title: Combined oral contraception and obesity are strong predictors of low-grade inflammation in healthy individuals: results from the Danish Blood Donor Study (DBDS).
abstract: BACKGROUND
  C-reactive protein (CRP) is a well-established marker of inflammation. The level of CRP is affected by several lifestyle factors. A slightly increased CRP level, also known as low-grade inflammation (LGI), is associated with increased risk of several diseases, especially cardiovascular disease. The aim of this study was to identify predictors of increased CRP levels in healthy individuals. We therefore assessed CRP in a large cohort of blood donors.
  
  
  METHODS
  We measured plasma CRP levels in 15,684 participants from the Danish Blood Donor Study. CRP was measured by a commercial assay. Furthermore, all participants completed a standard questionnaire on smoking status, alcohol consumption, physical activity, diet, and various body measurements. Female participants also reported the use of contraception, childbirth, and menopausal status. The relationship between LGI (defined here as a plasma CRP level between 3 mg/L and 10 mg/L) and predictors was explored by multivariable logistic regression analysis. Results were presented as odds ratios (OR) with 95% confidence intervals (CI).
  
  
  RESULTS
  We found LGI in a total of 1,561 (10.0%) participants. LGI was more frequent in women using combined oral contraception (OC) (29.9%) than in men (6.1%) and women not using OC (7.9%). Among premenopausal women, OC was the strongest predictor of LGI (odds ratio = 8.98, p<0.001). Additionally, body mass index (BMI) and waist circumference were positively associated with LGI.
  
  
  CONCLUSIONS
  High BMI and abdominal obesity strongly predicted LGI among healthy individuals. However, the most striking finding was the high prevalence of LGI among premenopausal women who used combined oral contraception. Although the significance of CRP as a marker of inflammation is well known, the role of CRP in pathogenesis is still uncertain. The impact of oral contraception on CRP levels should nevertheless be considered when CRP is used in risk assessment.
authors: Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
authors: Cecilie J
authors: CJ
authors: Sørensen
authors: Department of Clinical Immunology, Næstved Sygehus, Næstved, Denmark.
authors: Ole B
authors: OB
authors: Pedersen
authors: Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
authors: Mikkel S
authors: MS
authors: Petersen
authors: Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: Erik
authors: E
authors: Sørensen
authors: Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
authors: Sebastian
authors: S
authors: Kotzé
authors: Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: Lise W
authors: LW
authors: Thørner
authors: Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
authors: Henrik
authors: H
authors: Hjalgrim
authors: Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: Andreas S
authors: AS
authors: Rigas
authors: Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
authors: Bjarne
authors: B
authors: Møller
authors: Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
authors: Klaus
authors: K
authors: Rostgaard
authors: Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark.
authors: Mads
authors: M
authors: Riiskjær
authors: Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: Henrik
authors: H
authors: Ullum
authors: Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
authors: Christian
authors: C
authors: Erikstrup
mesh_terms: D000328:Adult; D001782:Blood Donors; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D003718:Denmark; D005260:Female; D006262:Health; D006801:Humans; D007249:Inflammation / Q000139:chemically induced* / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008593:Menopause; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications*; D012907:Smoking
chemical_list: D003277:Contraceptives, Oral, Combined; D002097:C-Reactive Protein