The Association Between C-Reactive Protein, Metabolic Syndrome, and Lifestyle in Korean Adults

Abstract

MAA4-PD-08 Introduction: It has been suggested that an increase in C-reactive protein (CRP) is related to high incidence of cardiovascular disease (CVD) and type 2 diabetes mellitus. The aim of this general population-based cross-sectional study is to investigate the relationship between CRP, metabolic syndrome (MS), and lifestyles. In addition, we are to evaluate the clinical significance of CRP. Methods: A total of 4385 subjects (1143 men, 3242 women) who underwent a medical checkup at 10 Korean health examinee cohort (KOEX) centers, 40 to 69 years of age, were included in this study. High-sensitivity CRP levels and MS defined by the NCEP-ATP were analyzed. The subjects' lifestyles (BMI, alcohol consumption, smoking status, exercise frequency) and CRP levels were analyzed. Cardiovascular disease (CVD) risks were evaluated by Framingham risk score (FRS) and the clinical significance of CRP was examined. Results: The prevalence of MS was 27% and the geometric mean of CRP was 0.62 mg/L. Odds ratio of highest quartile of CRP for MS was 2.53 (95% confidence interval [CI], 1.99–3.21) in multiple regression analysis adjusted for age, sex, BMI, alcohol consumption, smoking status, and exercise frequency. In multiple regression analysis adjusted for age, sex, and each of the lifestyle factors, odds ratios of lifestyles for high CRP (>1.04 mg/L) were 2.54 (95% CI, 2.14–3.02) among high BMI (>25) group, 0.42 (95% CI, 0.20–0.98) among men drinking less than 10 g of alcohol per week, 1.65 (95% CI, 1.23–2.21) among current smokers, and 0.68 (95% CI, 0.51–0.91) among people with exercise frequency of 5 or 6 times per week. When CVD risks were evaluated according to the recommendation of AHA/CDC (American Heart Association/Center for Disease Control and Prevention), 8.8% of individuals at 10% to 20% risk of CVD per 10 years was in high risk of developing CVD, but when evaluated by tertile of CRP of this study, 52.8% was in high risk. Conclusions: These results suggest that elevated CRP level is associated with increased risk of MS. Lifestyles such as obesity and smoking increase the CRP level. On the contrary, other lifestyles, such as moderate alcohol consumption and regular exercise, decrease the CRP level. In Korean adults, the risk for CVD might be underestimated, applied CRP recommendation by AHA/CDC. In the future, prospective studies will be needed to confirm the clinical significance of CRP and to establish a CRP criteria proper to Korean population for CVD risk estimation.