Abstract
C-reactive protein (CRP) is a routinely measured blood biomarker for inflammation. Elevated levels of circulating CRP are associated with response to infection, risk for a number of complex common diseases, and psychosocial stress. The objective of this study was to compare the contributions of genetic ancestry, socioenvironmental factors, and inflammation-related health conditions to ethnic differences in C-reactive protein levels. We used multivariable regression to compare CRP blood serum levels between Black and White ethnic groups from the United Kingdom Biobank (UKBB) prospective cohort study. CRP serum levels are significantly associated with ethnicity in an age and sex adjusted model. Study participants who identify as Black have higher average CRP than those who identify as White, CRP increases with age, and females have higher average CRP than males. Ethnicity and sex show a significant interaction effect on CRP. Black females have higher average CRP levels than White females, whereas White males have higher average CRP than Black males. Significant associations between CRP, ethnicity, and genetic ancestry are almost completely attenuated in a fully adjusted model that includes socioenvironmental factors and inflammation-related health conditions. BMI, smoking, and socioeconomic deprivation all have high relative effects on CRP. These results indicate that socioenvironmental factors contribute more to CRP ethnic differences than genetics. Differences in CRP are associated with ethnic disparities for a number of chronic diseases, including type 2 diabetes, essential hypertension, sarcoidosis, and lupus erythematosus. Our results indicate that ethnic differences in CRP are linked to both socioenvironmental factors and numerous ethnic health disparities.
Highlights
C-reactive protein (CRP) is synthesized by hepatocytes and secreted to the bloodstream in response to inflammation
Ethnic Differences in Inflammation are Explained by Socioenvironmental Factors
Our study of the United Kingdom Biobank (UKBB) found that CRP blood serum levels differ according to participant’s self-identification as belonging to Black or White ethnic groups, and ethnicity in our cohort is highly correlated with genetic ancestry
Summary
C-reactive protein (CRP) is synthesized by hepatocytes and secreted to the bloodstream in response to inflammation. CRP blood serum levels vary across ethnic groups (Nazmi and Victora 2007), with a number of studies showing that Black patients have higher average levels of circulating CRP than White patients (Wong et al, 2001; Abramson et al, 2002; Ford 2002; Danner et al, 2003; Khera et al, 2005; Matthews et al, 2005; Alley et al, 2006; Lakoski et al, 2006) Ethnic differences of this kind are likely to have multifactorial causes, including contributions from genetic, socioeconomic, and environmental factors. This is further complicated by the fact that socially defined ethnicity is an imprecise proxy for genetic diversity
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