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Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-Reactive Protein Levels in Overweight and Obese Adults. JAMA. 1999;282(22):2131–2135. doi:10.1001/jama.282.22.2131
Author Affiliations: Institute for Research in Extramural Medicine, Faculty of Medicine (Dr Visser and Prof Bouter), Vrije Universiteit, Amsterdam, the Netherlands; Epidemiology, Demography, and Biometry Program, National Institute on Aging, National Institutes of Health, Bethesda, Md (Drs Visser and Harris); National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md (Dr McQuillan); and the Departments of Laboratory Medicine and Medicine, University of Washington, Seattle (Dr Wener).
Context Human adipose tissue expresses and releases the proinflammatory cytokine
interleukin 6, potentially inducing low-grade systemic inflammation in persons
with excess body fat.
Objective To test whether overweight and obesity are associated with low-grade
systemic inflammation as measured by serum C-reactive protein (CRP) level.
Design and Setting The Third National Health and Nutrition Examination Survey, representative
of the US population from 1988 to 1994.
Participants A total of 16,616 men and nonpregnant women aged 17 years or older.
Main Outcome Measures Elevated CRP level of 0.22 mg/dL or more and a more stringent clinically
raised CRP level of more than 1.00 mg/dL.
Results Elevated CRP levels and clinically raised CRP levels were present in
27.6% and 6.7% of the population, respectively. Both overweight (body mass
index [BMI], 25-29.9 kg/m2) and obese (BMI, ≥30 kg/m2)
persons were more likely to have elevated CRP levels than their normal-weight
counterparts (BMI, <25 kg/m2). After adjustment for potential
confounders, including smoking and health status, the odds ratio (OR) for
elevated CRP was 2.13 (95% confidence interval [CI], 1.56-2.91) for obese
men and 6.21 (95% CI, 4.94-7.81) for obese women. In addition, BMI was associated
with clinically raised CRP levels in women, with an OR of 4.76 (95% CI, 3.42-6.61)
for obese women. Waist-to-hip ratio was positively associated with both elevated
and clinically raised CRP levels, independent of BMI. Restricting the analyses
to young adults (aged 17-39 years) and excluding smokers, persons with inflammatory
disease, cardiovascular disease, or diabetes mellitus and estrogen users did
not change the main findings.
Conclusion Higher BMI is associated with higher CRP concentrations, even among
young adults aged 17 to 39 years. These findings suggest a state of low-grade
systemic inflammation in overweight and obese persons.
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