title: Total cholesterol-to-high-density lipoprotein cholesterol ratio predicts high-sensitivity C-reactive protein levels in Turkish children.
abstract: BACKGROUND
  High-sensitivity C-reactive protein (hs-CRP) is a biomarker of continued long-term systemic inflammation and cardiovascular (CV) risk.
  
  
  OBJECTIVE
  To analyze the association of hs-CRP levels with CV risk factors in healthy school children.
  
  
  METHODS
  The study sample was derived from a survey on the prevalence of CV risk factors (dyslipidemia, obesity, high blood pressure, and insulin resistance in school children. Along with anthropometry, hs-CRP levels, lipids, glucose levels, and insulin levels were measured.
  
  
  RESULTS
  Ninety-one male (12.5 ± 3.4 years) and 77 female students (12.7 ± 3.4; P = .624) were included. Median (interquartile range) hs-CRP levels were similar among boys and girls (0.4 [1.2] vs 0.5 [0.7]; P = .928). Risk factors such as obesity (16%), high triglycerides (20%), low high-density lipoprotein cholesterol (HDL-C, 16%), and elevated blood pressure (25%) were commonly observed in study participants. Gender-stratified analysis displayed that insulin resistance (18 [19.8%] vs 3 [3.9%]; P = .002) and high triglycerides (26 [28.6%] vs 8 [10.4%]; P = .003) were more commonly observed among boys compared with girls. hs-CRP levels correlated positively with cardiometabolic risk factors such as waist circumference (boys) and total cholesterol (TC)-to-HDL-C ratio. Linear regression analysis displayed that among the covariates of age, body mass index, and glucose, TC-to-HDL-C ratio was the most significant determinant of hs-CRP levels (P = .004).
  
  
  CONCLUSIONS
  Cardiometabolic risk factors such as TC-to-HDL-C ratio correlate with hs-CRP levels in children and adolescents. Long-term prospective studies are needed to confirm the association between hs-CRP and cardiometabolic risk in children.
authors.affiliation: Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey. Electronic address: magirbasli@gmail.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Agirbasli
authors.affiliation: Department of Cardiology, Maltepe State Hospital, Istanbul, Turkey.
authors.forename: Azra
authors.initials: A
authors.lastname: Tanrikulu
authors.affiliation: Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Busra
authors.initials: B
authors.lastname: Acar Sevim
authors.affiliation: Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Munir
authors.initials: M
authors.lastname: Azizy
authors.affiliation: Department of Biostatistics, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Nural
authors.initials: N
authors.lastname: Bekiroglu
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000235:genetics / Q000473:pathology; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood* / Q000235:genetics; D050171:Dyslipidemias / Q000097:blood / Q000235:genetics / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000235:genetics / Q000473:pathology; D007333:Insulin Resistance / Q000235:genetics; D008297:Male; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014421:Turkey
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein
keywords: C-reactive protein; Cardiometabolic risk; Children; TC-to-HDL-C ratio