Abstract P023: Subclinical Inflammation and Weight Change in Middle-aged and Older Adults

Abstract

Introduction: C-reactive protein (CRP) is a marker of inflammation that is associated with obesity; inflammation also plays a role in the onset of cachexia. CRP and its relationship with weight change (gain and loss) is less well understood, particularly in studies including both middle-aged and older adults. Hypothesis: Elevated CRP is associated with both subsequent body mass index (BMI) gain and even more strongly associated with subsequent BMI loss in middle-aged and older adults. Methods: We analyzed BMI (kg/m2) changes in 11,136 ARIC participants followed since Visit 2 (1990 - 92) when CRP was measured (Table 1). BMI change between study visits was categorized as stable (<+/-2 kg/m2, average of <+/-13 lbs.), gain or loss (>+/-2 kg/m2). High sensitivity CRP (hs-CRP) was classified according to AHA/CDC guidelines for CVD risk. Multinomial logistic regression was used to characterize the association of BMI change with categories of hs-CRP. Results: Table 1 shows BMI change and its associations with categories of hs-CRP. Multinomial logistic regression demonstrated that individuals who had high CRP in midlife at visit 2 had increased odds of both subsequent BMI gain and loss both in the next 6 years (visit 2 to visit 4) and in the following 15 years (visit 4 to visit 5). Inflammation in late midlife (visit 4, median age: 62) was also predictive of subsequent BMI gain and loss (to visit 5, median age: 75). Similar associations were seen after further adjustment for diabetes, hypertension, physical activity and smoking (p<0.05). Conclusion: Elevated CRP was associated with subsequent BMI gain, but was more strongly associated with subsequent BMI loss in both midlife and older age. These findings suggest that inflammation is a marker associated with weight change that may help distinguish between healthy and unhealthy weight loss in middle-aged and older adults.