Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES)

Aims: High-sensitivity C-reactive protein (hs-CRP), a marker of inflammation, is associated with atherosclerosis, and recent studies indicate that therapies targeting inflammation are associated with reductions in cardiovascular risk. However, factors predictive of elevated hs-CRP in the general pop...

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Main Authors: Zachary D. Randall, Adam M. Brouillard, Elena Deych, Michael W. Rich
Format: Article
Language:English
Published: Elsevier 2022-09-01
Series:American Heart Journal Plus
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666602222001136
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author Zachary D. Randall
Adam M. Brouillard
Elena Deych
Michael W. Rich
author_facet Zachary D. Randall
Adam M. Brouillard
Elena Deych
Michael W. Rich
author_sort Zachary D. Randall
collection DOAJ
description Aims: High-sensitivity C-reactive protein (hs-CRP), a marker of inflammation, is associated with atherosclerosis, and recent studies indicate that therapies targeting inflammation are associated with reductions in cardiovascular risk. However, factors predictive of elevated hs-CRP in the general population have not been elucidated. Methods: In this cross-sectional study, multivariable logistic regression analysis was used to identify independent predictors of elevated hs-CRP (≥3 mg/L) utilizing the National Health and Nutrition Examination Survey (NHANES) 2015–2016 cycle. The model was verified using the independent NHANES 2017–2018 cycle. Candidate variables comprised demographic, behavioral, dietary, and clinical factors. The study included 5412 adults from the 2015–2016 cohort and 5856 adults from the 2017–2018 cohort. Results: Significant independent predictors of elevated hs-CRP included: older age (OR 1.09 per decade; 95 % CI 1.03–1.14; P = 0.024), female sex (OR 1.57; 95 % CI 1.36–1.80; P = 0.003), Black vs White race (OR 1.31; 95 % CI 1.10–1.56; P = 0.037), increased BMI (OR 1.12 per kg/m2; 95 % CI 1.10–1.14; P < 0.001), elevated white blood cell count (OR 1.21 per 1000 white blood cells/μL; 95 % CI 1.15–1.28; P = 0.002), and self-reported poor vs excellent health (OR 1.73; 95 % CI 1.04–2.22; P = 0.012). The model had excellent discrimination with a c-statistic of 0.77 in the 2015–2016 cycle and 0.76 in the 2017–2018 cycle. Conclusion: Older age, female sex, Black race, increased BMI, higher white blood cell count, and self-reported poor health were independent predictors of elevated hs-CRP levels. Additional studies are needed to determine if behavioral modifications can lower hs-CRP and whether this translates to reduced risk for cardiovascular disease and other conditions associated with chronic inflammation.
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spelling doaj.art-9685f0d9cfa24f258aad52e0793a63212022-12-22T03:12:31ZengElsevierAmerican Heart Journal Plus2666-60222022-09-0121100196Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES)Zachary D. Randall0Adam M. Brouillard1Elena Deych2Michael W. Rich3Washington University School of Medicine, St Louis, MO, USATexas Heart Institute, Houston, TX, USADivision of Cardiology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USADivision of Cardiology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; Corresponding author at: Washington University School of Medicine, Division of Cardiology, Department of Medicine, 660 South Euclid Avenue, Campus Box 8086, St Louis, MO 63110, USA.Aims: High-sensitivity C-reactive protein (hs-CRP), a marker of inflammation, is associated with atherosclerosis, and recent studies indicate that therapies targeting inflammation are associated with reductions in cardiovascular risk. However, factors predictive of elevated hs-CRP in the general population have not been elucidated. Methods: In this cross-sectional study, multivariable logistic regression analysis was used to identify independent predictors of elevated hs-CRP (≥3 mg/L) utilizing the National Health and Nutrition Examination Survey (NHANES) 2015–2016 cycle. The model was verified using the independent NHANES 2017–2018 cycle. Candidate variables comprised demographic, behavioral, dietary, and clinical factors. The study included 5412 adults from the 2015–2016 cohort and 5856 adults from the 2017–2018 cohort. Results: Significant independent predictors of elevated hs-CRP included: older age (OR 1.09 per decade; 95 % CI 1.03–1.14; P = 0.024), female sex (OR 1.57; 95 % CI 1.36–1.80; P = 0.003), Black vs White race (OR 1.31; 95 % CI 1.10–1.56; P = 0.037), increased BMI (OR 1.12 per kg/m2; 95 % CI 1.10–1.14; P < 0.001), elevated white blood cell count (OR 1.21 per 1000 white blood cells/μL; 95 % CI 1.15–1.28; P = 0.002), and self-reported poor vs excellent health (OR 1.73; 95 % CI 1.04–2.22; P = 0.012). The model had excellent discrimination with a c-statistic of 0.77 in the 2015–2016 cycle and 0.76 in the 2017–2018 cycle. Conclusion: Older age, female sex, Black race, increased BMI, higher white blood cell count, and self-reported poor health were independent predictors of elevated hs-CRP levels. Additional studies are needed to determine if behavioral modifications can lower hs-CRP and whether this translates to reduced risk for cardiovascular disease and other conditions associated with chronic inflammation.http://www.sciencedirect.com/science/article/pii/S2666602222001136Chronic inflammationC-reactive proteinRisk factorsCardiovascular disease
spellingShingle Zachary D. Randall
Adam M. Brouillard
Elena Deych
Michael W. Rich
Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES)
American Heart Journal Plus
Chronic inflammation
C-reactive protein
Risk factors
Cardiovascular disease
title Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES)
title_full Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES)
title_fullStr Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES)
title_full_unstemmed Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES)
title_short Demographic, behavioral, dietary, and clinical predictors of high-sensitivity C-reactive protein: The National Health and Nutrition Examination Surveys (NHANES)
title_sort demographic behavioral dietary and clinical predictors of high sensitivity c reactive protein the national health and nutrition examination surveys nhanes
topic Chronic inflammation
C-reactive protein
Risk factors
Cardiovascular disease
url http://www.sciencedirect.com/science/article/pii/S2666602222001136
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