Abstract 1679: Association Between Obesity, hsCRP≥2, and Subclinical Atherosclerosis -Implications for the JUPITER Trial: Multi-Ethnic Study of Atherosclerosis (MESA)
Background: The JUPITER trial has led to increasing interest in the use of high-sensitivity C-reactive protein (hsCRP) as a screening tool for initiating lipid-lowering therapy. hsCRP is an inflammatory marker that is markedly correlated with traditional cardiovascular risk factors, including anthropomorphic measures of obesity (ρ=0.40 – 0.55). To help elucidate the implications of hsCRP measurement, we conducted a stratified analysis of the relationship between obesity, hsCRP>=2, and subclinical atherosclerosis.
Methods: MESA is a longitudinal, population-based study of 6,814 men and women aged 45– 84 without clinical cardiovascular disease at enrollment. 4,533 individuals had baseline LDL-C <130 mg/dL. Body mass index (BMI) and hsCRP were measured at baseline, and all participants underwent non-contrast cardiac CT to measure coronary artery calcium (CAC) as well as carotid ultrasound to determine carotid intima-media thickness (CIMT). Patients were divided into 4 groups: non-obese/hsCRP<2, non-obese/hsCRP>=2, obese/hsCRP<2, obese/hsCRP>=2. Obesity was defined as BMI >=30 kg/m2. We then used multivariable logistic and robust linear regression to describe the association between obesity, hsCRP, CAC, and cIMT. CAC and cIMT were considered as binary (CAC>0, CIMT >75th percentile) and continuous variables in separate analyses.
Results: The mean BMI of the population was 28.3±5.5 kg/m2, and median hsCRP was 1.9 mg/dL (0.84–4.26). Approximately 32% were classified as obese, and 48% had hsCRP>=2. BMI and hsCRP were moderately correlated (ρ=0.42). The results of the analysis are shown below.
Conclusion: Within MESA, non-obese individuals with hsCRP>=2 have slightly increased CIMT, while obese individuals with hsCRP<2 have substantially increased CAC and CIMT. Anthropomorphic data can be measured non-invasively and cost-free in clinical medicine, raising the possibility of using obesity rather than hsCRP>=2 for parsimonious risk stratification.