C-reactive Protein In Adults Research Articles

Effects of Early Life Pathogenic Exposures and Obesity on Childhood Inflammation Levels in Galápagos, Ecuador

Early life nutritional and disease environments play a vital role in the development of the immune system. Elevated C-reactive protein (CRP), an indicator of inflammation, is a key risk factor for cardiovascular disease and associated with obesity. Studies in low resource environments show that pathogenic exposure during infancy is associated with lower CRP in adulthood. However, the consequences of concurrent pathogenic exposure and overnutrition in childhood remain unknown. This paper explores the effects of obesity and E. coli exposure on CRP in 166 children (2-10 years) living on San Cristobal. Longitudinal CRP was assayed from blood spots collected one-week apart. 43% of households had high E. coli levels, quantified from household water samples. Obesity (BMI z-score>2) was present in 19% of the children. Adjusted mixed-effects models tested the impact of E. coli and obesity on repeated measures of log-CRP. Obesity and high E. coli had significant, independent, opposing effects. While obesity increas...

From childhood trauma to elevated C-reactive protein in adulthood: the role of anxiety and emotional eating.

Childhood trauma is known to be related to inflammatory processes in adulthood, but underlying psychological/behavioral mechanisms have not been fully characterized. To investigate associations between childhood trauma and inflammation (indexed by C-reactive protein [CRP]), we used a structural equation modeling approach on a subsample of the Midlife in the United States biomarker project. Participants included 687 men and women without history of cancer, diabetes, cardiovascular disease, or stroke who completed a physical examination and extensive questionnaires and provided blood. To test for sex differences, we held as many parameters invariant across sexes as possible while still retaining good model fit. Tests of direct and indirect effects revealed that childhood trauma was significantly associated with elevated CRP, via elevated body mass index (BMI; p < .001). This relationship was mediated by a broad latent measure of distress, which was associated with using food as a coping mechanism. Men and women differed in reported levels of physical abuse, sexual abuse, and physical neglect. Compared with men, women showed a stronger association between BMI and CRP, whereas men had a stronger association between use of food to cope and elevated BMI. Our results are consistent with a model in which childhood trauma is associated with elevated CRP, a relationship associated with stress reactivity and compensatory emotional eating. Men and women may experience trauma in qualitatively distinct patterns but share many vulnerabilities, which can lead to elevated health risks. Emotional eating may be an important target for intervention in this population.

C-reactive protein in adults with pulmonary arterial hypertension associated with congenital heart disease and its prognostic value

ObjectivesTo assess the relationship of C-reactive protein (CRP) to clinical outcome and mortality in adults with pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH).BackgroundApproximately 5–10% of adults with...

Parental separation in childhood and adult inflammation: The importance of material and psychosocial pathways

Childhood adversities are known to be associated with poorer health outcomes. A potential mechanism may be through changes in inflammatory processes. One such childhood adversity is separation of parents, however relatively little is known about the association between parental separation and inflammation in adulthood. The aims of this study were to (1) investigate whether parental separation is associated with inflammation in mid-life, (2) focus upon the mechanisms that may be involved in translating childhood adversities, such as parental separation, into poorer health outcomes in adulthood. We examine the association of parental separation in childhood, defined as the breakdown of the parent's partnership, and levels of C-reactive protein (CRP) in middle age. The role played by material (through material disadvantage and educational attainment), psychosocial (through parent-child relationship quality and psychological distress) and adiposity (through BMI) mechanisms is investigated using path analysis in a multiply-imputed dataset from a British birth cohort with concurrent measurements made throughout the life course (n=7462). Participants that report parental separation have higher CRP levels at age 44 than those who grew up with both parents (β=0.16, 95% CI: 0.06, 0.27). This association is largely explained by BMI, material and psychosocial factors. Material disadvantage after separation and educational attainment seem to be particularly important in this association. Parental separation increases CRP in adulthood via chains of disadvantage across the life course. This study points towards potential points for intervention and highlights a need to support separating families in order to minimise the long-term impact on adult health.

Do environments in infancy moderate the association between stress and inflammation in adulthood? Initial evidence from a birth cohort in the Philippines.

