scholarly journals BMI, high-sensitivity C-reactive protein and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults: a cohort study

2020 ◽  
pp. 1-8
Author(s):  
Renying Xu ◽  
Peixiao Shen ◽  
Chunhua Wu ◽  
Yanping Wan ◽  
Zhuping Fan ◽  
...  

Abstract Objective: We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults. Design: Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up. Results: Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis. Conclusion: BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults.

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e035880 ◽  
Author(s):  
Tong Liu ◽  
Sarah Tan Siyin ◽  
Nan Yao ◽  
Ning Duan ◽  
Guoshuai Xu ◽  
...  

ObjectivesGallstone disease (GSD) can be caused by various health and clinical factors such as obesity, dyslipidaemia and an unhealthy diet, all of which are associated with higher high-sensitivity C reactive protein (hs-CRP) concentrations. Whether hs-CRP represents an independent risk factor for GSD is still unclear. We prospectively investigated hs-CRP in relation to the occurrence of GSD based on the Kailuan study.Study designProspective cohort study.SettingThe Kailuan cohort study was conducted in Tangshan City in northern China.Participants95 319 participants who were free from GSD were recruited in this study. Epidemiological data, anthropometric parameters and biochemical data of participants were collected.Primary and secondary outcome measuresCox proportional hazards regression models were used to evaluate the association between hs-CRP concentrations and the risk of GSD after adjustments for potential confounders.ResultsDuring the mean 7.58 years of follow-up among 95 319 participants, 4205 participants were identified as newly diagnosed with GSD or having undergone cholecystectomy for cholelithiasis. Compared with the hs-CRP<1 mg/L group, elevated hs-CRP concentrations were significantly associated with higher risk of GSD with the corresponding HR of 1.11 (95% CI 1.03 to 1.19), 1.12 (95% CI 1.04 to 1.22) in the 1≤hs-CRP≤3 mg/L and hs-CRP>3 mg/L group, respectively. The multivariate model which included hs-CRP not only had a better line of fitness but also had better predictive values to help identify new cases of GSD during follow-up.ConclusionElevated hs-CRP concentration is an independent risk factor for new-onset GSD among the Chinese population.Trial registration numberChiCTR-TNC-11001489.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Lise Lund Håheim ◽  
Kjersti S. Rønningen ◽  
Morten Enersen ◽  
Ingar Olsen

The predictive role of high-sensitivity C-reactive protein (hs-CRP), number of tooth extractions, and oral infections for mortality in people with and without diabetes is unclear. This prospective cohort study is a 12 1/2-year follow-up of the Oslo II study, a health survey in 2000. In all, 12,764 men were invited. Health information was retrieved from 6434 elderly men through questionnaire information, serum measurements, and anthropometric and blood pressure measurements. Diabetes was reported by 425 men. Distinct differences were observed in baseline characteristics in individuals with and without diabetes. In the diabetes group, age and hs-CRP were statistically significant whereas in the nondiabetes group, age, hs-CRP, number of tooth extractions, tooth extractions for infections and oral infections combined, nonfasting glucose, systolic blood pressure, total cholesterol, regular alcohol drinking, daily smoking, and level of education were independent risk factors. The number of tooth extractions <5 was inversely related whereas more extractions increased the risk. Multivariate analyses showed that hs-CRP was a significant predictor in persons with diabetes and tooth extractions and oral infections combined; the number of teeth extracted and hs-CRP were for persons without diabetes. Infection and inflammation were associated with mortality in individuals both with and without diabetes.


BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Tan Siyin ◽  
Tong Liu ◽  
Wenqiang Li ◽  
Nan Yao ◽  
Guoshuai Xu ◽  
...  

Abstract Background Competing risk method has not been used in a large-scale prospective study to investigate whether increased levels of high-sensitivity C-reactive protein (hs-CRP) elevate the risk of primary liver cancer (PLC). Our study aims to prospectively investigate the relationship between hs-CRP and new-onset PLC. Methods and results Ninety-five thousand seven hundred fifty-nine participants without the diagnosis of PLC, and who had their demographic characteristics and biochemical parameters recorded, were analyzed from the Kailuan Cohort study. Cox proportional hazards regression models and competing risk regression models were used to evaluate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of PLC. During a median follow-up of 11.07 years, 357 incidental PLC cases were identified over a total of 1,035,039 person-years. The multivariable HRs (95%CI) for the association of hs-CRP of 1–3 mg/L group and hs-CRP>3 mg/L with PLC were 1.07(0.82 ~ 1.38), 1.51(1.15 ~ 1.98) in a Cox proportional hazard regression analysis adjusted for other potential confounders. In the cause-specific hazard model, the multivariable HRs (95%CI) for the association of hs-CRP of 1–3 mg/L group and hs-CRP>3 mg/L with PLC were 1.06(0.81 ~ 1.40), 1.50(1.14 ~ 1.99). Similar results were also observed in the sub-distribution hazard function model with corresponding multivariate HRs (95%CI) of 1.05(0.80 ~ 1.40), 1.49(1.13 ~ 1.98) in hs-CRP of 1–3 mg/L group and hs-CRP>3 mg/L group, respectively. Conclusions This prospective study found a significant association of higher levels of hs-CRP with new-onset PLC. The main clinical implications would be an increased awareness of hs-CRP and its correlation to the risk of PLC. This study should be a steppingstone to further research on chronic inflammation and PLC. Trial registration Registration number:ChiCTR–TNRC–11001489.


