Ethnicity and sex modify the association of serum c-reactive protein with microalbuminuria.
OBJECTIVE
To study the association between serum C-reactive protein (CRP) and urinary albumin excretion in the Multi-Ethnic Study of Atherosclerosis and to assess whether the association is modified by ethnicity, sex, or systolic blood pressure.


METHODS
This was a cross-sectional study of 6675 participants who were free from macroalbuminuria and clinical cardiovascular disease (mean age 62.1 years, 53% female; 39% White, 27% African American, 22% Hispanic, and 12% Chinese). Urinary albumin excretion was measured by spot urine albumin-to-creatinine ratio (ACR). Effect modifications were tested after adjusting for age, diabetes, body mass index, smoking, use of angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker, other antihypertensive drugs, estrogens, statins, and high-density lipoprotein cholesterol and triglyceride levels.


RESULTS
The association between CRP and ACR was modified by ethnicity (P=.01) and sex (P<.001), but not by systolic blood pressure. After multivariate adjustment, the association remained in Chinese, African American, and Hispanic men and African American women (P<.02 for African American men, and P<.04 for the other subgroups).


CONCLUSIONS
The association between CRP and ACR was modified by ethnicity and sex; it was stronger in non-White men and African American women. These interactions have not been reported before, and future studies should consider them.
Palmas
Walter
W
Department of Medicine, Mailman School of Public Health, Columbia University, New York, New York, USA.
Ma
Shuangge
S
Jacobs
David R
DR
Arnett
Donna
D
Jackson
Sharon
S
Olson
Jean
J
Saad
Mohammed F
MF
Kronmal
Richard
R
Kramer
Holly
H
Barr
R Graham
RG
D000368:Aged; D000419:Albuminuria / Q000097:blood* / Q000208:ethnology* / Q000503:physiopathology; D050197:Atherosclerosis / Q000208:ethnology / Q000378:metabolism / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data*
D002097:C-Reactive Protein
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