C-Reactive Protein Identifies Low-Risk Metabolically Healthy Obese Persons: The European Prospective Investigation of Cancer-Norfolk Prospective Population Study.
van Wijk, Diederik F
Arsenault, Benoit J
Stroes, Erik SG
Journal of the American Heart Association
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van Wijk, D. F., Boekholdt, S. M., Arsenault, B. J., Ahmadi-Abhari, S., Wareham, N., Stroes, E. S., & Khaw, K. (2016). C-Reactive Protein Identifies Low-Risk Metabolically Healthy Obese Persons: The European Prospective Investigation of Cancer-Norfolk Prospective Population Study.. Journal of the American Heart Association, 5 (6)https://doi.org/10.1161/jaha.115.002823
BACKGROUND: Conflicting data exist about the cardiovascular risk of metabolically healthy obese persons. The prognostic value of C-reactive protein (CRP) in this intriguing group is unknown. We assessed the association between CRP levels and the risk of coronary heart disease (CHD) in metabolically healthy persons with abdominal obesity. METHODS AND RESULTS: In the European Prospective Investigation of Cancer-Norfolk prospective cohort, CRP levels and information on metabolic syndrome criteria were available for 7279 participants, of whom 825 (11%) developed CHD during a follow-up period of 10.9±1.8 years. There was a trend toward a higher multivariable-adjusted hazard ratio for CHD in metabolically healthy obese participants with CRP levels >2 mg/L compared with <2 mg/L (hazard ratio 1.59, 95% CI 0.97-2.62, P=0.066). Metabolically unhealthy obese participants had significantly higher CHD risk compared with metabolically healthy obese participants with CRP levels <2 mg/L (hazard ratio 1.88, 95% CI 1.20-2.94, P=0.006). Most important, we found that the risk of CHD among metabolically healthy obese persons with CRP levels <2 mg/L was comparable to that of metabolically healthy nonobese persons (hazard ratio 0.91, 95% CI 0.60-1.39, P=0.674). CONCLUSIONS: Among metabolically healthy obese persons, low CRP levels were associated with a CHD risk comparable to that of metabolically healthy nonobese persons. CRP appears to be an easy and widely available method for identifying a low-risk subpopulation among metabolically healthy obese persons.
Humans, Neoplasms, Coronary Disease, C-Reactive Protein, Risk Factors, Prospective Studies, Middle Aged, Female, Male, Obesity, Abdominal, Healthy Volunteers, Obesity, Metabolically Benign, Glycated Hemoglobin A, Metabolic Syndrome
EPIC‐Norfolk is supported by program grants from the Medical Research Council UK and Cancer Research UK. The CRP measurements in the full cohort were supported by a grant from the Medical Research Council to the Medical Research Council Epidemiology Unit, Cambridge, United Kingdom (MRC G0701863). The funding sources had no role in the study design, the conduct of the analysis, or the decision to submit the manuscript for publication.
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0512-10135)
MEDICAL RESEARCH COUNCIL (MR/N003284/1)
Medical Research Council (MC_U106179471)
External DOI: https://doi.org/10.1161/jaha.115.002823
This record's URL: https://www.repository.cam.ac.uk/handle/1810/294935
Attribution-NonCommercial-NoDerivatives 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc-nd/4.0/