Albert Lin1, Mary E Lacy1, Charles Eaton1, Adolfo Correa1, Wen-Chih Wu2. 1. From the Center of Innovation Long Term Services and Supports (LTSS), Veterans Affairs Hospital, Providence, RI (A.L., M.E.L., W.-C.W.); Department of Medicine, Alpert Medical School of Brown University, Providence, RI (A.L., W.-C.W.); Department of Epidemiology, School of Public Health, Brown University, Providence, RI (M.E.L., W.-C.W.); Center for Primary Care and Prevention, Department of Family Medicine, Memorial Hospital of Rhode Island, Pawtucket (C.E.); and Department of Medicine, University of Mississippi Medical Center, Jackson (A.C.). 2. From the Center of Innovation Long Term Services and Supports (LTSS), Veterans Affairs Hospital, Providence, RI (A.L., M.E.L., W.-C.W.); Department of Medicine, Alpert Medical School of Brown University, Providence, RI (A.L., W.-C.W.); Department of Epidemiology, School of Public Health, Brown University, Providence, RI (M.E.L., W.-C.W.); Center for Primary Care and Prevention, Department of Family Medicine, Memorial Hospital of Rhode Island, Pawtucket (C.E.); and Department of Medicine, University of Mississippi Medical Center, Jackson (A.C.). Wen-Chih.Wu@va.gov.
Abstract
OBJECTIVE: Reasons for variations in atherosclerotic burden among individuals with similar levels of obesity are poorly understood, especially in African Americans. This study examines whether high-sensitivity C-reactive protein (hsCRP) is useful for discriminating between benign and high-risk obesity phenotypes for subclinical atherosclerosis in African Americans. APPROACH AND RESULTS: Participants from the Jackson Heart Study (n=4682) were stratified into 4 phenotypes based on the presence of National Heart and Lung and Blood Institute definition of obesity or obesity-equivalent (body mass index ≥30 or body mass index 25-30 with waist circumference >102 cm in men and >88 cm in women) and inflammation by hsCRP ≥2 mg/L. Using multivariate regression models, we conducted cross-sectional analyses of the association between inflammatory obesity phenotypes and subclinical atherosclerosis determined by carotid intima-media thickness or coronary artery calcium scores. Sex-specific analyses were conducted given significant interaction for gender (P=0.03). The prevalence of obesity or equivalent was 65%, of which 30% did not have inflammation. Conversely, 37% of nonobese individuals had inflammation. Among nonobese men, hsCRP ≥2 mg/L identified a subset of individuals with higher carotid intima-media thickness (adjusted mean difference =0.05, 95% confidence interval 0.02, 0.08 mm) compared with their noninflammatory counterparts. Among obese men, hsCRP <2 mg/L identified a subset of individuals with lower coronary artery calcium compared with their inflammatory counterparts. Among women, associations between hsCRP and carotid intima-media thickness or coronary artery calcium were not found. CONCLUSIONS: In the largest African American population-based cohort to date, hsCRP was useful in identifying a subset of nonobese men with higher carotid intima-media thickness, but not in women. hsCRP did not identify a subset of obese individuals with less subclinical atherosclerosis.
OBJECTIVE: Reasons for variations in atherosclerotic burden among individuals with similar levels of obesity are poorly understood, especially in African Americans. This study examines whether high-sensitivity C-reactive protein (hsCRP) is useful for discriminating between benign and high-risk obesity phenotypes for subclinical atherosclerosis in African Americans. APPROACH AND RESULTS:Participants from the Jackson Heart Study (n=4682) were stratified into 4 phenotypes based on the presence of National Heart and Lung and Blood Institute definition of obesity or obesity-equivalent (body mass index ≥30 or body mass index 25-30 with waist circumference >102 cm in men and >88 cm in women) and inflammation by hsCRP ≥2 mg/L. Using multivariate regression models, we conducted cross-sectional analyses of the association between inflammatory obesity phenotypes and subclinical atherosclerosis determined by carotid intima-media thickness or coronary artery calcium scores. Sex-specific analyses were conducted given significant interaction for gender (P=0.03). The prevalence of obesity or equivalent was 65%, of which 30% did not have inflammation. Conversely, 37% of nonobese individuals had inflammation. Among nonobese men, hsCRP ≥2 mg/L identified a subset of individuals with higher carotid intima-media thickness (adjusted mean difference =0.05, 95% confidence interval 0.02, 0.08 mm) compared with their noninflammatory counterparts. Among obesemen, hsCRP <2 mg/L identified a subset of individuals with lower coronary artery calcium compared with their inflammatory counterparts. Among women, associations between hsCRP and carotid intima-media thickness or coronary artery calcium were not found. CONCLUSIONS: In the largest African American population-based cohort to date, hsCRP was useful in identifying a subset of nonobese men with higher carotid intima-media thickness, but not in women. hsCRP did not identify a subset of obese individuals with less subclinical atherosclerosis.
