Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 177, Issue 12, Pages 1430-1442Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kws443
Keywords
C-reactive protein; inflammation; population; risk factors
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Funding
- National Health and Medical Research Council of Australia [482800]
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C-reactive protein (CRP) is a well-known biomarker of systemic inflammation and cardiovascular disease. We investigated the trends in prevalence of elevated CRP levels (3.0 mg/L) in a general population of US adults. Data from 27,214 subjects aged 20 years in the 19992010 National Health and Nutrition Examination Survey were analyzed. After adjustment for age, sex, race/ethnicity, body mass index (weight (kg)/height (m)(2)), and medications for lowering blood pressure, glucose, and lipids, the prevalence of elevated CRP decreased significantly from 36.7 in 19992002 to 32.0 in 20072010, corresponding to a decrease in mean CRP level from 1.92 to 1.66 mg/L (both P 0.001). The trend remained significant after additional adjustment for several traditional cardiovascular risk factors and use of different medications, including statins. However, the decreasing trends were attenuated after additional adjustment for total bilirubin (P 0.08 and 0.02), which increased from 0.62 to 0.73 mg/dL over 12 years (P 0.001). The decreasing trend of CRP levels is encouraging and may be related to the increase in total bilirubin levels. Such trends may be explained in part by the increasing use of medications such as statins, which can increase bilirubin levels and decrease CRP levels.
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