Comment on “Elevated C-Reactive Protein in Patients With Depression, Independent of Genetic, Health, and Psychosocial Factors: Results From the UK Biobank”

Background: Coffee intake has been linked to lower type 2 diabetes (T2D) risk. We hypothesized this may be mediated by coffee’s effects on inflammation. Methods: Using participants from the UK Biobank (UKB n=145370) and Rotterdam Study (RS n=7172) cohorts, we studied associations of coffee intake with incident T2D; longitudinally measured insulin resistance (HOMA IR); serum levels of inflammation markers; and the mediating role of inflammation. Statistical regression models were adjusted for sociodemographic, lifestyle and health factors. Results: The median follow up was 7 (UKB) and 9 (RS) years. An increase of one coffee cup/day was associated with 4-6% lower T2D risk (RS HR=0.94 [95% CI 0.90; 0.98]; UKB HR=0.96 [0.94; 0.98]); lower HOMA IR (RS β=-0.017 [-0.024; -0.010]); with lower C reactive protein (CRP) and higher adiponectin (Figure1). Consumers of filtered coffee had the lowest T2D risk (UKB HR=0.88 [0.83; 0.93]). CRP levels mediated 9.6% (UKB) and 3.4% (RS) of the total effect of coffee on T2D (Figure 1). Conclusions: We suggest that coffee’s beneficial effects on lower T2D risk are partially mediated by improvements in systemic inflammation.Figure 1. a CRP and a adiponectin refer to the effect of coffee intake on CRP and adiponectin levels. a CRP RS : β=-0.014 (-0.022; -0.005); UKBB a CRP UKB : β=-0.011 (-0.012; -0.009) and RS a adiponectin : β=0.025 (0.007; 0.042). b CRP and b adiponectin refer to the effect of coffee related levels in CRP and adiponectin on incident T2D, independent of coffee. RS b CRP : HR=1.17 (1.04; 1.31); UKB b CRP : HR=1.45 (1.37; 1.54); and b adiponectin : HR=0.58 (0.32; 0.83). c′ refers to coffee’ effect on T2D going directly or via others mediators. UKB c′ independent of CRP : HR=0.96 (0.94; 0.99); RS c′ independent of CRP : HR=0.94 (0.90; 0.99); and RS c′ independent of CRP+adiponectin : HR=0.90 (0.80; 1.01). Coffee related changes in CRP may partially explain the beneficial link between coffee and T2D, mediating a 3.4% (0.6; 4.8, RS) and 9.6% (5.7; 24.4, UKB). Evidence of mediation was also found for adiponectin.

Download Full-text

FRI0561 PRO-INFLAMMATORY DIETS ARE ASSOCIATED WITH INCREASED C-REACTIVE PROTEIN AND RHEUMATOID ARTHRITIS IN THE UK BIOBANK COHORT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5961 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 882.3-883

Author(s):

J. Dainty ◽

E. Sayers ◽

M. Yates ◽

A. Macgregor

Keyword(s):

