Departments of Medicine (SD, BF) and Clinical Pharmacology and Experimental Therapeutics (SWK), Thomas Jefferson University, Philadelphia, Pennsylvania; and Nemours Cardiac Center (SSG) at A.I. DuPont Hospital for Children, Wilmington, Delaware.
Am J Med Sci. 2014 May;347(5):357-63. doi: 10.1097/MAJ.0b013e31829555f0.
C-reactive protein (CRP) is related to adiposity and metabolic risk and predicts events in adults. The objective was to determine if relationships between adiposity and CRP have similar magnitudes in adolescents as adults.
Healthy African Americans (484 adults and 282 adolescents) were recruited from similar environments. In both cohorts, measurements included anthropometrics, blood pressure (BP), metabolic risk factors and inflammatory markers. After stratification by high-sensitivity CRP (hsCRP: ≤1, 1-≤3, >3 mg/dL), adults and adolescents were compared with regard to body mass index (BMI; kg/m), waist circumference (WC; cm), BP and other risk factors. hsCRP was regressed on BMI and WC with covariates including cohort, age, sex, BP, insulin resistance, smoking, alcohol and other biomarkers. Interaction terms and a subset of the covariates were subject to a supervised variable selection procedure for a final model. Skewed variables were log transformed and summarized by geometric means (GMs) with 1st and 3rd quartiles (Q1, Q3).
Among adolescents (16.3%) and adults (34.1%) having high hsCRP(>3 mg/dL), BMI was distributed similarly (GM = 36.4 [32.7, 43.1] and GM = 34.7 [28.8, 40.8], respectively) as was WC (GM = 104.2 [93.0, 119.0] and GM = 104.9 [93.0, 117.2], respectively). In an adjusted regression model, for a given BMI, elevated WC was associated with elevated hsCRP (P = 0.02). Although elevated BMI was significantly associated with elevated hsCRP, the relationship was stronger among adolescents (interaction P = 0.04).
These findings demonstrate that, in African Americans, obesity is associated with inflammation and adverse changes in metabolic parameters among both adolescents and young adults.
C 反应蛋白(CRP)与肥胖和代谢风险有关,并可预测成年人的发病风险。本研究旨在确定 CRP 与肥胖之间的相关性在青少年和成年人中的程度是否相似。
本研究招募了来自相似环境的健康非裔美国人(484 名成年人和 282 名青少年)。在两个队列中,均对人体测量学、血压(BP)、代谢危险因素和炎症标志物进行了测量。在根据高敏 C 反应蛋白(hsCRP:≤1、1-≤3、>3mg/dL)进行分层后,比较了成年人和青少年的体重指数(BMI;kg/m)、腰围(WC;cm)、BP 和其他危险因素。使用协变量包括队列、年龄、性别、BP、胰岛素抵抗、吸烟、饮酒和其他生物标志物对 hsCRP 与 BMI 和 WC 进行回归分析。对交互项和协变量的子集进行有监督变量选择程序,以确定最终模型。偏态变量进行对数转换,几何均数(GM)及其第 1 四分位数(Q1)和第 3 四分位数(Q3)进行汇总。
在 hsCRP 升高(>3mg/dL)的青少年(16.3%)和成年人(34.1%)中,BMI 的分布相似(GM=36.4[32.7, 43.1]和 GM=34.7[28.8, 40.8]),WC 也相似(GM=104.2[93.0, 119.0]和 GM=104.9[93.0, 117.2])。在调整后的回归模型中,对于给定的 BMI,升高的 WC 与 hsCRP 升高相关(P=0.02)。虽然升高的 BMI 与 hsCRP 显著相关,但在青少年中这种相关性更强(交互作用 P=0.04)。
这些发现表明,在非裔美国人中,肥胖与炎症和代谢参数的不良变化有关,在青少年和年轻成年人中均如此。