title: Hepatic steatosis, obesity, and the metabolic syndrome are independently and additively associated with increased systemic inflammation.
abstract: OBJECTIVE
  The goal of this study was to assess the independent and collective associations of hepatic steatosis, obesity, and the metabolic syndrome with elevated high-sensitivity C-reactive protein (hs-CRP) levels.
  
  
  RESULTS
  We evaluated 2388 individuals without clinical cardiovascular disease between December 2004 and December 2006. Hepatic steatosis was diagnosed by ultrasound, and the metabolic syndrome was defined using National Heart, Lung, and Blood Institute criteria. The cut point of ≥3 mg/L was used to define high hs-CRP. Multivariate logistic regression was used to assess the independent and collective associations of hepatic steatosis, obesity, and the metabolic syndrome with high hs-CRP. Steatosis was detected in 32% of participants, 23% met criteria for metabolic syndrome, and 17% were obese. After multivariate regression, hepatic steatosis (odds ratio [OR] 2.07; 95% CI 1.68 to 2.56), obesity (OR 3.00; 95% CI 2.39 to 3.80), and the metabolic syndrome (2.39; 95% CI 1.88 to 3.04) were all independently associated with high hs-CRP. Combinations of these factors were associated with an additive increase in the odds of high hs-CRP, with individuals with 1, 2, and 3 factors having ORs for high hs-CRP of 1.92 (1.49 to 2.48), 3.38 (2.50 to 4.57), and 4.53 (3.23 to 6.35), respectively.
  
  
  CONCLUSIONS
  Hepatic steatosis, obesity, and the metabolic syndrome are independently and additively associated with increased odds of high hs-CRP levels.
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
authors.forename: Chiadi E
authors.initials: CE
authors.lastname: Ndumele
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.forename: Raquel D
authors.initials: RD
authors.lastname: Conceiçao
authors.forename: Jose A M
authors.initials: JA
authors.lastname: Carvalho
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Raul D
authors.initials: RD
authors.lastname: Santos
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D016017:Odds Ratio; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D002097:C-Reactive Protein