Rheumatoid Arthritis ◽

Recent Analysis ◽

Dietary Inflammatory Index ◽

Uk Biobank ◽

C Reactive Protein ◽

Dietary Recall ◽

Inflammatory Index ◽

Reactive Protein ◽

Modifiable Factors ◽

The Uk

Background:Several individual dietary components have been associated with the risk of rheumatoid arthritis (RA) and recent studies have suggested that dietary indices, which account for the consumption of multiple foods, can be used as more complete measures of risk.Objectives:In this study we aimed to use the Dietary Inflammatory Index (DII), an independent index of dietary variable associated with inflammatory biomarkers, to evaluate potential associations between pro-inflammatory exposures in the diet, an inflammation biomarker (C-reactive protein) and RA onset using the UK Biobank cohort.Methods:The DII was calculated from data obtained in 24-hour dietary recall questionnaires collected on healthy participants on four separate occasions over an approximate annual period between Feb 2011 and April 2012. Cases of RA in the UK Biobank cohort were identified from the participants with appropriate ICD10 codes and compared against a randomly selected subsample of controls matched (20:1) for age, sex, smoking status and BMI.Results:Among the 502,519 subjects enrolled in Biobank, 141,769 had completed 24-hour dietary recall questionnaires and had full data for the 18 dietary variables that were required to create the DII (mean=0.03, range: -3.88, 4.22). Higher (positive) DII values indicate more pro-inflammatory diets. This index was positively correlated (p<0.001) with C-reactive protein (CRP), attesting to the validity of this index for assessing dietary inflammatory potential. A total of 1,423 participants were classified as having RA (1% prevalence in ‘dietary’ cohort of 141,769) according to their ICD10 codes that were last updated in 2018. Their mean age at enrolment (2006-10) was 59 years. There was a significant association between DII and RA: OR 1.05 [1.01-1.09]; p=0.028) that suggested RA cases were more likely to be consuming a pro-inflammatory diet.Conclusion:These data show a significant association between diet, inflammation (CRP) and RA in the UK Biobank population. The findings are consistent with a recent analysis of the US Nurse’s Health Study which was based on data only from females, indicating that these findings are likely to be robust and generalisable. Diet is one of the few modifiable factors that has the potential to reduce the risk of future RA onset. These results open the way to providing evidence-based health advice and for designing clinical interventions.References:[1] Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public health nutrition 2014;17:1689-96.Acknowledgments:This research has been conducted using the UK Biobank Resource under Application Number ‘33557’Disclosure of Interests:None declared

Download Full-text

The association of anxiety and stress-related disorders with C-Reactive Protein (CRP) within the UK biobank

Brain, Behavior, & Immunity - Health ◽

10.1016/j.bbih.2021.100410 ◽

2021 ◽

pp. 100410

Author(s):

Emma Kennedy ◽

Claire L. Niedzwiedz

Keyword(s):

Uk Biobank ◽

C Reactive Protein ◽

Reactive Protein ◽

The Uk

Download Full-text

Point-of-care testing for C-reactive protein in acute cough presentations in primary care

Journal of Paramedic Practice ◽

10.12968/jpar.2020.12.1.cpd1 ◽

2020 ◽

Vol 12 (1) ◽

pp. 1-7

Author(s):

Simon Searle-Barnes ◽

Peter Phillips

Keyword(s):

Primary Care ◽

Point Of Care ◽

Point Of Care Testing ◽

C Reactive Protein ◽

Acute Cough ◽

Reactive Protein ◽

The United Kingdom ◽

Viral Aetiology ◽

Prescription Rates ◽

The Uk

Acute cough is one of the most common illnesses in the UK, with an estimated 48 million cases per annum. The majority of these presentations are thought to be of viral aetiology and self-limiting in nature, yet some studies report antibiotic prescription rates of approximately 65% in the UK. Clincians' decision-making process can be influenced by both patient expectations and difficulty in differentiating between viral and bacterial aetiologies by clinical examination alone. This article will consider the feasibility, efficacy, benefits and limitations of using point-of-care testing of C-reactive protein within primary care in the United Kingdom to help inform management of acute cough.

Download Full-text

C-reactive protein and neutrophil count laboratory test requests from primary care: what is the demand and would substitution by point-of-care technology be viable?

Journal of Clinical Pathology ◽

10.1136/jclinpath-2018-205688 ◽

2019 ◽

Vol 72 (7) ◽

pp. 474-481

Author(s):

José M Ordóñez-Mena ◽

Thomas R Fanshawe ◽

David McCartney ◽

Brian Shine ◽

Ann Van den Bruel ◽

...

Keyword(s):

Primary Care ◽

Neutrophil Count ◽

Point Of Care ◽

C Reactive Protein ◽

Reactive Protein ◽

Laboratory Services ◽

Number Of Patients ◽

Point Of Care Technology ◽

Care Technology ◽

The Uk

Aims C-reactive protein (CRP) and neutrophil count (NC) are important diagnostic indicators of inflammation. Point-of-care (POC) technologies for these markers are available but rarely used in community settings in the UK. To inform the potential for POC tests, it is necessary to understand the demand for testing. We aimed to describe the frequency of CRP and NC test requests from primary care to central laboratory services, describe variability between practices and assess the relationship between the tests.MethodsWe described the number of patients with either or both laboratory tests, and the volume of testing per individual and per practice, in a retrospective cohort of all adults in general practices in Oxfordshire, 2014–2016.Results372 017 CRP and 776 581 NC tests in 160 883 and 275 093 patients, respectively, were requested from 69 practices. CRP was tested mainly in combination with NC, while the latter was more often tested alone. The median (IQR) of CRP and NC tests/person tested was 1 (1–2) and 2 (1–3), respectively. The median (IQR) tests/practice/week was 36 (22–52) and 72 (50–108), and per 1000 persons registered/practice/week was 4 (3–5) and 8 (7–9), respectively. The median (IQR) CRP and NC concentrations were 2.7 (0.9–7.9) mg/dL and 4.1 (3.1–5.5)×109/L, respectively.ConclusionsThe high demand for CRP and NC testing in the community, and the range of results falling within the reportable range for current POC technologies highlight the opportunity for laboratory testing to be supplemented by POC testing in general practice.

