Restricted accessResearch articleFirst published online 2024-06
Association Between High-Sensitivity C-Reactive Protein and Metabolic Syndrome Among Hispanic/Latino Participants of the Hispanic Community Health Study/Study of Latinos
To determine whether high-sensitivity C-reactive protein (hsCRP) is associated with incident Metabolic Syndrome (MetS) among U.S. Hispanic/Latino adults.
Patients and Methods:
The Hispanic Community Health Study/Study of Latinos is a longitudinal observational cohort assessing cardiovascular health among diverse U.S. Hispanic/Latino adults. hsCRP was measured at visit 1 (2008–2011) and classified as low, moderate, or high, based on the Centers for Disease Control and Prevention and American Heart Association (CDC/AHA) guidelines. All MetS components [abdominal obesity, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and fasting glucose] were measured at visit 1 and visit 2 (2014–2017). MetS was defined as the presence of three or more components based on the 2005 definition from the modified Third Report of the National Cholesterol Education Program Adult Treatment Panel (modified NCEP ATP III). Participants free of MetS at visit 1 and with complete data on hsCRP and all MetS components were included (n = 6121 participants). We used Poisson regression analysis to determine whether hsCRP was associated with incident MetS after adjusting for demographic, behavioral, and clinical factors. All analyses accounted for the complex survey design of the study.
Results:
In fully adjusted models, moderate versus low hsCRP was associated with a 33% increased risk of MetS [incidence rate ratio (IRR): 1.33, 95% confidence interval (CI): 1.10–1.61], while high versus low hsCRP was associated with a 89% increased risk of MetS (IRR: 1.89, 95% CI: 1.58–2.25).
Conclusions:
Greater levels of hsCRP were associated with new onset of MetS in a diverse sample of U.S. Hispanic/Latino adults. Results suggest that hsCRP may be an independent risk factor for MetS.
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References
1.
AlbertiKGMM, EckelRH, GrundySM, et al.Harmonizing the metabolic syndrome. Circulation, 2009; 120(16):1640–1645; doi: 10.1161/circulationaha.109.192644
2.
LiangXP, OrCY, TsoiMF, et al.Prevalence of metabolic syndrome in the United States National Health and Nutrition Examination Survey (NHANES) 2011–2018. Eur Heart J, 2021; 42(Suppl 1):2420; doi: 10.1093/eurheartj/ehab724.2420
3.
Velasco-MondragonE, JimenezA, Palladino-DavisAG, et al.Hispanic health in the USA: A scoping review of the literature. Public Health Rev, 2016; 37(1):31; doi: 10.1186/s40985-016-0043-2
4.
HeissG, SnyderML, TengY, et al.Prevalence of metabolic syndrome among Hispanics/Latinos of diverse background: The Hispanic Community Health Study/Study of Latinos. Diabetes Care, 2014; 37(8):2391–2399; doi: 10.2337/dc13-2505
5.
DaviglusML, TalaveraGA, Avilés-SantaML, et al.Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. JAMA, 2012; 308(17):1775–1784; doi: 10.1001/jama.2012.14517
NashDT. Relationship of C-reactive protein, metabolic syndrome and diabetes mellitus: Potential role of statins. J Natl Med Assoc, 2005; 97(12):1600–1607.
8.
LuanY-Y, YaoY-M. The clinical significance and potential role of C-reactive protein in chronic inflammatory and neurodegenerative diseases. Front Immunol, 2018; 9:1302; doi: 10.3389/fimmu.2018.01302
9.
DevarajS, SiegelD, JialalI. Statin therapy in metabolic syndrome and hypertension post-JUPITER: What is the value of CRP?. Curr Atheroscler Rep, 2011; 13(1):31–42; doi: 10.1007/s11883-010-0143-2
10.
DevarajS, SinghU, JialalI. Human C-reactive protein and the metabolic syndrome. Curr Opin Lipidol, 2009; 20(3):182–189; doi: 10.1097/MOL.0b013e32832ac03e
11.