Chronic inflammation is a potentially important pathway through which psychosocial stressors increase risk for cardiovascular disease. However, prior research on stress and inflammation has been conducted almost exclusively in high income, industrialized populations with low levels of infectious disease. In this study we test the hypothesis that psychosocial stressors are associated with elevated concentrations of C-reactive protein (CRP) among young adults in the Philippines (n=1622), who have grown up in an ecological and epidemiological setting that differs substantially from that of the US. In addition, we apply a developmental, ecological perspective to consider whether microbial and nutritional environments in infancy alter patterns of association between stressors and CRP. Data come from the Cebu Longitudinal Health and Nutrition Survey, a prospective cohort study that began collecting data in 1983-1984 when participants were in utero. A series of regression models indicate trends toward significant interactions between perceived stress and environmental factors in infancy, including exposure to animal feces, season of birth, and birth weight. Parental absence in childhood was a significant predictor of CRP in adulthood in interaction with exposure to animal feces in infancy. Positive associations between stressors and CRP were only evident for individuals with lower levels of microbial exposure in infancy, or lower birth weight. These results suggest that early environments influence the development of inflammatory phenotypes in ways that moderate sensitivity to psychosocial stressors in adulthood, and they underscore the value of a comparative, developmental approach to research on social environments, inflammation, and disease.

The Association Between Periodontitis and High C-Reactive Protein in Adults with Chronic Kidney Disease is Not Clearly Established

Periodontitis predicts elevated C-reactive protein levels in chronic kidney disease. Ioannidou E, Swede H, Dongari-Bagtzoglou A. J Dent Res 2011;90:1411-5. Monica A. Fisher, PhD, DDS, MS, MPH, Zhen-qiang Ma, MD, MPH, MS The authors attempted to study the association between periodontitis and elevated C-reactive protein among adults with chronic kidney disease Government: NIH/NIDCR K23DE018689 ; and NIH General Clinical Research Center M01RR06192 Cross-sectional study Level 3: Other evidence Not applicable

Assessing the Performance of the Birmingham Vasculitis Activity Score at Diagnosis for Children with Antineutrophil Cytoplasmic Antibody-associated Vasculitis in A Registry for Childhood Vasculitis (ARChiVe)

There are no validated tools for measuring disease activity in pediatric vasculitis. The Birmingham Vasculitis Activity Score (BVAS) is a valid disease activity tool in adult vasculitis. Version 3 (BVAS v.3) correlates well with physician's global assessment (PGA), treatment decision, and C-reactive protein in adults. The utility of BVAS v.3 in pediatric vasculitis is not known. We assessed the association of BVAS v.3 scores with PGA, treatment decision, and erythrocyte sedimentation rate (ESR) at diagnosis in pediatric antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Children with AAV diagnosed between 2004 and 2010 at all ARChiVe centers were eligible. BVAS v.3 scores were calculated with a standardized online tool (www.vasculitis.org). Spearman's rank correlation coefficient (r(s)) was used to test the strength of association between BVAS v.3 and PGA, treatment decision, and ESR. A total of 152 patients were included. The physician diagnosis of these patients was predominantly granulomatosis with polyangiitis (n = 99). The median BVAS v.3 score was 18.0 (range 0-40). The BVAS v.3 correlations were r(s) = 0.379 (95% CI 0.233 to 0.509) with PGA, r(s) = 0.521 (95% CI 0.393 to 0.629) with treatment decision, and r(s) = 0.403 (95% CI 0.253 to 0.533) with ESR. Applied to children with AAV, BVAS v.3 had a weak correlation with PGA and moderate correlation with both ESR and treatment decision. Prospective evaluation of BVAS v.3 and/or pediatric-specific modifications to BVAS v.3 may be required before it can be formalized as a disease activity assessment tool in pediatric AAV.

Association between the Severity of Nonalcoholic Fatty Liver Disease and High Sensitivity C-reactive Protein in Adults

Background: The relationship between nonalcoholic fatty liver disease (NAFLD) and serum high sensitivity C reactive protein (hs-CRP) is not well established, and very few studies have addressed the role of serum hs-CRP as a predictor of NAFLD severity. Methods: We examined 3,905 subjects who visited a health promotion center and were over 19 years of age. A total of 948 subjects who satisfied the NAFLD criteria were included in the final analysis. Factors associated with serum hs-CRP level or affecting body fat distribution were excluded by testing total white blood cell count, serum creatinine level, and thyroid function. The subjects were categorized into 3 groups according to the amounts of hepatic fat contents. Hepatic steatosis was assessed by ultrasonography, and the diagnosis of metabolic syndrome was made on the basis of the National Cholesterol Education Program criteria. Metabolic risk factors and hs-CRP levels were analyzed. Results: According to the NAFLD severity, 832 subjects were categorized as normal, 92 subjects were included in the mild to moderate NAFLD group, and 24 subjects were categorized into the severe group. As the NAFLD progressed to severe, the frequencies of metabolic risk factors and elevated hs-CRP level were increased (P-trend < 0.01). In univariate analysis, most metabolic risk factors were associated with NAFLD severity in both gender but the significance for elevated blood pressure and abnormal hs-CRP level were noted inonly females. After adjusting for potential confounding variables, such as other metabolic risks and liver function test, the association with NAFLD severity and serum hs-CRP level remained significant in females and in obese

