C-reactive protein and carotid intimal medial thickness in a community population.
BACKGROUND
C-reactive protein (CRP) has been linked to cardiovascular disease and atherosclerosis. Large-scale epidemiological studies have shown a correlation of CRP level with risk of stroke, myocardial infarction and peripheral arterial disease. Nevertheless, the question whether serum CRP itself is an independent indicator of the atherosclerotic process remains unanswered.


METHODS
In a community-based sample free of advanced atherosclerotic disease (n = 1018; mean age +/- SD, 54.1 +/- 12.0 years; 49.7% women) we examined the relationship between carotid intimal medial thickness (IMT), conventional vascular risk factors (that is, smoking, obesity, elevated blood pressure, diabetes mellitus, hypercholesterolaemia) and serum CRP.


RESULTS
We found an association between increasing IMT values with increasing CRP values for all sites within the carotid system (for example, common carotid artery [CCA-] IMT, beta = 0.174, P < 0.001). The relationship was weakened after accounting for the above-mentioned conventional risk factors (linear regression), particularly body mass index, but remained significant (for example, mean CCA-IMT beta = 0.02, P = 0.042). Including fibrinogen in the regression made the relationship no longer significant (mean CCA-IMT beta = 0.01, P = 0.277).


CONCLUSIONS
It is unlikely that CRP per se is a major independent cause of early arteriosclerosis. Elevations of CRP, or less specifically chronic inflammation, may mediate the effect of certain conventional risk factors on promoting atherogenesis, especially obesity.
Sitzer
Matthias
M
Department of Neurology, J.W. Goethe-University Frankfurt am Main, Germany, St George's Hospital Medical School, London, UK. sitzer@em.uni-franfurt.de
Markus
Hugh S
HS
Mendall
Michael A
MA
Liehr
Rüdiger
R
Knorr
Uwe
U
Steinmetz
Helmuth
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D017536:Carotid Artery, Common / Q000737:chemistry* / Q000000981:diagnostic imaging / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D003153:Community Health Services; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors; D012737:Sex Factors; D013223:Statistics as Topic; D017539:Tunica Intima / Q000737:chemistry* / Q000000981:diagnostic imaging / Q000378:metabolism; D014463:Ultrasonography
D002097:C-Reactive Protein; D008078:Cholesterol, LDL; D005340:Fibrinogen; D006442:Glycated Hemoglobin