Download Full-text

C-Reactive Protein Partially Mediates the Inverse Association Between Coffee Consumption and Risk of Type 2 Diabetes: The UK Biobank and the Rotterdam Study Cohorts

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_063 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1070-1070

Author(s):

Carolina Ochoa-Rosales ◽

Niels van der Schaft ◽

Kim Braun ◽

Frederick Ho ◽

Fanny Petermann ◽

...

Keyword(s):

Type 2 Diabetes ◽

Systemic Inflammation ◽

Coffee Consumption ◽

Uk Biobank ◽

Rotterdam Study ◽

C Reactive Protein ◽

Coffee Intake ◽

Reactive Protein ◽

Filtered Coffee

Abstract Objectives Given its popularity, there is an increasing interest in the study of coffee intake and its effect on health. Previous studies linked coffee consumption to lower type 2 diabetes (T2D) risk. However, potential underlying mechanisms remain unclear. We hypothesized that coffee's effects on systemic inflammation may play a role. We studied cross sectional and longitudinal associations of habitual coffee consumption with T2D risk and inflammation. Methods Participants from UK Biobank (UKB, n = 145,370) and Rotterdam Study (RS, n = 7172) cohorts were included. Coffee intake data were collected through self-administrated food frequency questionnaire or during home interviews. We studied associations of coffee intake with incident T2D using cox proportional hazard models; with longitudinally measured insulin resistance (HOMA IR) through linear mixed effect models; with serum baseline levels of inflammation markers using linear regressions; and the role of inflammation in coffee-T2D associations using mediation analysis. Models were adjusted for sociodemographic, lifestyle and health factors. Results were respectively expressed as hazard ratio (HR); β log transformed HOMA IR level; β log transformed ug/mL; and percentage mediated; and 95% confidence interval [95% CI]. Results UKB participants were 58% female and 55.2 years in average; RS were 59.7% female and 65.1 years. The median follow up was 7 (UKB) and 9 (RS) years. The modal coffee consumption was 0.5–2 cups/day (UKB) and 3–4 cups/day (RS). An increase of one coffee cup/day was associated with 4–6% lower T2D risk (RS HR 0.94 [95% CI 0.90; 0.98]; UKB HR 0.96 [0.94; 0.98]); lower HOMA IR (RS β −0.017 [−0.024; −0.010]); lower C reactive protein (CRP, RS β −0.014 [−0.022; −0.005]; UKBB β −0.011 [−0.012; −0.009] and higher adiponectin (RS β 0.025 [0.007; 0.042]. About coffee types, habitual consumers of filtered coffee had the lowest T2D risk (UKB HR 0.88 [0.83; 0.93]), compared to decaffeinated or instantaneous coffee. CRP levels mediated 9.6% (UKB) and 3.4% (RS) of the total effect of coffee on T2D. Adiponectin also showed evidence for mediation. Conclusions Coffee's beneficial effects on lower T2D risk may be partially mediated by improvements in systemic inflammation. Among coffee drinkers, filtered coffee may be of preference. Funding Sources Partially funded by the Institute for Scientific Information on Coffee.

Download Full-text

Circulating C‐reactive protein increases lung cancer risk: Results from a prospective cohort of UK Biobank

International Journal of Cancer ◽

10.1002/ijc.33780 ◽

2021 ◽

Author(s):

Mengmeng Ji ◽

Lingbin Du ◽

Zhimin Ma ◽

Junxing Xie ◽

Yanqian Huang ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Risk ◽

Prospective Cohort ◽

Lung Cancer Risk ◽

Uk Biobank ◽

C Reactive Protein ◽

Reactive Protein

Download Full-text

Approaches to minimising the epidemiological impact of sources of systematic and random variation that may affect biochemistry assay data in UK Biobank

Wellcome Open Research ◽

10.12688/wellcomeopenres.16171.2 ◽

2021 ◽

Vol 5 ◽

pp. 222

Author(s):

Naomi E. Allen ◽

Matthew Arnold ◽

Sarah Parish ◽

Michael Hill ◽

Simon Sheard ◽

...

