Association of C-reactive protein and metabolic syndrome in a rural Chinese population

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Abstract

Objective

To explore the relationship between C-reactive protein (CRP) and metabolic syndrome (MetS) in a rural Chinese population.

Design and methods

We performed a population-based cross-sectional study.

Results

The median CRP was 0.90 mg/L. After exclusion of subjects with a CRP value > 10 mg/L, The median CRP with 0, 1, 2, 3, 4, and 5 components of MetS were 0.61, 0.61, 0.73, 1.07, 1.51, and 1.16 mg/L (P = 0.029 for linear trend) in men, and were 0.37, 0.45, 0.62, 1.10, 1.52, and 2.17 mg/L (P = 0.002 for linear trend) in women, respectively. After adjustment for potential confounders, compared with those without components of MetS, those with 1, 2, 3, 4, and 5 components of MetS had ORs of 1.39, 1.08, 1.84, 2.65, and 1.21 for elevated CRP in men and 1.91, 2.06, 3.10, 4.06, and 6.01 in women, respectively.

Conclusion

In this rural Chinese population, the CRP concentration was lower than that of Caucasians and strongly related to the MetS, especially in women.

Introduction

C-reactive protein (CRP) is an acute-phase reactant of systemic inflammation. To date, many studies have confirmed that CRP is a predictor of cardiovascular disease, diabetes and the metabolic syndrome (MetS) [1], [2], [3], [4], [5]. However, CRP levels have been reported to vary among different populations [6], [7], [8], [9], [10], [11], [12], and the distribution of CRP levels have only been well-documented in developed countries [6], [7], [8], [9], [10]. Although there have been several reports on the distribution of CRP levels in a Chinese population-based study that have been conducted in urban cities and nearby areas [13], [14], [15], relatively little is known about the CRP concentration distribution in rural Chinese populations.

The MetS is a constellation of interrelated metabolic risk factors, including abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, elevated plasma glucose, and a prothrombotic and proinflammatory state [16]. The MetS has become increasingly common not only in the West but in China. Prevalence of the MetS has been reported as affecting nearly one quarter of US adults [17], with Gu et al. [18] reporting that the prevalence of the MetS among Chinese men and women aged 35–74 years was 9.8% and 17.8%, respectively, from a national cross-sectional survey in 2000-01, based on criteria by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) [16]. Recent studies in China, which have been conducted in urban cities and nearby areas, have demonstrated that CRP is correlated with the MetS among the Chinese population aged 50 to 85 years [14], [15]. However, 57.01% of Chinese people live in rural districts [19], therefore it is unclear whether the relationship between CRP and the MetS that has been observed in the previous studies also applies to Chinese persons living in rural areas, who have different diets, body mass index (BMI), levels of physical activity, and prevalence of chronic inflammatory diseases.

In this report, we report on the distribution of CRP in a large group of rural Chinese people aged 30 years and over, and evaluate its relationship with the MetS.

Section snippets

Study population

We performed a cross-sectional analysis using data from The Handan Eye Study (HES). Detailed information about the methods and procedures of this survey is available elsewhere [20]. The HES is a population-based cohort study which was designed to survey eye diseases and other health-related problems in non-institutionalized, community dwelling persons aged 30 years and older in Yongnian, a rural county of Handan, which is located about 500 km south of Beijing and covers 980 km2. The population

Results

The baseline characteristics of the study population are shown in Table 1. A total of 2194 men and 2746 women, aged 30–97 years, were included in the study. Compared with men, women had higher BMI, TGs, total cholesterol, HDL-C, LDL-C, and lower waist circumference, waist/hip ratio (WHR), and education level. Men had a significantly higher rate of current smoking (57.3% versus 0.1%) and alcohol consumption (39.8% versus 0.7%) than women. Of the women (n = 2667), 59.1% were postmenopausal at

Discussion

To our knowledge, this is the first population-based study to describe the CRP concentration distribution in a rural Chinese population. Furthermore, we report a strong association between higher CRP levels and components of the MetS, especially in women.

CRP levels have been reported in a few studies in Western and Chinese populations [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]. To date, the best detailed data about the CRP concentration distribution have come from National Health

Acknowledgments

This study was supported by the National Basic Research Program of China (973 Program), the Ministry of Science and Technology of China (Grant 2007CB512201), the Ministry of Health of China and The Handan Bureau of Science & Technology. Additional support was provided by Beijing Tongren Hospital (Grant 2005).

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