Determinants of C-reactive protein levels in general population, subject at cardiovascular risk and heart failure
L Monzo, C Xhaard, J P Ferreira, G Baudry, Z Lamiral, E Bozec, J M Boivin, F Zannad, N GirerdAbstract
Background
Although several determinants of high-sensitivity C-reactive protein (hs-CRP) have been identified, it remains uncertain whether their relative contribution varies across the cardiovascular (CV) continuum and according to body mass index (BMI). Using a large, harmonized multicohort dataset, we sought to characterize the clinical determinants of elevated hs-CRP across the CV spectrum and BMI strata.
Methods
We analysed 7,094 participants from the HOMAGE (Heart"omics"in AGEing) consortium with at least a hs-CRP measurement, classified as healthy (n=2,148), with CV risk factors (n=3,919), or with heart failure (HF; n=1,027). Univariable and multivariable logistic regression models were used to identify determinants of elevated hs-CRP (≥2 mg/L) across phenotypes and BMI categories (<25, 25–29.9, ≥30 kg/m²).
Results
Median hs-CRP increased progressively from healthy individuals (1.5 mg/L) to those with CV risk factors (1.9 mg/L) and HF (3.6 mg/L). In univariable analyses, BMI, current smoking and heart rate showed a positive association with elevated hs-CRP across phenotypes, while whereas renal function and serum albumin showed a strong inverse association. In multivariable analyses, higher BMI (OR per 5 kg/m²: healthy, 1.92, CV risk, 1.70, and HF, 1.36), current smoking (OR 1.74–2.22), higher heart rate (OR per bpm ~1.02–1.04), and lower serum albumin (OR ~0.14–0.52) remained independently associated with elevated hs-CRP, with moderate discrimination (C-indices ~0.70–0.72) (Figure 1). BMI-stratified analyses indicated that adiposity predominated in healthy and CV-risk individuals, while lower serum albumin emerged as a strong additional determinant in HF (Figure 2).
Conclusions
Adiposity-related factors were consistently associated with elevated hs-CRP across the CV spectrum, though it predominated in healthy and CV-risk individuals.Multivariate analysisFor image description, please refer to the figure legend and surrounding text.BMI strataFor image description, please refer to the figure legend and surrounding text.