Toemen L, Gishti O, Vogelezang S, Gaillard R, Hofman A, Franco O H, Felix J F, Jaddoe V W V
1] The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
1] The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands [2] Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Int J Obes (Lond). 2015 Jul;39(7):1101-8. doi: 10.1038/ijo.2015.73. Epub 2015 Apr 29.
High body mass index is associated with increased C-reactive protein levels in childhood and adulthood. Little is known about the associations of detailed adiposity measures with C-reactive protein levels in childhood. We examined the associations of general and abdominal adiposity measures with C-reactive protein levels at school age. To gain insight into the direction of causality, we used genetic risk scores based on known genetic variants in adults as proxies for child adiposity measures and C-reactive protein levels.
Within a population-based cohort study among 4338 children at the median age of 6.2 years, we measured body mass index, fat mass percentage, android/gynoid fat mass ratio and preperitoneal abdominal fat mass. We also measured C-reactive protein blood levels and defined increased levels as ⩾3.0 mg l(-1). Single-nucleotide polymorphisms (SNPs) for the weighted genetic risk scores were extracted from large genome-wide association studies on adult body mass index, waist-hip ratio and C-reactive protein levels.
All fat mass measures were associated with increased C-reactive protein levels, even after adjusting for multiple confounders. Fat mass percentage was most strongly associated with increased C-reactive protein levels (odds ratio 1.46 (95% confidence interval 1.30-1.65) per increase standard deviation scores in fat mass percentage). The association was independent of body mass index. The genetic risk score based on adult body mass index SNPs, but not adult waist-hip ratio SNPs, tended to be associated with increased C-reactive protein levels at school age. The genetic risk score based on adult C-reactive protein level SNPs was not associated with adiposity measures at school age.
Our results suggest that higher general and abdominal fat mass may lead to increased C-reactive protein levels at school age. Further studies are needed to replicate these results and explore the causality and long-term consequences.
高体重指数与儿童期及成年期C反应蛋白水平升高相关。关于儿童期详细肥胖指标与C反应蛋白水平之间的关联，我们了解甚少。我们研究了学龄期总体肥胖指标和腹部肥胖指标与C反应蛋白水平之间的关联。为深入了解因果关系方向，我们使用基于成年人已知基因变异的遗传风险评分作为儿童肥胖指标和C反应蛋白水平的替代指标。
在一项针对4338名中位年龄为6.2岁儿童的基于人群的队列研究中，我们测量了体重指数、体脂百分比、男性型/女性型脂肪量比值和腹膜前腹部脂肪量。我们还测量了血液中C反应蛋白水平，并将升高水平定义为⩾3.0 mg l(-1)。用于加权遗传风险评分的单核苷酸多态性（SNP）是从关于成人体重指数、腰臀比和C反应蛋白水平的大型全基因组关联研究中提取的。
即使在调整了多个混杂因素后，所有脂肪量指标均与C反应蛋白水平升高相关。体脂百分比与C反应蛋白水平升高的关联最为强烈（体脂百分比每增加一个标准差评分，比值比为1.46（95%置信区间1.30 - 1.65））。这种关联独立于体重指数。基于成人体重指数SNP的遗传风险评分，但不是基于成人腰臀比SNP的遗传风险评分，在学龄期往往与C反应蛋白水平升高相关。基于成人C反应蛋白水平SNP的遗传风险评分与学龄期肥胖指标无关。
我们的结果表明，较高的总体和腹部脂肪量可能导致学龄期C反应蛋白水平升高。需要进一步研究来重复这些结果，并探索因果关系和长期后果。