RidkerPM, BuringJE, CookNR, et al.C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events. Circulation, 2003; 107(3):391–397; doi: 10.1161/01.cir.0000055014.62083.05
12.
RidkerPM, WilsonPWF, GrundySM. Should C-Reactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk?. Circulation, 2004; 109(23):2818–2825; doi: 10.1161/01.cir.0000132467.45278.59
13.
HongGB, GaoPC, ChenYY, et al.High-sensitivity C-reactive protein leads to increased incident metabolic syndrome in women but not in men: A five-year follow-up study in a Chinese population. Diabetes Metab Syndr Obes, 2020; 13:581–590; doi: 10.2147/DMSO.S241774
14.
LaaksonenDE, NiskanenL, NyyssönenK, et al.C-reactive protein and the development of the metabolic syndrome and diabetes in middle-aged men. Diabetologia, 2004; 47(8):1403–1410; doi: 10.1007/s00125-004-1472-x
15.
XueQ, YangX, HuangY, et al.Association between baseline and changes in high-sensitive C-reactive protein and metabolic syndrome: A nationwide cohort study and meta-analysis. Nutr Metab, 2022; 19(1):2; doi: 10.1186/s12986-021-00632-6
16.
LimS, LeeHK, KimmKC, et al.C-reactive protein level as an independent risk factor of metabolic syndrome in the Korean population. CRP as risk factor of metabolic syndrome. Diabetes Res Clin Pract, 2005; 70(2):126–133; doi: 10.1016/j.diabres.2005.02.020
17.
SaishoY, HiroseH, RobertsR, et al.C-reactive protein, high-molecular-weight adiponectin and development of metabolic syndrome in the Japanese general population: A longitudinal cohort study. PLoS One, 2013; 8(9):e73430; doi: 10.1371/journal.pone.0073430
18.
OdaE. High-sensitivity C-reactive protein and white blood cell count equally predict development of the metabolic syndrome in a Japanese health screening population. Acta Diabetol, 2013; 50(4):633–638; doi: 10.1007/s00592-013-0477-7
19.
YoonK, RyuS, LeeJ, et al.Higher and increased concentration of hs-CRP within normal range can predict the incidence of metabolic syndrome in healthy men. Diabetes Metab Syndr, 2018; 12(6):977–983; doi: 10.1016/j.dsx.2018.06.008
20.
BoS, RosatoR, CicconeG, et al.What predicts the occurrence of the metabolic syndrome in a population-based cohort of adult healthy subjects?. Diabetes Metab Res Rev, 2009; 25(1):76–82; doi: 10.1002/dmrr.910
21.
HassinenM, LakkaTA, KomulainenP, et al.C-reactive protein and metabolic syndrome in elderly women: A 12-year follow-up study. Diabetes Care, 2006; 29(4):931–932; doi: 10.2337/diacare.29.04.06.dc05-2508
22.
MusaniSK, VasanRS, BidulescuA, et al.Aldosterone, C-reactive protein, and plasma B-type natriuretic peptide are associated with the development of metabolic syndrome and longitudinal changes in metabolic syndrome components: Findings from the Jackson Heart Study. Diabetes Care, 2013; 36(10):3084–3092; doi: 10.2337/dc12-2562
23.
RodriguezF, PeraltaCA, GreenAR, et al.Comparison of C-reactive protein levels in less versus more acculturated Hispanic adults in the United States (from the National Health and Nutrition Examination Survey 1999–2008). Am J Cardiol, 2012; 109(5):665–669; doi: 10.1016/j.amjcard.2011.10.020
24.
OccaA, MorganSE, PotterJE. Underrepresentation of Hispanics and other minorities in clinical trials: Recruiters' perspectives. J Racial Ethn Health Disparities, 2018; 5(2):322–332; doi: 10.1007/s40615-017-0373-x
SorliePD, Avilés-SantaLM, Wassertheil-SmollerS, et al.Design and implementation of the Hispanic Community Health Study/Study of Latinos. Ann Epidemiol, 2010; 20(8):629–641; doi: 10.1016/j.annepidem.2010.03.015
27.
