Elevated serum C-reactive protein levels and early arterial changes in healthy children

Objective-Elevated serum concentration of C-reactive protein (CRP) predicts cardiovascular events in adults. Because atherosclerosis begins in childhood, we undertook a study to determine whether changes in brachial artery endothelial function and the thickness of the carotid intima-media complex, 2 markers of early atherosclerosis, are related to CRP levels in healthy children. Methods and Results-Brachial artery flow-mediated dilatation (FMD) and carotid artery intima-media thickness (IMT) were measured with ultrasound in 79 children (aged 10.5+/-1.1 years). Compared with the children with CRP levels under the detection limit (<0.1 mg/L, n=40, group 1), the children with higher CRP (0.1 mg/Lless than or equal toCRPless than or equal to0.7 mg/L, n=20, group 2; CRP>0.7 mg/L, n=19, group 3) had lower FMD (9.0+/-4.4% versus 7.8+/-3.3% versus 6.5+/-2.6%, respectively; P=0.015 for trend) and greater carotid IMT (0.45+/-0.03 versus 0.46+/-0.04 versus 0.49+/-0.06 mm, respectively, P=0.002 for trend). CRP level remained a statistically significant independent predictor for brachial FMD and carotid IMT in multivariate analyses. Conclusions-These data suggest that CRP affects the arteries of healthy children by disturbing endothelial function and promoting intima-media thickening. The findings support the hypothesis that CRP plays a role in the pathogenesis of early atherosclerosis.