2020 ◽  
Vol 14 (15) ◽  
pp. 1427-1437
Author(s):  
Hend Alqaderi ◽  
Ebaa Al-Ozairi ◽  
Saadoun Bin-Hasan ◽  
Mary Tavares ◽  
Jo M Goodson ◽  
...  

Aim: This study aimed to investigate the mediating effect of C-reactive protein (CRP) on obesity and hyperglycemia. Materials & methods: Fasting blood glucose, high-sensitivity CRP (hs-CRP) levels and waist circumference (WC) were measured on 353 participants. Multilevel regression modeling and mediation analyses were used to investigate the link between abdominal obesity, hs-CRP and hyperglycemia. Results: Elevation in hs-CRP was predictive of hyperglycemia in nonobese individuals (OR = 1.3, p = 0.03). With every 1-mg/l increase in hs-CRP, there was a 1-cm increase in WC (B = 0.87, p = 0.001). hs-CRP was a full mediator in the relationship between WC and hyperglycemia. Conclusion: hs-CRP predicts hyperglycemia development in nonobese individuals and the effect of increased WC on hyperglycemia was fully mediated by hs-CRP.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Hui-Xu Dai ◽  
Zhi-Ying Zhao ◽  
Yang Xia ◽  
Qi-Jun Wu ◽  
Yu-Hong Zhao

Purpose. The aim of the present cohort study was to explore the longitudinal association between high-sensitivity C-reactive protein (CRP) and hyperuricemia in Chinese population. Furthermore, we conducted subgroup analyses to explore this association according to age, sex, and body mass index. Methods. A total of 5,419 healthy participants were enrolled in the final cohort analysis. The high-sensitivity CRP level was measured by immunoturbidimetric assay. Hyperuricemia was defined as serum uric acid ≥7.0 mg/dL (416 μmol/L) in men and ≥6.0 mg/dL (357 μmol/L) in women. Multivariate logistic regression was used to analyze the association. Results. During the 4 years follow-up, 474 participants developed hyperuricemia. Compared with participants in the lowest tertile of high-sensitivity CRP, the multivariate-adjusted odds ratio (OR) (95% confidence interval [CI]) for incident hyperuricemia in the highest tertile was 1.36 (1.02, 1.82). In the subgroup analyses, high-sensitivity CRP was positively associated with the incidence of hyperuricemia after multivariate adjustments (P for trend=0.04) in women. Compared with the women in the lowest tertile of high-sensitivity CRP, the multivariate-adjusted OR (95% CI) in the highest tertile was 1.69 (1.10, 2.66). No statistically significant association was found in other subgroups. Conclusions. The findings of this prospective cohort study suggest that higher level of high-sensitivity CRP is an independent risk factor for hyperuricemia in Chinese, especially in women.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015112 ◽  
Author(s):  
Ryo Yoshinaga ◽  
Yasufumi Doi ◽  
Katsuhiko Ayukawa ◽  
Shizukiyo Ishikawa