Early origins of inflammation: microbial exposures in infancy predict lower levels of C-reactive protein in adulthood

Early origins of inflammation: microbial exposures in infancy predict lower levels of C-reactive protein in adulthood

Early origins of inflammation: microbial exposures in infancy predict lower levels of C-reactive protein in adulthood

Ecological factors are important determinants of the development and function of anti-pathogen defences. Inflammation is a central part of innate immunity, but the developmental factors that shape the regulation of inflammation are not known. We test the hypothesis that microbial exposures in infancy are associated with high sensitivity C-reactive protein (CRP) in adulthood using prospective data from a birth cohort in the Philippines (n = 1461). Lower birth weight was associated with increased CRP, consistent with a role for inflammation in the widely documented inverse relationship between birth weight and adult cardiovascular diseases. In addition, higher levels of microbial exposure in infancy were associated with lower CRP. These associations were independent of socioeconomic status, measures of current body fat and other health behaviours. We conclude that measures of microbial exposure and nutrition during the pre-natal and early post-natal periods are important predictors of CRP concentration in young adulthood. We speculate that the development of anti-inflammatory regulatory networks in response to early microbial exposure represents plasticity in the development of anti-pathogen defences, and that this process may help explain the low CRP concentrations in this population.

Processed Tomato Consumption Is Associated with Improved Diet Quality and Lower C-Reactive Protein in Adults

Description of Dataset • NHANES is a continuous survey conducted by the National Center for Health Statistics with survey data released every two years • The present analysis combined 3 NHANES datasets (NHANES 1999-2000, NHANES 2001-2002, and NHANES 2003-2004) • Processed tomato consumers were individuals who reported consumption of tomato products (i.e., cooked and canned tomatoes, tomato sauce, tomato juice and tomato-based condiments, including ketchup, salsa and BBQ sauce), during a 24-hour dietary recall • Groups Examined: Individuals who consumed ≥ 1/4 cup (n=1,851) of processed tomatoes to those who consumed <1/4 cup processed tomatoes (n=11,441)

C-Reactive protein in adults with chronic spinal cord injury: increased chronic inflammation in tetraplegia vs paraplegia

Cross-sectional. In community-dwelling adults with chronic spinal cord injury (SCI), to (1) quantify C-reactive protein (CRP), a marker of inflammation and cardiovascular disease (CVD) risk; (2) determine factors associated with CRP. Hamilton, Ontario, Canada. We examined CVD risk factors in 69 participants. Measurements included length, weight, waist circumference, blood pressure, percent fat mass (bioelectrical impedance analysis) and fasting blood parameters (high-sensitivity CRP, lipids, insulin, glucose, insulin resistance by homeostasis model assessment (HOMA)). Mean CRP of the group was 3.37+/-2.86 mg-l(-1), consistent with the American Heart Association (AHA) definition of high risk of CVD. CRP was 74% higher in persons with tetraplegia (4.31+/-2.97) than those with paraplegia (2.47+/-2.47 mg l(-1), P=0.002), consistent with high CVD risk. Participants with high CRP (3.1-9.9 mg l(-1)) had greater waist circumference, BMI, percent fat mass and HOMA values than those with lower CRP (< or =3.0 mg l(-1), all P<0.05). LogCRP was independently correlated with waist circumference (r=0.612), logTriglycerides (r=0.342), logInsulin (r=0.309) and logHOMA (r=0.316, all P<0.05). Only level of lesion and waist circumference remained significantly associated with logCRP when variables with significant bivariate correlations were included in multiple regression analysis. Mean CRP values in this sample of adults with chronic SCI were consistent with the AHA classification of high CVD risk, especially those of persons with tetraplegia. Level of lesion and waist circumference are independently associated with CRP in this population.