LavangeLM, KalsbeekWD, SorliePD, et al.Sample design and cohort selection in the Hispanic Community Health Study/Study of Latinos. Ann Epidemiol, 2010; 20(8):642–649; doi: 10.1016/j.annepidem.2010.05.006
28.
Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Manual 7—Addendum Central Laboratory Procedures. 2011. June 22, 2011, Version 1.0. Available from: https://sites.cscc.unc.edu/hchs/protocols-and-manuals [Last accessed: March22, 2024].
29.
PearsonTA, MensahGA, AlexanderRW, et al.Markers of inflammation and cardiovascular disease: Application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation, 2003; 107(3):499–511; doi: 10.1161/01.cir.0000052939.59093.45
30.
GrundySM, CleemanJI, DanielsSR, et al.Diagnosis and management of the metabolic syndrome. Circulation, 2005; 112(17):2735–2752; doi: 10.1161/circulationaha.105.169404
31.
Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Manual 2 Field Center Procedures. 2011. January 18, 2011, Version 2.3. Available from: https://sites.cscc.unc.edu/hchs/protocols-and-manuals [Last accessed: March22, 2024].
32.
HanTS, SattarN, WilliamsK, et al.Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study. Diabetes Care, 2002; 25(11):2016–2021; doi: 10.2337/diacare.25.11.2016
33.
AlbertiKGMM, ZimmetP, ShawJ. Metabolic syndrome–a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med, 2006; 23(5):469–480; doi: 10.1111/j.1464-5491.2006.01858.x
34.
ChirinosDA, LlabreMM, GoldbergR, et al.Defining abdominal obesity as a risk factor for coronary heart disease in the U.S.: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Diabetes Care, 2020; 43(8):1774–1780; doi: 10.2337/dc19-1855
35.
ArredondoEM, Sotres-AlvarezD, StoutenbergM, et al.Physical activity levels in U.S. Latino/Hispanic adults: Results from the Hispanic Community Health Study/Study of Latinos. Am J Prev Med, 2016; 50(4):500–508; doi: 10.1016/j.amepre.2015.08.029
36.
ChiuveSE, FungTT, RimmEB, et al.Alternative dietary indices both strongly predict risk of chronic disease. J Nutr, 2012; 142(6):1009–1018; doi: 10.3945/jn.111.157222
37.
AndresenEM, MalmgrenJA, CarterWB, et al.Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med, 1994; 10(2):77–84.
38.
DevarajS, SinghU, JialalI. The evolving role of C-reactive protein in atherothrombosis. Clin Chem, 2009; 55(2):229–238; doi: 10.1373/clinchem.2008.108886
39.
ParrinelloCM, LutseyPL, BallantyneCM, et al.Six-year change in high-sensitivity C-reactive protein and risk of diabetes, cardiovascular disease, and mortality. Am Heart J, 2015; 170(2):380–389; doi: 10.1016/j.ahj.2015.04.017
O'HearnM, LaurenBN, WongJB, et al.Trends and disparities in cardiometabolic health among U.S. adults, 1999–2018. J Am Coll Cardiol, 2022; 80(2):138–151; doi: 10.1016/j.jacc.2022.04.046
42.
TremblayJ, BelloNA, MesaRA, et al.Life's essential 8 and incident hypertension among US Hispanic/Latino adults: Results from the Hispanic Community Health Study/Study of Latinos. J Am Heart Assoc, 2023; 12(24):e031337; doi: 10.1161/jaha.123.031337
43.
HummerRA, HaywardMD. Hispanic older adult health & longevity in the United States: Current patterns & concerns for the future. Daedalus, 2015; 144(2):20–30; doi: 10.1162/DAED_a_00327
44.
CaplanS. Latinos, acculturation, and acculturative stress: A dimensional concept analysis. Policy Polit Nurs Pract, 2007; 8(2):93–106; doi: 10.1177/1527154407301751
45.