Authors: Lynne E Wagenknecht; Carl D Langefeld; Barry I Freedman; J Jeffery Carr; Donald W Bowden Journal: Am J Epidemiol Date: 2007-05-09 Impact factor: 4.897
Authors: Michael Wacker; Betsy Risendal; Kim Westerlind; Dennis Lezotte; Tim Byers Journal: J Womens Health (Larchmt) Date: 2009-04 Impact factor: 2.681
Authors: Su Min Chang; Faisal Nabi; Jiaqiong Xu; Leif E Peterson; Arup Achari; Craig M Pratt; John J Mahmarian Journal: J Am Coll Cardiol Date: 2009-11-10 Impact factor: 24.094
Authors: Stephen Kaptoge; Emanuele Di Angelantonio; Lisa Pennells; Angela M Wood; Ian R White; Pei Gao; Matthew Walker; Alexander Thompson; Nadeem Sarwar; Muriel Caslake; Adam S Butterworth; Philippe Amouyel; Gerd Assmann; Stephan J L Bakker; Elizabeth L M Barr; Elizabeth Barrett-Connor; Emelia J Benjamin; Cecilia Björkelund; Hermann Brenner; Eric Brunner; Robert Clarke; Jackie A Cooper; Peter Cremer; Mary Cushman; Gilles R Dagenais; Ralph B D'Agostino; Rachel Dankner; George Davey-Smith; Dorly Deeg; Jacqueline M Dekker; Gunnar Engström; Aaron R Folsom; F Gerry R Fowkes; John Gallacher; J Michael Gaziano; Simona Giampaoli; Richard F Gillum; Albert Hofman; Barbara V Howard; Erik Ingelsson; Hiroyasu Iso; Torben Jørgensen; Stefan Kiechl; Akihiko Kitamura; Yutaka Kiyohara; Wolfgang Koenig; Daan Kromhout; Lewis H Kuller; Debbie A Lawlor; Tom W Meade; Aulikki Nissinen; Børge G Nordestgaard; Altan Onat; Demosthenes B Panagiotakos; Bruce M Psaty; Beatriz Rodriguez; Annika Rosengren; Veikko Salomaa; Jussi Kauhanen; Jukka T Salonen; Jonathan A Shaffer; Steven Shea; Ian Ford; Coen D A Stehouwer; Timo E Strandberg; Robert W Tipping; Alberto Tosetto; Sylvia Wassertheil-Smoller; Patrik Wennberg; Rudi G Westendorp; Peter H Whincup; Lars Wilhelmsen; Mark Woodward; Gordon D O Lowe; Nicholas J Wareham; Kay-Tee Khaw; Naveed Sattar; Chris J Packard; Vilmundur Gudnason; Paul M Ridker; Mark B Pepys; Simon G Thompson; John Danesh Journal: N Engl J Med Date: 2012-10-04 Impact factor: 91.245
Authors: Engelbert A Nonterah; Michiel L Bots; Abraham Oduro; Godfred Agongo; Cassandra C Soo; Lisa K Micklesfield; Felistas Mashinya; Palwendé R Boua; Shukri F Mohamed; Alisha N Wade; Catherine Kyobutungi; Halidou Tinto; Shane A Norris; Stephen M Tollman; Michèle Ramsay; Diederick E Grobbee; Kerstin Klipstein-Grobusch; Nigel J Crowther Journal: Glob Heart Date: 2021-03-19
Authors: Michal S Beeri; Hung-Mo Lin; Mary Sano; Ramit Ravona-Springer; Xiaoyu Liu; Barbara B Bendlin; Carey E Gleason; Elizabeth Guerrero-Berroa; Laili Soleimani; Lenore J Launer; Scott Ehrenberg; Orit Lache; Yaakov K Seligman; Andrew P Levy Journal: JAMA Netw Open Date: 2018-11-02