title: Factors determining high-sensitivity C-reactive protein values in the Spanish population. Di@bet.es study.
abstract: BACKGROUND
  Although high-sensitivity C-reactive protein (hs-CRP) is currently used as a risk marker of cardiovascular disease, it has been suggested that genetic, clinical, biochemical or environmental factors could modify hs-CRP levels. The aim of this study was to investigate sources of interindividual hs-CRP variability in the Spanish population.
  
  
  METHODS
  A representative sample of the Spanish population within the di@bet.es study was used. Study variables included a clinical and demographic structured survey, a lifestyle survey, a physical examination, plasmatic hs-CRP and other biochemical parameters.
  
  
  RESULTS
  Median and interquartile range of plasma hs-CRP values were 1·73 ± 2·75 mg/dL. Thirty per cent of the study population had hs-CRP levels above 3 mg/dL and 38% from 1 to 3 mg/dL. Body mass index was the strongest factor associated with moderate and high hs-CRP levels. Age, sex, waist-to-hip ratio, weight increase, plasma lipid levels, glucose metabolism (HOMA-IR and abnormal glucose regulation categories), pharmacological treatment (lipid-lowering agents, psychotropic drugs and levothyroxine), smoking, physical activity, different dietary patterns, quality of life and educational level were all significantly associated with hs-CRP levels. Interactions were observed between variables. These interactions modulated the effect of previously described factors on hs-CRP.
  
  
  CONCLUSIONS
  Thirty per cent of the Spanish population have hs-CRP levels considered to represent a cardiovascular risk. Different clinical, anthropometric, biochemical and environmental variables modulate hs-CRP levels. In addition, multiple interactions between variables complicate the interpretation of hs-CRP values.
authors.affiliation: Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Rojo-Martínez
authors.forename: Federico
authors.initials: F
authors.lastname: Soriguer
authors.forename: Natalia
authors.initials: N
authors.lastname: Colomo
authors.forename: Alfonso
authors.initials: A
authors.lastname: Calle
authors.forename: Alberto
authors.initials: A
authors.lastname: Goday
authors.forename: Elena
authors.initials: E
authors.lastname: Bordiú
authors.forename: Elías
authors.initials: E
authors.lastname: Delgado
authors.forename: Edelmiro
authors.initials: E
authors.lastname: Menéndez
authors.forename: Emilio
authors.initials: E
authors.lastname: Ortega
authors.forename: Inés
authors.initials: I
authors.lastname: Urrutia
authors.forename: Juan
authors.initials: J
authors.lastname: Girbés
authors.forename: Luis
authors.initials: L
authors.lastname: Castaño
authors.forename: Miguel
authors.initials: M
authors.lastname: Catalá
authors.forename: Sonia
authors.initials: S
authors.lastname: Gaztambide
authors.forename: Sergio
authors.initials: S
authors.lastname: Valdés
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D025341:Principal Component Analysis; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D049629:Waist-Hip Ratio / Q000706:statistics & numerical data
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein