Impaired metabolic health over‐time and high abdominal fat are prospectively associated with high‐sensitivity C‐reactive protein in children: The IDEFICS study

Abstract Background: The JUPITER (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin) trial suggests that increased high-sensitivity C-reactive protein (hsCRP) concentrations may be useful in decisions about the initiation of statin therapy for primary prevention of vascular disease. Although studies of specific populations have suggested that hsCRP is a reliable longitudinal marker, it is unclear how strongly hsCRP tracks in individuals after a single increased concentration. Methods: We evaluated tracking of hsCRP in 8901 individuals randomized to placebo in the JUPITER trial. These individuals had screening LDL cholesterol concentrations <130 mg/dL (<3.37 mmol/L) and hsCRP concentrations ≥2 mg/L, with subsequent hsCRP measurements made before randomization; at 13 weeks; 1, 2, 3, and 4 years later; and at trial termination. Longitudinal trends and associations were evaluated nonparametrically with box plots and Spearman correlations. After data transformation to achieve normality, repeated-measures regression models estimated the intraclass correlation of hsCRP, with and without controlling for known demographic, lifestyle, and medical determinants of hsCRP concentration. For comparison, we evaluated tracking of systolic and diastolic blood pressure; total, LDL, and HDL cholesterol; and fasting triglycerides. Results: The median hsCRP concentration in these untreated individuals showed modest regression to the mean over time, declining from 3.8 mg/L at randomization to 3.4 mg/L at 4 years. Tracking correlations for hsCRP over time were comparable to those for blood pressure and LDL cholesterol, but lower than those for HDL, fasting triglycerides, and total cholesterol. The intraclass correlation for repeated hsCRP measurements was 0.54 (95% CI, 0.53–0.55) without covariate adjustment and 0.50 (95% CI, 0.49–0.51) after adjustment for demographic, lifestyle, and comorbidity determinants. Conclusions: Concentrations of hsCRP show strong tracking, even after selection of individuals with initially high values. Without statin therapy, increased concentrations of hsCRP generally remain high over time.

Download Full-text

Analytical Performance and Diagnostic Accuracy of Immunometric Assays for the Measurement of Circulating Oxidized LDL

Clinical Chemistry ◽

10.1373/clinchem.2005.064337 ◽

2006 ◽

Vol 52 (4) ◽

pp. 760-764 ◽

Cited By ~ 54

Author(s):

Paul Holvoet ◽

Elizabeth Macy ◽

Michele Landeloos ◽

Dan Jones ◽

Jenny S Nancy ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Total Cholesterol ◽

Roc Analysis ◽

Oxidized Ldl ◽

High Sensitivity ◽

C Reactive Protein ◽

Longitudinal Stability ◽

Reactive Protein ◽

Commercial Assay ◽

Over Time

Abstract Background: Oxidized LDL (ox-LDL) plays an important role in the pathogenesis of coronary heart disease (CHD). Several tests for circulating ox-LDL have been published. We believe it is critical to carefully evaluate these assays because small differences in performance may have profound effects when results are compared; we therefore compared the analytical and clinical performances of 2 assays: one developed in our laboratory and a commercial assay (Mercodia) that uses the same monoclonal antibody (4E6). Methods: We determined the variance of ox-LDL in both tests, including its longitudinal stability (n = 225; 3 time points per person) and its diagnostic accuracy, by ROC analysis of 95 consecutive CHD patients and 20 controls. Results: The between-person variability was 77% for the in-house assay (with the remaining 23% being within-person and analytical variance) and 74% for the commercial assay. For comparison, previously reported values were 66% for high-sensitivity C-reactive protein and 82% for total cholesterol. The areas under the curves for CHD in the 2 assays were identical (0.85). The odds ratios (logistic regression) for CHD among persons with high ox-LDL (≥15 mg/L) compared with persons with low ox-LDL were not different: 4.3 (95% confidence interval, 1.4–12) for the in-house assay and 3.3 (1.1–10) for the commercial assay. Conclusions: The longitudinal stability of ox-LDL, as assessed by multiple measures in people over time, is similar to that of total cholesterol and high-sensitivity C-reactive protein. Both assays tested similarly distinguish between healthy controls and CHD patients.

Download Full-text

Prospective associations between dietary patterns and high sensitivity C-reactive protein in European children: the IDEFICS study

European Journal of Nutrition ◽

10.1007/s00394-017-1419-x ◽

2017 ◽

Vol 57 (4) ◽

pp. 1397-1407 ◽

Cited By ~ 2

Author(s):

Esther María González-Gil ◽

◽

Gianluca Tognon ◽

Lauren Lissner ◽

Timm Intemann ◽

...

Keyword(s):

Dietary Patterns ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Idefics Study

Download Full-text

High‐sensitivity C‐reactive Protein is a Predictive Factor of Adiposity in Children: Results of the Identification and prevention of Dietary‐ and lifestyle‐induced health Effects in Children and InfantS (IDEFICS) Study

Journal of the American Heart Association ◽

10.1161/jaha.113.000101 ◽

2013 ◽

Vol 2 (3) ◽

Cited By ~ 31

Author(s):

Annunziata Nappo ◽

Licia Iacoviello ◽

Arno Fraterman ◽

Esther M. Gonzalez‐Gil ◽

Charis Hadjigeorgiou ◽

...

