title: Risk factors for coronary heart disease and acute-phase proteins. A population-based study.
abstract: OBJECTIVE
  Circulating levels of C-reactive protein and serum amyloid A protein increase markedly, and albumin levels fall, during the acute-phase response to tissue injury, infection and inflammation. Some acute-phase proteins have been associated with increased risks of coronary heart disease in long-term prospective studies. The aim of the present study was to determine whether circulating concentrations of C-reactive protein, albumin and serum amyloid A protein are correlated with one another, standard vascular risk factors, markers of persistent infection, or indicators of socio-economic status.
  
  
  RESULTS
  We report a cross-sectional study of 704 individuals without a history of coronary heart disease from five general practices in Bedfordshire, U.K. Plasma levels of C-reactive protein and serum amyloid A protein were strongly associated with each other (2 P<0.00001) and inversely related to levels of serum albumin (2 P<0.00001). There were highly significant associations of plasma C-reactive protein concentrations with cigarette smoking and obesity (2 P<0.00001 for each). Serum albumin levels were strongly associated with blood pressure (2 P<0.0001) and plasma lipids (2 P<0.001), and concentrations of serum amyloid A protein were strongly correlated with obesity (2 P<0.0001).
  
  
  CONCLUSIONS
  Previously reported long-term prospective studies have found an increased risk of coronary heart disease of about 50% in people with raised baseline levels of plasma C-reactive protein or low albumin. The strong cross-sectional associations we have found between levels of these proteins with each other and with concentrations of serum amyloid A protein suggest that some underlying process related to inflammation is likely to be of relevance to the causation of disease. Further studies are needed to determine if the strong associations of plasma levels of C-reactive protein with cigarette smoking and obesity indicate that this particular protein can mediate some of the effects of those risk factors on coronary heart disease.
authors.affiliation: Clinical Trial Service Unit and Epidemiological Studies Unit, Radcliffe Infirmary, Oxford.
authors.forename: J
authors.initials: J
authors.lastname: Danesh
authors.forename: J
authors.initials: J
authors.lastname: Muir
authors.forename: Y K
authors.initials: YK
authors.lastname: Wong
authors.forename: M
authors.initials: M
authors.lastname: Ward
authors.forename: J R
authors.initials: JR
authors.lastname: Gallimore
authors.forename: M B
authors.initials: MB
authors.lastname: Pepys
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis*; D000328:Adult; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D006801:Humans; D008875:Middle Aged; D009765:Obesity; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D000685:Serum Amyloid A Protein / Q000032:analysis; D012907:Smoking; D012923:Social Class; D012959:Socioeconomic Factors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D012709:Serum Albumin; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein