2007, Number S3
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salud publica mex 2007; 49 (S3)
C-reactive protein concentrations in Mexican men and women: high prevalence of a cardiovascular risk factor
Flores M, Barquera S, Carrión C, Rojas R, Villalpando S, Olaiz-Fernández G, González-Villalpando C
Language: Spanish
References: 38
Page: 348-360
PDF size: 283.33 Kb.
ABSTRACT
Objective. To examine the distribution and correlates of C-reactive protein (CRP) concentrations in Mexican adults.
Material and Methods. Data was analyzed from 2 194 Mexican adults who participated in the 2000 National Health Survey (ENSA-2000). CRP concentrations were measured with a high-sensitivity assay. Information on sociodemographic characteristics, chronic disease and habits was obtained. Fasting blood glucose, blood pressure, weight, height and waist circumference were measured.
Results. A total of 730 men and 1 464 non-pregnant women were studied. Mean age was 38.3±15.2 years. CRP concentrations ranged from 0.19 to 255 mg/L (median: 2.26; interquartile range (FIR): 0.96, 5.83 mg/L). CRP concentrations were higher in women (median: 2.86; IR: 1.11, 6.68 mg/L) than men (median: 1.63; IR: 0.8, 3.87 mg/L;
p‹0.001). Thirty-one percent of individuals (35.1% women, 23.3% men) had CRP concentrations ›3.0-10 mg/L. Multivariate probit regression analysis showed that age, BMI, waist circumference, diabetes, microalbuminuria and use of oral contraceptives were positively associated with CRP concentrations ›1 mg/L. Male gender and moderate alcohol consumption were negatively associated with CRP concentrations ›3 mg/L (
p‹0.05).
Conclusion. There is a high prevalence of CRP concentrations in the range of ›3.0-10 mg/l in Mexican adults, indicating a considerable proportion of individuals at risk for cardiovascular disease, independent of other risk factors.
REFERENCES
Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003;111:1805-1812.
Hackam DG, Anand SS. Emerging risk factors for atherosclerotic vascular disease. A critical review of the evidence. JAMA 2003;290: 932-940.
Danesh J, Whincup P, Walker M, Lennon L, Thomson A, Appleby P, et al. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ 2000;321:199-204.
Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice. A statement for health care professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499-511.
Barquera S, Carrión C, Campos I, Espinosa J, Rivera JA, Olaiz-Fernández G. Methodology of the fasting sub-sample from the Mexican Health Survey 2000. Salud Publica Mex 2007;49:S421-S426.
Ledue TB, Weiner DL, Sipe JD, Poulin SE, Collins MF, Rifai N. Analytical evaluation of particle-enhanced immunonephelometric assays for C-reactive protein, serum amyloid A, and mannose-binding protein in human serum. Ann Clin Biochem 1998;35(Pt6):745-753.
US Department of Health and Human Services. Food and Drug Administration. Review criteria for assessment of C-reactive protein (CRP), high sensitivity C-reactive protein (hsCRP) and cardiac C-reactive protein (cCRP) Assays. Document issued on: September 22, 2005. Disponible en: NK «http://www.fda.gov/cdrh/oivd/guidance/1246.pdf» http://www.fda.gov/cdrh/oivd/guidance/1246.pdf.
Lohman T, Roche A, Martorell R. Anthropometrics standardization reference manual. Champaign, IL: Human Kinetics Books, 1988.
Habicht JP. Standardization of quantitative epidemiological methods in the field. Bol Of Sanit Panam 1974;76(5):375-384.
Lipsy RJ. The National Cholesterol Education Program Adult Treatment Panel III guidelines. J Manag Care Pharm 2003;9 Suppl 1:2-5.
Ford ES, Giles WH, Myers GL, Mannino DM. Population distribution of high-sensitivity C-reactive protein among US men: findings from National Health and Nutrition Survey 1999-2000. Clin Chem 2003;49(4):686-689.
Ford ES, Giles WH, Mokdad AH, Myers GL. Distribution and correlates of C-reactive protein concentrations among US adult women. Clin Chem 2004;50(3):574-581.
