Perceived stress and high-sensitivity C-reactive protein among healthcare workers: A cross-sectional analysis
F. Maher, M. Bouhoula, S. Mrad, O. Salah, M. Makhloufi, I. Kacem, A. Aloui, A. Chouchane, H. Kalboussi, O. El Maalel, S. Chatti, B. Charfeddine, M. MaouaIntroduction
Psychosocial stress may upregulate low-grade inflammation implicated in atherosclerosis. High-sensitivity C-reactive protein (hs-CRP) is a validated biomarker of cardiovascular inflammatory risk (low <1 mg/L, average 1–3 mg/L, high >3 mg/L). The Perceived Stress Scale (PSS-10) offers a quantification of stress in clinical-epidemiological settings.
Objectives
To evaluate the association between perceived stress levels and High-sensitivity C-reactive protein value among healthcare professionals
Methods
We conducted a cross-sectional analytic study among hospital personnel at CHU Farhat Hached (Sousse, Tunisia). Perceived stress was assessed with the 10-item Perceived stress Score ( PSS-10). Fasting blood (≥12 h) was analyzed for hs-CRP in the biochemistry laboratory. Associations between stress and hs-CRP were explored using Spearman correlation and Mann–Whitney tests, following the predefined analysis plan.
Results
Among participants with available hs-CRP (n=9 of 133 with PSS-10), mean age was 43.8±9.9 years; 8/9 were women; mean BMI 26.9±3.8 kg/m². Median hs-CRP was 2.0 mg/L (IQR 1–3); 2/9 (22.2%) were in the high-risk category (>3 mg/L), and 7/9 (77.8%) in the average-risk category (1–3 mg/L). One value exceeded 10 mg/L (20 mg/L), a level for which retesting to exclude acute inflammation is recommended. PSS-10 averaged 20.1±3.8; most participants were in the moderate stress range (8/9), with 1/9 low and none high. Stress and hs-CRP showed a positive but non-significant correlation (Spearman ρ=0.29; p=0.44). Median hs-CRP was 1.0 mg/L in the low-stress group vs 2.0 mg/L in the moderate-stress group (Mann–Whitney p=0.42). In a sensitivity analysis excluding the single value >10 mg/L, the correlation remained non-significant (ρ=0.35; p=0.39).
Conclusions
In this preliminary subset with hs-CRP, perceived stress trended positively—but not significantly—with hs-CRP. Most values fell in the “average-risk” range, with a minority >3 mg/L. These early findings mirror the mixed literature on the stress–CRP link and highlight the need for larger samples and careful handling of potential acute inflammatory outliers when evaluating low-grade inflammation in shift-working healthcare staff.
Disclosure of Interest
None Declared