ObjectiveWe investigated whether serum high-sensitivity C reactive protein (hs-CRP) levels measured in an emergency department (ED) are associated with inhospital mortality in patients with cardiovascular disease (CVD).DesignA retrospective cohort study.SettingED of a teaching hospital in Japan.Participants12 211 patients with CVD aged ≥18 years who presented to the ED by an ambulance between 1 February 2006 and 30 September 2014 were evaluated.Main outcome measuresInhospital mortality.Results1156 patients had died. The inhospital mortality increased significantly with the hs-CRP levels (<3.0 mg/L: 7.0%, 95% CI 6.4 to 7.6; 3.1–5.4 mg/L: 9.6%, 95% CI 7.9 to 11.3: 5.5–11.5 mg/L: 11.2%, 95% CI 9.4 to 13.0; 11.6–33.2 mg/L: 12.3%, 95% CI 10.5 to 14.1 and ≥33.3 mg/L: 19.9%, 95% CI 17.6 to 22.2). The age-adjusted and sex-adjusted HR for total mortality was increased significantly in the three ≥5.5 mg/L groups compared with the <3.0 mg/L group (5.5–11.5 mg/L: HR=1.32, 95% CI 1.09 to 1.60, p=0.005; 11.6–33.2 mg/L: HR=1.38, 95% CI 1.14 to 1.65, p=0.001 and ≥33.3 mg/L: HR=2.15, 95% CI 1.84 to 2.51, p<0.001). Similar findings were observed for the CVD subtypes of acute myocardial infarction, heart failure, cerebral infarction and intracerebral haemorrhage. This association remained unchanged even after adjustment for age, sex and white cell count and withstood Bonferroni adjustment for multiple testing. When the causes of death were divided into primary CVD and non-CVD deaths, the association between initial hs-CRP levels and mortality remained significant, but the influence of hs-CRP levels was greater in non-CVD deaths than CVD deaths. The percentage of non-CVD deaths increased with hs-CRP levels; among the patients with hs-CRP levels ≥33.3 mg/L, non-CVD deaths accounted for 37.5% of total deaths.ConclusionOur findings suggest that increased hs-CRP is a significant risk factor for inhospital mortality among patients with CVD in an ED. Particular attention should be given to our finding that non-CVD death is a major cause of death among patients with CVD with higher hs-CRP levels.


2020 ◽  
Vol 10 ◽  
pp. 2 ◽  
Author(s):  
Rhythm Bains ◽  
Aseem P. Tikku ◽  
Wahid Ali ◽  
Promila Verma ◽  
Pragya Pandey

Objective: The objective of the study was to evaluate the impact of lesions of endodontic origin (LEO) and their treatment on the patients’ serum high-sensitivity C-reactive protein (hs-CRP) levels. Materials and Methods: A total of 20 healthy patients with radiographic evidence of LEO in at least one tooth were recruited for the study, of which 11 were finally evaluated. Before initiating the endodontic treatment, 10 ml of patient’s venous was taken from the antecubital vein to assess the pre-operative serum hs-CRP levels (T0). Canals were prepared with K-files till a suitable size and irrigated with 2.5% sodium hypochlorite. At the subsequent appointment after 1 week, teeth were obturated. The patients were then recalled 30 days after the completion of endodontic therapy. Again blood samples will be taken at time-frame T1 to assess the serum hs- CRP levels. The change in pre- and post-treatment values for T0 and T1 was statistically evaluated to assess the effect of treatment on serum hs-CRP levels. Results: The mean CRP (mg/L) at T0 ± SD (Range) at baseline was 6.18 ± 3.72 (0.96–11.02) and the mean CRP at T1 ± SD (Range) was 3.92 ± 3.59 (1.108–11.04) and mean change in CRP ± SD (Range) after 30 days follow-up was −2.26 ± 3.04 (−8.26–1.16). Significance of change in CRP levels (Paired t-test) was t = 2.458; P = 0.034. Conclusion: The results of the present study indicate that root canal treatment reduced the levels of hs-CRP in the serum of the patients having LEO. Timely diagnosis and treatment of these lesions may have some contribution in reducing systemic inflammatory burden.


Stroke ◽  
2019 ◽  
Vol 50 (7) ◽  
pp. 1655-1660 ◽  
Author(s):  
Renying Xu ◽  
Yanan Zhang ◽  
Xiang Gao ◽  
Yanping Wan ◽  
Zhuping Fan

Background and Purpose— CRP (C-reactive protein) is an inflammatory biomarker which predicts the risk of cardiovascular diseases. However, whether CRP is associated with carotid artery plaque (CAP) remains unclear. Methods— The current retrospective study was performed in 8229 Chinese aged adults (aged 65–99 years; 4677 men and 3552 women). hs-CRP (high-sensitivity CRP) concentrations were measured at baseline (2013), and further classified into 3 groups: low risk (<1.0 mg/L), intermediate risk (1.0–3.0 mg/L), and high risk (≥3.0 mg/L). Ultrasound B-mode imaging was repeatedly performed annually to detect CAP during 5-year follow-up (2013–2018). Potential confounders, including body mass index, blood pressure, fasting blood glucose, alanine transferase, aspartate transferase, alkaline phosphatase, gamma-glutamyl transferase, total bilirubin, direct bilirubin, blood urea nitrogen, creatinine, and uric acid, lipid profiles, were also collected at baseline. White blood cell was collected as well. We used a logistic regression model for the cross-sectional relation between CRP concentration and CAP status and proportional hazardous Cox model for prospective analyses. Results— Comparing to the low-risk group, the adjusted odds ratios for CAP was 1.66 (95% CI, 1.43–1.92) in the intermediate-risk group and 1.72 (95% CI, 1.39–2.13) in the high-risk group, after adjustment for potential confounders. We identified 512 incident CAP cases during 5-year follow-up. Each mg/L increase of hs-CRP was associated with a hazard ratio of 1.1 (95% CI, 1.03–1.17) to developing CAP. Sensitivity analysis generated similar results with prospective analyses after excluding participants with overweight and obesity, with elevated fasting blood glucose, LDL (low-density lipoprotein) cholesterol, and white blood cell. The association lost significant when we excluded participants with elevated blood pressure, however, few cases of CAP (n=41) was recruited in participants with normal blood pressure during follow-up. Conclusions— High hs-CRP concentration was associated with the high risk of developing CAP in Chinese aged adults.


