Universidade do Estado do Rio de Janeiro, Hospital Universitário Pedro Ernesto, Divisão de Nutrição, Rio de Janeiro, Brazil.
Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Programa de Pós-Graduação em Ciências Médicas, Rio de Janeiro, Brazil.
Eur J Clin Nutr. 2017 Oct;71(10):1206-1211. doi: 10.1038/ejcn.2017.74. Epub 2017 May 24.
BACKGROUND/OBJECTIVES: C-reactive protein (CRP) is a marker of inflammation that has been shown to be predictive of cardiovascular diseases in adults. To evaluate the distribution of CRP as well as its association with metabolic syndrome and its components.
SUBJECTS/METHODS: This is a cross-sectional study on adolescents aged 12-17, participants in the Study of Cardiovascular Risk in Adolescents (ERICA). Anthropometric, biochemical and blood pressure data were collected from 6316 adolescents, selected from a random sample of students in the cities of Brasilia, Fortaleza, João Pessoa, Manaus, Porto Alegre and Rio de Janeiro. Metabolic syndrome was defined by the criteria proposed by International Diabetes Federation for adolescent. Poisson regression model with robust variance, taking into consideration the study's complex sampling design, was used to determine multivariate-adjusted prevalence rate ratios expressing the relationship of metabolic syndrome with CRP.
In adolescents with metabolic syndrome, CRP concentrations were five times higher (1.01 mg/l; interquartile range (IQR): 0.54-3.47) compared with those without metabolic syndrome (0.19 mg/l; IQR: 0.10-0.78). In multivariate Poisson regression analysis adjusted by sex, age and skin color, the prevalence of elevated CRP (>3.0 mg/l) was almost three times higher in adolescents with metabolic syndrome than in those without this condition (prevalence ratio (PR): 2.9; 95%CI: 2.0-4.3; P<0.001). Of the metabolic syndrome components, elevated waist circumference, low high-density lipoprotein-cholesterol and high triglycerides were significantly related to CRP in a graded (dose-response) manner.
The association of CRP with metabolic syndrome and its components suggests that inflammation may be useful in assessing cardiovascular risk in adolescents.
背景/目的：C 反应蛋白（CRP）是一种炎症标志物，已被证明可预测成年人的心血管疾病。评估 CRP 的分布及其与代谢综合征及其成分的关系。
受试者/方法：这是一项横断面研究，对象为 12-17 岁的青少年，参与者为青少年心血管风险研究（ERICA）。从巴西利亚、福塔莱萨、若昂佩索阿、马瑙斯、阿雷格里港和里约热内卢等城市的学生随机样本中选择了 6316 名青少年，收集了他们的人体测量、生化和血压数据。代谢综合征的定义采用国际糖尿病联合会为青少年提出的标准。使用具有稳健方差的泊松回归模型，考虑到研究的复杂抽样设计，以确定多元调整后表示代谢综合征与 CRP 关系的患病率比。
在患有代谢综合征的青少年中，CRP 浓度高 5 倍（1.01mg/l；四分位距（IQR）：0.54-3.47）与无代谢综合征的青少年相比（0.19mg/l；IQR：0.10-0.78）。在按性别、年龄和肤色调整的多元泊松回归分析中，患有代谢综合征的青少年中 CRP 升高（>3.0mg/l）的患病率几乎是没有这种情况的青少年的三倍（患病率比（PR）：2.9；95%CI：2.0-4.3；P<0.001）。在代谢综合征的组成部分中，腰围升高、高密度脂蛋白胆固醇降低和甘油三酯升高与 CRP 呈明显的分级（剂量反应）关系。
CRP 与代谢综合征及其成分的关联表明，炎症可能有助于评估青少年的心血管风险。
