C-reactive protein reference percentiles among pre-adolescent children in Europe based on the IDEFICS study population.
OBJECTIVE
C-reactive protein (CRP) is involved in a wide range of diseases. It is a powerful marker for inflammatory processes used for diagnostic and monitoring purposes. We aimed to establish reference values as data on the distribution of serum CRP levels in young European children are scarce.


METHODS
Reference values of high-sensitivity CRP concentrations were calculated for 9855 children aged 2.0-10.9 years, stratified by age and sex. The children were recruited during the population-based European IDEFICS study (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS) with 18 745 participants recruited from 2007 to 2010.


RESULTS
In 44.1% of the children, CRP values were below or equal the detection limit of 0.2 mg/l. Median CRP concentrations showed a slight negative age trend in boys and girls, whereas serum CRP values were slightly higher in girls than in boys across all age groups.


CONCLUSIONS
Our population-based reference values of CRP may guide paediatric practice as elevated values may require further investigation or treatment. Therefore, the presented reference values represent a basis for clinical evaluation and for future research on risk assessment of diseases associated with increased CRP levels among children.
Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
H
H
Schlenz
Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
T
T
Intemann
Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
M
M
Wolters
Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain.
E M
EM
González-Gil
Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
A
A
Nappo
Medizinisches Versorgungszentrum Dr Eberhard und Partner Dortmund, Laboratoriumsmedizin, Dortmund, Germany.
A
A
Fraterman
National Institute for Health Development, Tallinn, Estonia.
T
T
Veidebaum
National Institute of Health Promotion, University of Pécs, Pécs, Hungary.
D
D
Molnar
Research and Education Institute of Child Health, Strovolos, Cyprus.
M
M
Tornaritis
Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
I
I
Sioen
Department of Paediatrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
S
S
Mårild
Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo, NEUROMED, Italy.
L
L
Iacoviello
1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Bremen, Germany.
W
W
Ahrens
D050154:Adiposity; D000367:Age Factors; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D011237:Predictive Value of Tests; D012016:Reference Values; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D044465:White People
D015415:Biomarkers; D002097:C-Reactive Protein