2020 ◽  
Author(s):  
Ren-ying Xu ◽  
Xiaomin Jiang ◽  
Zhuping Fan ◽  
Yanping Wan ◽  
Xiang Gao

Abstract Background: We performed a cohort study to evaluate the association between the CRP trajectory and incident diabetes in Chinese adults. Methods: Included were 6,439 adults (4,111 men and 2,249 women; aged 46.6±11.9 years). The concentration of high sensitivity CRP (hs-CRP) was measured in 2013 (baseline), 2014, and 2015. The hs-CRP trajectory was identified based the above three measurements by latent mixture modeling. Incident diabetes cases were diagnosed by fasting blood glucose (³126mg/dl) or Hb A1c (³6.5%) during subsequent three years (2016-2018). Results: Hs-CRP concentration during 2013 -2015 was classified into 3 levels: low (<1.0 mg/L), moderate (1.0–3.0 mg/L), and high (³3.0 mg/L) based on a statement by American Heart Association. We named four hs-CRP trajectories as following: “low-stable” (low in 2013 and maintained at low concentration in 2014 and 2015), “moderate-fluctuated” (moderate in 2013, then increased to high concentration in 2014, and decreased to low concentration in 2015), “high-decreased” (high in 2013 but decreased to moderate concentration in 2014 and 2015), and “moderate-increased (moderate in 2013 and increased to high concentration in 2014 and 2015)”. We identified 235 incident diabetes during subsequent three years. The adjusted HR for incident diabetes was 1.71 (95% CI: 1.02, 2.87) comparing the moderate-increased and the low-stable group, after adjusting for potential confounders. In the secondary analyses, two single-measured hs-CRP concentration (in 2013 or in 2015) and the average of hs-CRP were associated with high risk of diabetes (P-trend<0.01 for all). Conclusions: The hs-CRP trajectory pattern was associated with altered incident diabetes in Chinese adults.


2021 ◽  
Vol 10 (15) ◽  
pp. 3291
Author(s):  
Hack-Lyoung Kim ◽  
Woo-Hyun Lim ◽  
Jae-Bin Seo ◽  
Sang-Hyun Kim ◽  
Joo-Hee Zo ◽  
...  

Background: Both C-reactive protein (CRP) and arterial stiffness are associated with the development of cardiovascular disease (CVD). This study was performed to investigate whether a combination of these two measurements could improve cardiovascular risk stratification. Methods: A total of 6572 consecutive subjects (mean age, 60.8 ± 11.8 years; female, 44.2%) who underwent both high-sensitivity CRP (hs-CRP) and brachial–ankle pulse wave velocity (baPWV) measurement within 1 week were retrospectively analyzed. Major adverse cardiovascular events (MACE), including cardiovascular death, acute myocardial infarction, coronary revascularization, and stroke were assessed during the clinical follow-up. Results: During a mean follow-up period of 3.75 years (interquartile range, 1.78–5.31 years), there were 182 cases of MACE (2.8%). The elevated baPWV (≥1505 cm/s) (hazard ratio (HR), 4.21; 95% confidence interval (CI), 2.73–6.48; p < 0.001) and hs-CRP (≥3 mg/L) (HR, 1.57; 95% CI, 1.12–2.21; p < 0.001) levels were associated with MACE even after controlling for potential confounders. The combination of baPWV and hs-CRP further stratified the subjects’ risk (subjects with low baPWV and hs-CRP vs. subjects with high baPWV and hs-CRP; HR, 7.08; 95% CI, 3.76−13.30; p < 0.001). Adding baPWV information to clinical factors and hs-CRP had an incremental prognostic value (global Chi-square score, from 126 to 167, p < 0.001). Conclusions: The combination of hs-CRP and baPWV provided a better prediction of future CVD than either one by itself. Taking these two simple measurements simultaneously is clinically useful in cardiovascular risk stratification.


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