Keyword(s):

Health Effects ◽

Predictive Factor ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Idefics Study

Download Full-text

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

Clinical Chemistry ◽

10.1373/clinchem.2008.115360 ◽

2009 ◽

Vol 55 (2) ◽

pp. 336-341 ◽

Cited By ~ 12

Author(s):

Tomer Shemesh ◽

Kevin G Rowley ◽

Alicia J Jenkins ◽

James D Best ◽

Kerin O'Dea

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Risk Factor ◽

Systolic Blood Pressure ◽

High Sensitivity ◽

C Reactive Protein ◽

Cvd Risk ◽

Reactive Protein ◽

Over Time

AbstractBackground: 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.

Download Full-text

Association between a metabolic syndrome score and high sensitivity C-reactive protein in European children: the IDEFICS study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120006011 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Esther M. Gonzalez-Gil ◽

Annunziata Nappo ◽

Javier Santabarbara ◽

Maike Wolters ◽

Paola Russo ◽

...

Keyword(s):

Metabolic Syndrome ◽

Logistic Regression ◽

High Sensitivity ◽

C Reactive Protein ◽

Mean Values ◽

Time Points ◽

Reactive Protein ◽

Inflammatory State ◽

Idefics Study ◽

Hs Crp

AbstractIntroductionMetabolic syndrome (MetS) is a combination of risk factors that may be present already in childhood. MetS has been associated with inflammatory biomarkers such as high sensitivity C-reactive protein (hsCRP) in aduls. In 2014, Ahrens et al, published reference standards for a paediatric MetS score based on reference values from European children. The aim of this study is to assess longitudinally the relationship between a MetS score and hsCRP in a sample of European children.Materials and MethodsOut of the baseline sample of the IDEFICS Study, 2913 children aged 2–9 years were included in this study. Inclusion criteria was having available data of waist circumference (WC), diastolic and systolic blood pressure (DBP, SBP), high density lipoprotein (HDL) cholesterol, triglycerides (TG), glucose and insulin, to calculate the homeostasis model assessment index (HOMA); and hs-CRP as a marker of inflammation, at baseline (T0) and two years later (T1). hs-CRP was categorized into two categories as some children had lower concentration than the detection limit of 0.02mg/dL. Student t-test and logistic regression were used to assess these associations. Logistic regression was adjusted by age, sex, body mass index (BMI), socioeconomic level and country.ResultsDifferences of mean values of the components of the MetS and the two categories of hs-CRP were observed between both time points. Mean values of SBP, DBP, WC, TG and HOMA were significantly higher in children with a higher category of hsCRP (p < 0.005). In addition, MetS score was significantly higher in those with a higher category of hs-CRP (p < 0.001) at both measurement points, T0 and T1. Finally, logistic regression between components of MetS and categories of hs-CRP, at both time points, showed significant associations (p < 0.001) for WC (OR = 1.06 at T0 and OR = 1.04 at T1) and HDL (OR = 0.98 at T0 and OR = 0.98 at T1) and the MetS score (OR = 1.07) score at T1.DiscussionThe association between MetS and inflammation is already present in children. Out of the components of the MetS, WC and HDL were the ones more associated with an inflammatory state at two times points. Also the MetS score, but only at the follow-up, was associated with the hs-CRP. Therefore, in order to prevent the inflammatory state in childhood, efforts to improve the metabolic profile, specially WC and HDL, need to be made.

Download Full-text

Abstract 14450: Association of Trajectory of High Sensitivity C-reactive Protein and Incident Heart Failure in African Americans: The Jackson Heart Study

Circulation ◽

10.1161/circ.142.suppl_3.14450 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Arsalan Hamid ◽

Wondwosen Yimer ◽

Adebamike A Oshunbade ◽

Shahzeb Khan ◽

Rodney K Kipchumba ◽

...

Keyword(s):

Heart Failure ◽

African Americans ◽

High Sensitivity ◽

C Reactive Protein ◽

Hscrp Level ◽

Reactive Protein ◽

Heart Study ◽

Increased Risk ◽

Over Time

Introduction: Elevation in the inflammatory marker high sensitivity C-reactive protein (hsCRP) is associated with worse outcomes in patients with heart failure (HF). We aimed to determine if baseline or trajectory of hsCRP levels over time predict incident HF hospitalization. Methods: Jackson Heart Study (JHS) participants’ (n=4203 African Americans) hsCRP levels were measured over 3 visits (visit 1: 2000 to 2004; visit 2: 2005 to 2008; visit 3: 2009 to 2013). We assessed the association of a single hsCRP level measurement at baseline (visit 1) with incident HF hospitalization using Cox proportional hazard models. Furthermore, we assessed the association of trajectory of hsCRP over repeated measurements (visit 1-3) with incident HF using a joint model, which incorporates estimated hsCRP from a linear mixed effects model into a Cox hazards model to predict incident HF hospitalization while incorporating trajectory of hsCRP over visits. All hazard ratios (HR) are presented as an increase in hsCRP by 1 standard deviation on a Log 2 scale. Results: At baseline, mean age of participants was 55±13 years, 63.4% were women, and mean hsCRP level was 0.5±0.7 mg/dl. Over a median follow-up of 12 years, 353 (8.4%) participants were hospitalized with incident HF. After adjustment for covariates, baseline hsCRP was not associated with increased risk of incident HF hospitalization (Table, p>0.05). However, increases in hsCRP levels on follow-up were associated with a significantly increased risk of incident HF hospitalization (Table, p<0.05). Conclusions: While an elevated hsCRP level at one time point may not be associated with incident HF, the increasing trajectory of change in hsCRP over time is predictive of increased risk for incident HF hospitalization in African Americans. These data support the role of increased inflammatory status in the development of heart failure.

Download Full-text