title: Effect of body mass index, physical activity, depression, and educational attainment on high-sensitivity C-reactive protein in patients with atrial fibrillation.
abstract: Atherosclerosis development is a complex process, with inflammation, indicated by elevated high-sensitivity C-reactive protein (hs-CRP), as a potential mediator. Obesity, physical activity, and depression have all been reported to affect hs-CRP. However, these factors are interconnected, and their relative individual importance remains unclear. From a separate prospective cohort study, 289 patients were selected for the present substudy. We assessed the relation of a variety of potential predictors and hs-CRP. Obesity, physical activity, and depression, in addition to several other potential factors, were analyzed in bivariate and multivariate linear regression models, adjusting for potential confounders. In unadjusted analyses, mild-to-moderate and severe depression were associated with increased hs-CRP compared to no or minimal depression. Vigorous physical activity was associated with decreased hs-CRP compared to no physical activity. All classes of obesity were associated with increased hs-CRP. In addition, attaining a college or graduate degree was associated with decreased hs-CRP compared to high school or less educational attainment. On multivariate analysis, depression was no longer associated with increased hs-CRP. Physical activity remained associated with decreased hs-CRP but only at vigorous levels. Educational attainment also remained associated but only at the collegiate or professional education level. Ultimately, obesity remained the greatest absolute predictor of elevated hs-CRP. In conclusion, in analyses of multiple factors potentially predictive of elevated hs-CRP in a large population of patients with subclinical coronary heart disease, we found the most important predictor to be obesity.
authors.affiliation: Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. jrommel@unch.unc.edu
authors.forename: John
authors.initials: J
authors.lastname: Rommel
authors.forename: Ross
authors.initials: R
authors.lastname: Simpson
authors.forename: John Paul
authors.initials: JP
authors.lastname: Mounsey
authors.forename: Eugene
authors.initials: E
authors.lastname: Chung
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schwartz
authors.forename: Irion
authors.initials: I
authors.lastname: Pursell
authors.forename: Anil
authors.initials: A
authors.lastname: Gehi
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009657:North Carolina / Q000453:epidemiology; D010045:Outpatients; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein