Abstract 3904: What Drives (Elevated) High-Sensitive CRP In The General Population?
Background. Recently, elevated hs-CRP in otherwise healthy adults has been associated with increased cardiovascular risk. In univariate analyses, hs-CRP clusters with several conventional risk indicators. We addressed hs-CRP’s population determinants (among conventional risk factors, body size indices and lifestyle variables) in a multivariable setting. The Asklepios study is a representative sample (apparently healthy M/F volunteers, aged 35–55 y at study initiation) from the Belgian general population.
Methods. Our study included 2498 subjects free from clinical inflammation. Vascular echographies (Vivid 7) of carotid and femoral arteries were systematically performed. Atherosclerosis was defined by presence of carotid or femoral plaque or intima-media thickness >0.9mm. hs-CRP was assayed by particle-enhanced immunoturbidimetry (fasting blood samples) and values > 20 mg/l (1.0 % of the subjects) were excluded from analyses.
Results. Echographically detectable atherosclerosis was present in 39.5% of subjects; its presence explained at best 1.2% of hs-CRP variance. Multivariate models explaining variance of hs-CRP included age, gender, body size, lipid levels, smoking and passive smoking, blood pressures, season of blood sampling, glycaemia, lipid or blood pressure lowering drugs, fruit/vegetable intake, physical activity, educational achievement and alcohol intake as input. Independent determinants of log(hs-CRP) in the groups with and without atherosclerosis are summarized in the Table⇓.
Conclusions. At population level, the primary determinants of hs-CRP are gender and waist circumference, both in subjects with and without echographically detectable atherosclerosis. Gender and waist explain about 15% of the variance of hs-CRP. Presence of atherosclerosis and/or additional factors adds limited information (3–4% variance) suggesting that fat-driven inflammation is the primary source of hs-CRP in the general population.