Association of lipid and inflammatory markers with C-reactive protein in cardiovascular risk assessment for primary prevention.
BACKGROUND
High-sensitivity C-reactive protein (hsCRP) has been recognized as an independent marker of cardiovascular risk. Since atherosclerosis is a multifactorial disease, the aim of this study was to determine association between hsCRP and other markers of inflammation and dyslipidemia.


METHODS
In 242 healthy volunteers, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), nonHDL-C, triglycerides (TG) and hsCRP were measured using Olympus AU2700. Apolipoprotein A-I (apoAI), apolipoprotein B (apo B), lipoprotein (a) (Lp(a)), haptoglobin, alpha1-acid glycoprotein (A1AGP), C3 and C4 complement components were determined on Architect c8000, and serum amyloid A (SAA) and fibrinogen on BN II nephelometer and ACL 7000, respectively.


RESULTS
Significant (P < 0.05) partial Pearson's correlation coefficients were found between hsCRP and TC (r = 0.172), nonHDL-C (r = 0.182), LDL-C (r = 0.154), apoB (r = 0.167), fibrinogen (r = 0.411), SAA (r = 0.493), A1AGP (r = 0.462), haptoglobin (r = 0.310), C3 (r = 0.349) and C4 (r = 0.371). In multiple regression analysis, BMI, SAA, A1AGP, fibrinogen and nonHDL-C showed independent correlation with hsCRP. Multinomial logistic regression analysis demonstrated that BMI, nonHDL, fibrinogen and SAA were strong predictors of hsCRP concentration. Odds ratios for intermediate and high risk categories compared with the low risk category were 1.177 (1.033-1.341) and 1.289 (1.091-1.523), 1.515 (1.021-2.249) and 2.062 (1.246-3.411), 2.241 (1.268-3.959) and 7.123 (3.259-15.568), and 1.387 (1.179-1.632) and 1.691 (1.397-2.047), for BMI, nonHDL-C, fibrinogen and SAA, respectively.


CONCLUSIONS
The prediction of risk for future cardiac events based on hsCRP concentration, which is the recommended parameter for improving cardiovascular risk stratification, might be complemented with the information about BMI, nonHDL-C, fibrinogen and SAA.
Institute of Medical Biochemistry, Clinical Centre of Serbia, Belgrade, Serbia. hionati@gmail.com
Snezana
S
Jovicić
Svetlana
S
Ignjatović
Marijana
M
Dajak
Ranka
R
Kangrga
Nada
N
Majkić-Singh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000276:immunology / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011322:Primary Prevention; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000032:analysis*
D015415:Biomarkers; D000685:Serum Amyloid A Protein; D005340:Fibrinogen; D002097:C-Reactive Protein; D002784:Cholesterol