Sattar N, Gaw A, Scherbakova O, Ford I, O’Reilly D, Haffner SM, et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003;108:414-419.
Ridker PM. High-sensitivity C-reactive protein, inflammation, and cardiovascular risk: from concept to clinical practice to clinical benefit. Am Heart J 2004;148:S19-S26.
Ridker PM, Wilson PW, Grundy SM. Should C-reactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk? Circulation 2004;109:2818-2825.
Cook NR, Buring JE, Ridker PM. The effect of including C-reactive protein in cardiovascular risk prediction models for women. Ann Intern Med 2006;145:21-29.
Long SJ. Regression models for categorical and limited dependent variables. Thousand Oaks, CA: SAGE Publications, 1997.
Ley de Información Estadística y Geográfica. Diario Oficial de la Federación, Estados Unidos Mexicanos, 1980.
Diverse Populations Collaborative Group. Prediction of mortality from coronary heart disease among diverse populations: is there a common predictive function? Heart 2002;88:222-228.
Ford ES. Body mass index, diabetes, and C-reactive protein among U.S. adults. Diabetes Care 1999;22(12):1971-1977.
Han TS, Sattar N, Williams K, González-Villalpando C, Lean ME, Haffner SM. Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study. Diabetes Care 2002;25(11):2016-2021.
Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001;286:327-334.
Freeman DJ, Norrie J, Caslake MJ, Gaw A, Ford I, Lowe GD, et al. C-reactive protein is an independent predictor of risk of the development of diabetes in the West of Scotland Coronary Prevention Study. Diabetes 2002;51:1596-1600.
Barzilay JL, Abraham L, Heckbert SR, Cushman M, Kuller LH, Resnick HE, et al. The relation of markers of inflammation to the development of glucose disorders in the elderly: the Cardiovascular Health Study. Diabetes 2001;50:2384-2389.
Schmidt MI, Duncan BB, Sharrett AR, Lindberg G, Savage PJ, Offenbacher S, et al. Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities study): a cohort study. Lancet 1999;353:1649-1652.
Pickup JC. Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. Diabetes Care 2004;27:813-823.
Tataranni PA, Ortega E. Does and adipokine-induced activation of the immune system mediate the effect of overnutrition on type 2 diabetes? Diabetes 2005;54:917-927.
Libby P. Inflammation in atherosclerosis. Nature 2002;420:868-874.
Wang TJ, Nam BH, Wilson PW, Wolf PA, Levy D, Polak JF, et al. Association of C-reactive protein with carotid atherosclerosis in men and women: The Framingham Heart Study. Arterioscler Thromb Vasc Biol 2002;22:1662-1667.
Zwaka TP, Hombach V, Torzewski J. C-reactive protein-mediated low density lipoprotein uptake by macrophages: implications for atherosclerosis. Circulation 2001;103:1194-1197.
Clapp BR, Hirschfield GM, Storry C, Gallimore JR, Stidwill RP, Singer M, et al. Inflammation and endothelial function: direct vascular effects of human C-reactive protein on nitric oxide bioavailability. Circulation 2005;111(12):1530-1536.
US Department of Health and Human Services. Centers for Disease Control and Prevention. National Center for Health Statistics. Health, United States, 2004. Disponible en: /hus/hus04trend.pdf#067” http://www.cdc.gov/nchs/data/hus/hus04trend.pdf#067.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-3421.
Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel W. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837-1847.
Pepys MB, Hirschfield GM, Tennent GA, Gallimore JR, Kahan MC, Belloti B, et al. Targeting C-reactive protein for the treatment of cardiovascular disease. Nature 2006;440:1217-1221.
Smith GD, Timpson N, Lawlor DA. C-reactive protein and cardiovascular disease risk: still an unknown quantity? Ann Intern Med 2006;145:70-71.
Scirica BM, Morrow DA. Is C-reactive protein an innocent bystander or proatherogenic culprit? The veridict is still out. Circulation 2006;113:2128-2134.
Rivera JA, Barquera S, Campirano F, Campos I, Safdie M, Tovar V. Epidemiological and nutritional transition in Mexico: rapid increase of non-communicable chronic diseases and obesity. Public Health Nutr 2002; 5(1A):113-122.