title: Bronchial airflow limitation, smoking, body mass index, and statin use are strongly associated with the C-reactive protein level in the elderly. The Tromsø Study 2001.
abstract: BACKGROUND
  Bronchial airflow limitation is a known predictor of raised C-reactive protein (CRP) level. The aim of this study was to explore this association in an elderly population, as well as the influence of other known and possible predictors of the CRP level, like smoking and the use of statins and inhaled corticosteroids.
  
  
  METHODS
  The study population consists of 3877 Norwegians aged 60 years or more who took part in the fifth Tromsø study in 2001, a cross-sectional study. The examinations included questionnaires, spirometry and the measurement of CRP.
  
  
  RESULTS
  A geometric mean CRP value of 3.15 mg/L was found in subjects with severe airflow limitation (FEV(1)%<50 predicted and FEV(1)/FVC<70%), compared to 1.64 mg/L in subjects with normal spirometry, (p<0.001), and 19% of the subjects with severe airflow limitation had a CRP value above 10 mg/L compared to 4.9% in those with mild airflow limitation or normal spirometry. Elevated body mass index (BMI), smoking, hormone replacement therapy, and increasing age, were also strong independent predictors of increased CRP. Statin use was a strong predictor of decreased CRP level, while the use of inhaled corticosteroids was not associated with decreased CRP values.
  
  
  CONCLUSIONS
  We found a strong link between bronchial airflow limitation and the circulating CRP level in an elderly population, independent of self-reported diseases, medication, smoking, and elevated BMI. The CRP value increased with increasing age in men, but not in women, which may be partly explained by a greater impact of chronic obstructive pulmonary disease (COPD) morbidity on the CRP level in men than in women. Measuring CRP may show to be a useful part of the diagnostic work-up in COPD patients.
authors.affiliation: Institute of Community Medicine, University of Tromso, 9037 Tromso, Norway. hasse.melbye@ism.uit.no
authors.forename: Hasse
authors.initials: H
authors.lastname: Melbye
authors.forename: Dag S
authors.initials: DS
authors.lastname: Halvorsen
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Hartz
authors.forename: Astri
authors.initials: A
authors.lastname: Medbø
authors.forename: Jan
authors.initials: J
authors.lastname: Brox
authors.forename: Anne Elise
authors.initials: AE
authors.lastname: Eggen
authors.forename: Inger
authors.initials: I
authors.lastname: Njølstad
mesh_terms: D000280:Administration, Inhalation; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016084:Bronchoconstriction / Q000502:physiology*; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D015914:Estrogen Replacement Therapy; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006306:Health Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000503:physiopathology; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D013147:Spirometry