Abstract 9898: Weight Loss Decreases High Sensitivity C-Reactive Protein Irrespective of Dietary Composition
Introduction: Randomized trials indicate that statins reduce the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) by 20-40%. Although not as widely publicized, diet-induced weight loss also reduces hsCRP. However, the magnitude of this effect in overweight individuals is uncertain and little is known about how diets differing in fat, protein, or carbohydrate composition modify this effect.
Hypothesis: Weight loss will decrease hsCRP in overweight individuals, and diets lower in carbohydrate will be most effective.
Methods: POUNDS (Preventing Overweight Using Novel Dietary Strategies) LOST was a 2 year trial of overweight and obese adults randomly allocated to 1 of 4 weight loss diets with targeted percentages of energy derived from fat, protein, and carbohydrates (20, 15, 65%; 20, 25, 55%; 40, 15, 45%; 40, 25, 35%, respectively). hsCRP was measured at baseline, 6, and 24 months among 710 participants, and data on adiposity as measured by dual X-ray absorptiometry (N=340) or abdominal computed tomography (N=126) were also evaluated as potential correlates of hsCRP change.
Results: At 6 months, hsCRP was reduced in all trial participants by a median 25% (IQR +7%, -50%), weight by 7% (IQR -3%, -11%), and waist circumference by 6% (IQR -3%, -10%) (all P<.002) with no significant differences observed according to randomized dietary composition. Irrespective of diet composition, the percent change in hsCRP at 6 and 24 months correlated modestly with change in weight, waist circumference, fasting insulin, fasting glucose, HOMA, and most lipid levels. Reductions in hsCRP persisted throughout the study period despite an approximate 50% regain of weight by 24 months. In imaging studies, the percent change in hsCRP at 24 months significantly correlated with changes in percent total body fat (r=0.42), as well as absolute changes in total abdominal adiposity (r=0.52), subcutaneous abdominal adiposity (r=0.52), and visceral adiposity (r=0.47) (all P<.001).
Conclusion: Weight loss, regardless of dietary composition, reduces hsCRP with a magnitude of effect similar to statin therapy. As is recommended for individuals with elevated LDL cholesterol, the first intervention for those with elevated hsCRP should be weight loss via caloric restriction.
- © 2011 by American Heart Association, Inc.