2 risk-factor screenings over a median (interquartile range) follow-up time of 829 (814–1001) days. hsCRP was measured by high-sensitivity nephelometry.Results: Geometric mean hsCRP concentrations at baseline and follow-up were 4.5 and 5.1 mg/L, respectively (P = 0.220), and Pearson product-moment correlation was 0.775. The proportion of people at high CVD risk (hsCRP >3.0 mg/L) at baseline was 67.1% and remained consistently high (68.6%) at follow-up. Linear regression analysis for follow-up hsCRP as a function of baseline hsCRP, sex, and differences in total and regional body fatness showed that baseline hsCRP was the single predictor in the model, accounting for 63.9% of the total variance in follow-up hsCRP (Pmodel < 0.001). Prevalence agreement (95% CI) between baseline and follow-up for the hsCRP >3.0 mg/L category was 84% (73%–92%) (PMcNemar = not significant), and κ coefficient was fair (0.64, compared with 0.31 for systolic blood pressure ≥140 mmHg and 0.43 for total cholesterol ≥5.5 mmol/L).Conclusions: hsCRP concentrations remained consistently reproducible over time across a wide concentration range in an Aboriginal cohort. Correlations between concentrations over time were better than for other traditional CVD risk factors. hsCRP concentration has potential as a marker of future CVD risk.

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Differential association of C-reactive protein with adiposity in men and women in an Aboriginal community in northeast Arnhem Land of Australia

Cited by 40 publications

References 40 publications

Population differences in associations between C-reactive protein concentration and adiposity: comparison of young adults in the Philippines and the United States

Population differences in associations between C-reactive protein concentration and adiposity: comparison of young adults in the Philippines and the United States

Progression of Kidney Disease in Indigenous Australians: The eGFR Follow-up Study

C-Reactive Protein Concentrations Are Very High and More Stable over Time Than the Traditional Vascular Risk Factors Total Cholesterol and Systolic Blood Pressure in an Australian Aboriginal Cohort

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