From the Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Spain (VA-C, BS, AG-Q); Primary Care Center, A Estrada, Spain (CF-M, JS-C); Department of Clinical Epidemiology, Complejo Hospitalario Universitario, Santiago de Compostela, Spain (MA-S, FG).
J Am Board Fam Med. 2021 Sep-Oct;34(5):974-983. doi: 10.3122/jabfm.2021.05.210072.
Measurements of C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) are frequently ordered jointly in clinical practice.
To investigate the factors associated with discordances between CRP concentration and ESR in adults.
We conducted a cross-sectional study of 1472 adults with no known inflammatory disorders (44.5% male; median age, 52 years; range, 18-91 years), randomly selected from a municipality in Spain. The participants underwent simultaneous measurements of ESR, serum CRP, and interleukin-6 concentrations. Alcohol consumption, smoking, and physical activity were evaluated by questionnaire. Body mass index (BMI) measurement and metabolic syndrome criteria were available for all participants.
Most (n = 1123, 74.9%) of the participants showed normal CRP and ESR values. Sixty-nine (4.6%) participants showed high CRP and ESR values. Seventy-two (4.8%) participants showed a discordant pattern of high ESR and normal CRP values, which was associated with age after adjusting for sex, alcohol consumption, physical activity, BMI, and the presence of metabolic syndrome (odds ratio [OR], 1.052; 95% CI, 1.034-1.071; < .001). A total of 208 (13.8%) participants showed a discordant pattern of high CRP and normal ESR values, which was associated with BMI after adjusting for covariates (OR, 1.099; 95% CI, 1.064-1.136; < .001). BMI appeared to be the main determinant of serum CRP concentrations in this population. Serum interleukin-6 concentrations were positively associated with the discordant pattern of high CRP and normal ESR values.
In this general adult population with no overt inflammatory disease, the discordant pattern of high ESR and normal CRP was associated with greater age, whereas the pattern of high CRP and normal ESR was associated with higher BMI.
在临床实践中，C 反应蛋白（CRP）浓度和红细胞沉降率（ESR）的测量经常同时进行。
探讨成年人 CRP 浓度与 ESR 不一致的相关因素。
我们对来自西班牙一个市的 1472 名无已知炎症性疾病的成年人（44.5%为男性；中位年龄 52 岁；范围为 18-91 岁）进行了横断面研究。对参与者同时进行 ESR、血清 CRP 和白细胞介素-6 浓度的测量。通过问卷调查评估酒精摄入量、吸烟和体力活动。所有参与者均有体重指数（BMI）测量值和代谢综合征标准。
大多数（n=1123，74.9%）参与者的 CRP 和 ESR 值正常。69（4.6%）名参与者的 CRP 和 ESR 值高。72（4.8%）名参与者表现出 ESR 升高而 CRP 正常的不一致模式，这种模式在调整性别、酒精摄入、体力活动、BMI 和代谢综合征的存在后与年龄相关（比值比 [OR]，1.052；95%置信区间，1.034-1.071；<0.001）。共有 208（13.8%）名参与者表现出 CRP 升高而 ESR 正常的不一致模式，这种模式在调整了混杂因素后与 BMI 相关（OR，1.099；95%置信区间，1.064-1.136；<0.001）。在该人群中，BMI 似乎是血清 CRP 浓度的主要决定因素。血清白细胞介素-6 浓度与 CRP 升高而 ESR 正常的不一致模式呈正相关。
在无明显炎症性疾病的一般成年人群中，ESR 升高而 CRP 正常的不一致模式与年龄较大相关，而 CRP 升高而 ESR 正常的模式与 BMI 较高相关。