Relationship of Early Life Stress and Psychological Functioning to Adult C-Reactive Protein in the Coronary Artery Risk Development in Young Adults Study

Low socioeconomic status (SES) and a harsh family environment in childhood have been linked to mental and physical health disorders in adulthood. The objective of the present investigation was to evaluate a developmental model of pathways that may help explain these links and to relate them to C-reactive protein (CRP) in the Coronary Artery Risk Development in Young Adults (CARDIA) dataset. Participants (n = 3248) in the CARDIA study, age 32 to 47 years, completed measures of childhood SES (CSES), early family environment (risky families [RF]), adult psychosocial functioning (PsyF, a latent factor measured by depression, mastery, and positive and negative social contacts), body mass index (BMI), and C-reactive protein. Structural equation modeling indicated that CSES and RF are associated with C-reactive protein via their association with PsyF (standardized path coefficients: CSES to RF, RF to PsyF, PsyF to CRP, CSES to CRP, all p < .05), with good overall model fit. The association between PsyF and CRP was partially mediated by BMI (PsyF to BMI, BMI to CRP, both p < .05). Low childhood SES and a harsh early family environment appear to be related to elevated C-reactive protein in adulthood through pathways involving psychosocial dysfunction and high body mass index.

CRP—Marker or Maker of Cardiovascular Disease?

C-reactive protein (CRP) has emerged as an interesting novel and potentially clinically useful marker for increased cardiovascular risk.1,2 This is an attractive concept because atherosclerosis is a disease characterized by chronic arterial inflammation3,4 and suggests the possibility that subclinical states of atherosclerosis can be identified by an increase in circulating markers of inflammation before acute events occur. Based on data obtained primarily from in vitro studies it has also been proposed that CRP in itself is actively contributing to disease progression and that it should be considered as true risk factor and consequently as a target for intervention. However, in the present issue of Arteriosclerosis, Thrombosis, and Vascular Biology , two independent reports demonstrate that transgenic overexpression of CRP does not affect the development of atherosclerosis in mice, suggesting that this is not the case. See pages 1635 and 1641 The association between moderately elevated CRP levels and an increased risk for development of cardiovascular disease is well established. Although the increase in risk may have been overestimated in initial studies, recent meta-analysis comprising >7000 patients with coronary events shows that subjects with CRP in the upper tertile have a 50% increased risk for development of acute cardiovascular events.2 There are several possible explanations for this association (Figure). (1) The inflammatory process in arterial tissue affected by atherosclerosis results in release of cytokines into the circulation that subsequently activates expression of CRP in the liver. Plasma CRP levels would then reflect the severity of atherosclerosis and, as a consequence, the risk for development of clinical events. If CRP in addition …

Measurement of C-reactive protein in adults with febrile neutropenia after hematopoietic cell transplantation.

The aim of this study was to evaluate the usefulness of C-reactive protein (CRP) monitoring in the differential diagnosis and prognosis of febrile neutropenic episodes in hematopoietic cell transplantation (HCT). In all, 100 patients were enrolled in the study. The CRP was determined in serum every 48 h from admission until resolution of the febrile episode. All patients presented with fever during the post-HCT neutropenic period. The febrile episodes were classified as microbiologically documented infection in 32 cases, clinically documented infection in 27 patients and fever of unknown origin in 41 patients. The mean CRP values on the first day of fever in these three groups were similar (NS). On the fifth day of antibiotic treatment, 50 patients remained pyrexial. Of these, 41 improved with modifications of antibiotherapy (mean CRP: 9.5 mg/dl; standard deviation (s.d.): 6.2) and nine died, five due to an infectious etiology (CRP: 21 mg/dl; s.d.: 4.4; P<0.003) and four from other causes (CRP: 11 mg/dl; s.d.: 3.4). On multivariate analysis, the CRP on the fifth day of treatment was an independent prognostic factor for fatal outcome. We conclude that persistent elevation of the CRP is an independent factor predicting a fatal outcome in patients who remain febrile on the fifth day of antibiotherapy during neutropenic febrile episodes post-HCT.

Serum levels of interleukin-6, tumour necrosis factor-α, interferon-γ and C-reactive protein in adults with community-acquired pneumonia

Interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), interferon-γ (IFN-γ) and C-reactive protein concentrations in sera from 54 adults with pneumonia were determined using immunoassays. Sera sampled on days 1, 3 and 14 were examined. Eleven out of 27 patients with pneumonia due to Streptococcus pneumoniae, 2 2 with Legionella infection and 0 25 with infection due to Moraxella, Haemophilus, Staphylococcus aureus, Mycoplasma, Chlamydia, influenza A, and RS virus had IL-6 values > 500 pg ml −1 on admission. Three patients who subsequently died had persistently high values, whereas 50 51 patients who survived had decreased values on day 3. Of three patients with serum TNF-α concentrations > 200 pg ml −1, two later died. On admission the IFN-γ concentration was increased in 13 17 patients with pneumonia due to viruses, Mycoplasma pneumoniae, Chlamydia species and Legionella species. IFN-γ and IL-6 determination was found to have a differential-diagnostic potential in patients with pneumonia.