Keyword(s):

Uk Biobank ◽

Sample Collection ◽

Sodium Potassium ◽

Reactive Protein ◽

Serum Assay ◽

Wide Range ◽

Epidemiological Impact ◽

The Uk ◽

The Impact ◽

Random Variation

Background: UK Biobank is a large prospective study that recruited 500,000 participants aged 40 to 69 years, between 2006-2010.The study has collected (and continues to collect) extensive phenotypic and genomic data about its participants. In order to enhance further the value of the UK Biobank resource, a wide range of biochemistry markers were measured in all participants with an available biological sample. Here, we describe the approaches UK Biobank has taken to minimise error related to sample collection, processing, retrieval and assay measurement. Methods: During routine quality control checks, the laboratory team observed that some assay results were lower than expected for samples acquired during certain time periods. Analyses were undertaken to identify and correct for the unexpected dilution identified during sample processing, and for expected error caused by laboratory drift of assay results. Results: The vast majority (92%) of biochemistry serum assay results were assessed to be not materially affected by dilution, with an estimated difference in concentration of less than 1% (i.e. either lower or higher) than that expected if the sample were unaffected; 8.3% were estimated to be diluted by up to 10%; very few samples appeared to be diluted more than this. Biomarkers measured in urine (creatinine, microalbumin, sodium, potassium) and red blood cells (HbA1c) were not affected. In order to correct for laboratory variation over the assay period, all assay results were adjusted for date of assay, with the exception of those that had a high biological coefficient of variation or evident seasonal variability: vitamin D, lipoprotein (a), gamma glutamyltransferase, C-reactive protein and rheumatoid factor. Conclusions: Rigorous approaches related to sample collection, processing, retrieval, assay measurement and data analysis have been taken to mitigate the impact of both systematic and random variation in epidemiological analyses that use the biochemistry assay data in UK Biobank.

Download Full-text

Approaches to minimising the epidemiological impact of sources of systematic and random variation that may affect biochemistry assay data in UK Biobank

Wellcome Open Research ◽

10.12688/wellcomeopenres.16171.1 ◽

2020 ◽

Vol 5 ◽

pp. 222

Author(s):

Naomi E. Allen ◽

Matthew Arnold ◽

Sarah Parish ◽

Michael Hill ◽

Simon Sheard ◽

...

Keyword(s):

Uk Biobank ◽

Sample Collection ◽

Sodium Potassium ◽

Reactive Protein ◽

Serum Assay ◽

Wide Range ◽

Epidemiological Impact ◽

The Uk ◽

The Impact ◽

Random Variation

Background: UK Biobank is a large prospective study that recruited 500,000 participants aged 40 to 69 years, between 2006-2010.The study has collected (and continues to collect) extensive phenotypic and genomic data about its participants. In order to enhance further the value of the UK Biobank resource, a wide range of biochemistry markers were measured in all participants with an available biological sample. Here, we describe the approaches UK Biobank has taken to minimise error related to sample collection, processing, retrieval and assay measurement. Methods: During routine quality control checks, the laboratory team observed that some assay results were lower than expected for samples acquired during certain time periods. Analyses were undertaken to identify and correct for the unexpected dilution identified during sample processing, and for expected error caused by laboratory drift of assay results. Results: The vast majority (92%) of biochemistry serum assay results were assessed to be not materially affected by dilution, with an estimated difference in concentration of less than 1% (i.e. either lower or higher) than that expected if the sample were unaffected; 8.3% were estimated to be diluted by up to 10%; very few samples appeared to be diluted more than this. Biomarkers measured in urine (creatinine, microalbumin, sodium, potassium) and red blood cells (HbA1c) were not affected. In order to correct for laboratory variation over the assay period, all assay results were adjusted for date of assay, with the exception of those that had a high biological coefficient of variation or evident seasonal variability: vitamin D, lipoprotein (a), gamma glutamyltransferase, C-reactive protein and rheumatoid factor. Conclusions: Rigorous approaches related to sample collection, processing, retrieval, assay measurement and data analysis have been taken to mitigate the impact of both systematic and random variation in epidemiological analyses that use the biochemistry assay data in UK Biobank.

Download Full-text