C-reactive protein as a screening test for cardiovascular risk in a multiethnic population.
BACKGROUND
Small increases in the inflammatory marker C-reactive protein (CRP) are predictive of vascular events among asymptomatic individuals. There are few data supporting the use of CRP as a risk marker among nonwhite individuals.


RESULTS
1250 adults of South Asian, Chinese, European, and Aboriginal ancestry were randomly sampled from 4 communities in Canada. Participants provided fasting blood samples for CRP, glucose, lipids, and coagulation factors, and they had undergone a carotid B-mode ultrasound. Cardiovascular disease was determined by history and electrocardiogram. The age- and sex-adjusted mean CRP was 3.74 mg/L (standard error, 0.14) among Aboriginals, 2.59 mg/L (0.12) among South Asians, and 1.18 mg/L (0.13) among Chinese compared with 2.06 mg/L (0.12) among Europeans (overall P<0.0001). Differences in the CRP concentration between ethnic groups were substantially diminished, but not abolished, after adjustment for metabolic factors. CRP was independently associated with CVD after adjusting for the Framingham risk factors, atherosclerosis, anthropometric measurements, and ethnicity (OR=1.03 for a 0.1-increase in CRP; P=0.02).


CONCLUSIONS
CRP varies substantially between people of different ethnic origin and is influenced by their differences in metabolic factors. Prospective validation of CRP as a risk predictor for cardiovascular disease among nonwhite ethnic groups is required.
Anand
Sonia S
SS
Department of Medicine, McMaster University, Hamilton, ON, Canada. anands@mcmaster.ca
Razak
Fahad
F
Yi
Qilong
Q
Davis
Bonnie
B
Jacobs
Ruby
R
Vuksan
Vlad
V
Lonn
Eva
E
Teo
Koon
K
McQueen
Matthew
M
Yusuf
Salim
S
D000328:Adult; D000368:Aged; D000886:Anthropometry; D001208:Asia / Q000208:ethnology; D001779:Blood Coagulation Factors / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology; D002681:China / Q000208:ethnology; D004562:Electrocardiography; D005006:Ethnicity; D005060:Europe / Q000208:ethnology; D005260:Female; D006801:Humans; D007198:Indians, North American; D008055:Lipids / Q000097:blood; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012016:Reference Values; D012306:Risk; D012494:Sampling Studies; D014463:Ultrasonography
D001779:Blood Coagulation Factors; D001786:Blood Glucose; D008055:Lipids; D002097:C-Reactive Protein