MuñozE, GalloLC, HuaS, et al.Stress is associated with neurocognitive function in Hispanic/Latino adults: Results from HCHS/SOL Socio-Cultural Ancillary Study. J Gerontol B Psychol Sci Soc Sci, 2021; 76(4):e122–e128; doi: 10.1093/geronb/gbz144
46.
Miller De RuttéAM, RubensteinBP. Acculturative stress and the effects on health and health behaviors in Hispanic immigrants: A systematic review. Hispanic J Behav Sci, 2021; 43(4):433–455; doi: 10.1177/07399863211044897
47.
MarquineMJ, GalloLC, TarrafW, et al.The association of stress, metabolic syndrome, and systemic inflammation with neurocognitive function in the Hispanic Community Health Study/Study of Latinos and Its Sociocultural Ancillary Study. J Gerontol B Psychol Sci Soc Sci, 2022; 77(5):860–871; doi: 10.1093/geronb/gbab150
48.
VargasED, SanchezGR, JuárezM. Fear by association: Perceptions of anti-immigrant policy and health outcomes. J Health Polit Policy Law, 2017; 42(3):459–483; doi: 10.1215/03616878-3802940
49.
RohlederN. Stimulation of systemic low-grade inflammation by psychosocial stress. Psychosom Med, 2014; 76(3):181–189; doi: 10.1097/psy.0000000000000049
50.
RidkerPM. A test in context: High-sensitivity C-reactive protein. J Am Coll Cardiol, 2016; 67(6):712–723; doi: 10.1016/j.jacc.2015.11.037
51.
Expert Panel onDetection, Evaluation, and Treatment of High Blood Cholesterol inAdults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 2001; 285(19):2486–2497; doi: 10.1001/jama.285.19.2486
52.
GoffDC, Lloyd-JonesDM, BennettG, et al.2013 ACC/AHA guideline on the assessment of cardiovascular risk. Circulation, 2014; 129(25 Suppl 2):S49–S73; doi: 10.1161/01.cir.0000437741.48606.98
QatoDM, LeeTA, Durazo-ArvizuR, et al.Statin and aspirin use among Hispanic and Latino adults at high cardiovascular risk: Findings from the Hispanic Community Health Study/Study of Latinos. J Am Heart Assoc, 2016; 5(4):e002905; doi: 10.1161/jaha.115.002905
55.
LakkaTA, LaaksonenDE, LakkaHM, et al.Sedentary lifestyle, poor cardiorespiratory fitness, and the metabolic syndrome. Med Sci Sports Exerc, 2003; 35(8):1279–1286; doi: 10.1249/01.mss.0000079076.74931.9a
56.
SoltaniS, ChitsaziMJ, Salehi-AbargoueiA. The effect of dietary approaches to stop hypertension (DASH) on serum inflammatory markers: A systematic review and meta-analysis of randomized trials. Clin Nutr, 2018; 37(2):542–550; doi: 10.1016/j.clnu.2017.02.018
57.
JacobsJA, AddoDK, ZheutlinAR, et al.Prevalence of statin use for primary prevention of atherosclerotic cardiovascular disease by race, ethnicity, and 10-year disease risk in the US: National Health and Nutrition Examination Surveys, 2013 to March 2020. JAMA Cardiol, 2023; 8(5):443–452; doi: 10.1001/jamacardio.2023.0228
58.
RidkerPM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation, 2003; 107(3):363–369; doi: 10.1161/01.cir.0000053730.47739.3c
59.
MartinezE, MartorellJ, RiambauV. Review of serum biomarkers in carotid atherosclerosis. J Vasc Surg, 2020; 71(1):329–341; doi: 10.1016/j.jvs.2019.04.488
60.
KoenigW, KhuseyinovaN. Biomarkers of atherosclerotic plaque instability and rupture. Arterioscler Thromb Vasc Biol, 2007; 27(1):15–26; doi: 10.1161/01.atv.0000251503.35795.4f
61.
WangJ, TanGJ, HanLN, et al.Novel biomarkers for cardiovascular risk prediction. J Geriatr Cardiol, 2017; 14(2):135–150; doi: 10.11909/j.issn.1671-5411.2017.02.008
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