Long-term C-Reactive Protein Variability and Prediction of Metabolic Risk

Abstract

Purpose-This analysis was undertaken to determine the long-term intraindividual variability, determinants of change, and capacity of the inflammatory marker, C-reactive protein (CRP), to predict metabolic traits and diabetes in a large community-based population.Methods-Intraindividual CRP variability, predictors of CRP change and metabolic events were evaluated in the Framingham Heart Study Offspring cohort using data from the same 2409 participants with CRP measured by the same methodology at each of 3 exam cycles, spanning 20 years.Results-Between first and second examinations (averaging 16 years apart), 23-47% of men and 27-49% of women remained within the same quintile of CRP values. An additional 24-51% of men and 24-50% of women occupied an adjacent quintile. Intermediate-term CRP variability (over 4 years) was similar to long-term variability. Both long and intermediate-term variability of CRP was significantly less than that of plasma cholesterol, measured in these same groups. Linear regression models for CRP at the intermediate examination demonstrated that CRP at the initial examination contributed the largest proportion of the variability (partial R-square=0.27) seen in the overall model after adjustment for other covariates known to affect CRP concentrations. Although logistic regression models demonstrated that CRP over the intermediate term did not predict new-onset metabolic syndrome at the final examination, CRP did predict an increase in glucose and new-onset diabetes.Conclusions-Results of this longitudinal analysis suggest the intraindividual, long-term variability of CRP concentrations is relatively small and over an intermediate-term of 4 years is predictive of new diabetes.

Porównanie wpływu krótkotrwałego leczenia hipolipemicznego na stężenie adipokin w osoczu kobiet i mężczyzn z izolowaną hipercholesterolemią

“…The authors of the last study [16] explained higher hsCRP levels by a higher percentage of adipose tissue in women than in men. It is possible that the similar hsCRP levels observed by our research team and found previously by other authors [18,19] reflect either smaller differences in fat content between men and women participating in these studies or may result from higher levels of proinflammatory cytokines stimulating systemic low-grade inflammation. Such a role may be played by TNF-a, and possibly also by interleukin-6, being the most important stimulator of CRP production [20].…”

“…Studies conducted hitherto have provided conflicting results; the obtained results are in line with the findings of some [18,19] but not other [16] research groups. The authors of the last study [16] explained higher hsCRP levels by a higher percentage of adipose tissue in women than in men.…”

Biomarkers and Cardiovascular Risk Assessment for Primary Prevention: An Update

“…Between two routine examinations (a mean of 16 years apart), approximately half of the more than 2,000 individuals studied remained within the same quintile of CRP values. 32 …”

Clinical correlates of change in inflammatory biomarkers: The Framingham Heart Study

“…Prior studies have reported the relations of CVD risk factors to circulating inflammatory biomarkers assessed on a single occasion [5–7]. Nevertheless, there are only a few observational studies available examining the longitudinal progression of circulating inflammatory biomarkers [8]. Understanding modulators of longitudinal progression in inflammation potentially may improve early recognition of atherosclerosis and enhance risk prediction of CVD beyond traditional clinical risk factors [4].…”