Heather R Farmer1,2, Linda A Wray3, Ying Xian4,5, Hanzhang Xu6,7, Neha Pagidipati4,8, Eric D Peterson4,8, Matthew E Dupre1,2,4,9. 1. Department of Population Health Sciences, Duke University, Durham, North Carolina. 2. Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina. 3. Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania. 4. Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina. 5. Department of Neurology, Duke University Medical Center, Durham, North Carolina. 6. Department of Family Medicine and Community Health, Duke University Medical Center, Durham, North Carolina. 7. Duke School of Nursing, Duke University Medical Center, Durham, North Carolina. 8. Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina. 9. Department of Sociology, Duke University, Durham, North Carolina.
Abstract
OBJECTIVES: To investigate racial differences in elevated C-reactive protein (CRP) and the potential factors contributing to these differences in US older men and women. DESIGN: Nationally representative cohort study. SETTING: Health and Retirement Study, 2006 to 2014. PARTICIPANTS: Noninstitutionalized non-Hispanic black and white older adults living in the United States (n = 13 517). MEASUREMENTS: CRP was categorized as elevated (>3.0 mg/L) and nonelevated (≤3.0 mg/L) as the primary outcome. Measures for demographic background, socioeconomic status, psychosocial factors, health behaviors, and physiological health were examined as potential factors contributing to race differences in elevated CRP. RESULTS: Median CRP levels (interquartile range) were 1.67 (3.03) mg/L in whites and 2.62 (4.95) mg/L in blacks. Results from random effects logistic regression models showed that blacks had significantly greater odds of elevated CRP than whites (odds ratio = 2.58; 95% confidence interval [CI] = 2.20-3.02). Results also showed that racial difference in elevated CRP varied significantly by sex (predicted probability [PP] [white men] = 0.28 [95% CI = 0.27-0.30]; PP [black men] = 0.38 [95% CI = 0.35-0.41]; PP [white women] = 0.35 [95% CI = 0.34-0.36]; PP [black women] = 0.49 [95% CI = 0.47-0.52]) and remained significant after risk adjustment. In men, the racial differences in elevated CRP were attributable to a combination of socioeconomic (12.3%) and behavioral (16.5%) factors. In women, the racial differences in elevated CRP were primarily attributable to physiological factors (40.0%). CONCLUSION: In the US older adult population, blacks were significantly more likely to have elevated CRP than whites; and the factors contributing to these differences varied in men and women. J Am Geriatr Soc 68:362-369, 2020.
OBJECTIVES: To investigate racial differences in elevated C-reactive protein (CRP) and the potential factors contributing to these differences in US older men and women. DESIGN: Nationally representative cohort study. SETTING: Health and Retirement Study, 2006 to 2014. PARTICIPANTS: Noninstitutionalized non-Hispanic black and white older adults living in the United States (n = 13 517). MEASUREMENTS: CRP was categorized as elevated (>3.0 mg/L) and nonelevated (≤3.0 mg/L) as the primary outcome. Measures for demographic background, socioeconomic status, psychosocial factors, health behaviors, and physiological health were examined as potential factors contributing to race differences in elevated CRP. RESULTS: Median CRP levels (interquartile range) were 1.67 (3.03) mg/L in whites and 2.62 (4.95) mg/L in blacks. Results from random effects logistic regression models showed that blacks had significantly greater odds of elevated CRP than whites (odds ratio = 2.58; 95% confidence interval [CI] = 2.20-3.02). Results also showed that racial difference in elevated CRP varied significantly by sex (predicted probability [PP] [white men] = 0.28 [95% CI = 0.27-0.30]; PP [black men] = 0.38 [95% CI = 0.35-0.41]; PP [white women] = 0.35 [95% CI = 0.34-0.36]; PP [black women] = 0.49 [95% CI = 0.47-0.52]) and remained significant after risk adjustment. In men, the racial differences in elevated CRP were attributable to a combination of socioeconomic (12.3%) and behavioral (16.5%) factors. In women, the racial differences in elevated CRP were primarily attributable to physiological factors (40.0%). CONCLUSION: In the US older adult population, blacks were significantly more likely to have elevated CRP than whites; and the factors contributing to these differences varied in men and women. J Am Geriatr Soc 68:362-369, 2020.
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