Abstract MP14: Lower Cardiovascular Fitness is Associated With Higher C-Reactive-Protein-Related Cardiovascular Risk in Healthy Adolescents and Young Adults

Abstract

Introduction: Inflammatory markers, such as C-reaction protein (CRP), have been shown to be highly associated with cardiovascular disease. However, it is unclear if baseline levels of cardiovascular fitness in young, healthy persons are related to inflammatory biomarkers who have not yet manifested cardiovascular disease. Methods: Data was compiled from the National Health and Nutrition Examination Survey (NHANES). Cardiovascular fitness level (low, moderate, high) was categorized by estimated VO2 max (with age/sex adjustment cut points). Associations with CRP-based cardiovascular risk were analyzed using ANOVA/Kruskal-Wallis and Chi-squared. Ordered logistic regression was employed to identify predictors of increasing CRP-based cardiovascular risk. To account for the complex survey design, all analyses were conducted using appropriate estimated weights following NHANES analytic guidelines. Results: 2,201 participants from 1999-2004 from ages 12-49 completed cardiovascular fitness testing and had full laboratory analysis. A sensitivity analysis was performed grouping participants into CRP-based cardiovascular risk categories (low <1mg/L, moderate 1-3 mg/L, high >3 mg/L) based on the 2003 AHA/CDC Scientific Statement. Increase in cardiovascular fitness category was associated with decrease in CRP-based cardiovascular risk (OR 0.83, 95% CI 0.75 to 0.91, p<0.001). The relationship was strengthened (OR 0.77, 95% CI 0.68 to 0.87, p<0.001) when adjusting for age, sex, BMI, diabetes, and smoking. Conclusions: In a sample representative of the United States civilian non-institutionalized population, lower levels of cardiovascular fitness were associated with increased inflammatory biomarkers related to cardiovascular risk, even with adjustment for fitness-related covariates. Further studies will help us to understand the therapeutic role on VO2 max and cardiovascular fitness improvement in reducing atherosclerosis-related inflammation.