Alfred O Osoti1,2, Stephanie T Page3, Barbra A Richardson4,5,6, Brandon L Guthrie2,5, John Kinuthia2,5,7, Stephen J Polyak8, Carey Farquhar1,5,9. 1. Department of Epidemiology, University of Washington, Seattle, WA, USA. 2. Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya. 3. Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, Diabetes Institute, University of Washington, Seattle, WA, USA. 4. Department of Biostatistics, University of Washington, Seattle, WA, USA. 5. Department of Global Health, University of Washington, Seattle, WA, USA. 6. Vaccine and Infectious Disease Division, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 7. Department of Research and Programs and Department of Reproductive Health, Kenyatta National Hospital, Nairobi, Kenya. 8. Department of Laboratory Medicine, University of Washington, Seattle, WA, USA. 9. Department of Medicine (Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA.
Abstract
OBJECTIVE: To evaluate the association between metabolic syndrome (MetS) and high-sensitivity C-reactive protein (hsCRP), a biomarker of chronic inflammation and an independent predictor for cardiovascular disease overall and in subgroups of women with/without pre-eclampsia and gestational hypertension (GHT). METHODS: A prospective cohort study was conducted in Nairobi, Kenya. Women with pre-eclampsia or GHT and normotensive women within 12 weeks postpartum underwent physical, anthropometric, fasting lipid profile, plasma glucose, and hsCRP measurements at 6 months postpartum. A generalized linear regression model with Poisson distribution adjusted for body mass index and age was used to estimate the association between elevated hsCRP and MetS overall and stratified by pre-eclampsia or GHT. RESULTS: In the 171 women included in the study, risk of elevated hsCRP (>3 mg/L) was greater among women with compared to those without MetS (adjusted relative risk [ARR] 1.70, 95% confidence interval [CI] 1.05-2.73, P=0.03) and was statistically significantly higher in the hypertensive (ARR 2.16 95% CI 1.01-4.62, P=0.04) but not in the normotensive (ARR 1.46, 95% CI 0.93-2.28) group. CONCLUSION: Increased risk of elevated hsCRP postpartum can guide longitudinal mechanistic and intervention studies to reduce postpartum cardiovascular morbidity in women with MetS, especially after pre-eclampsia or GHT.
OBJECTIVE: To evaluate the association between metabolic syndrome (MetS) and high-sensitivity C-reactive protein (hsCRP), a biomarker of chronic inflammation and an independent predictor for cardiovascular disease overall and in subgroups of women with/without pre-eclampsia and gestational hypertension (GHT). METHODS: A prospective cohort study was conducted in Nairobi, Kenya. Women with pre-eclampsia or GHT and normotensive women within 12 weeks postpartum underwent physical, anthropometric, fasting lipid profile, plasma glucose, and hsCRP measurements at 6 months postpartum. A generalized linear regression model with Poisson distribution adjusted for body mass index and age was used to estimate the association between elevated hsCRP and MetS overall and stratified by pre-eclampsia or GHT. RESULTS: In the 171 women included in the study, risk of elevated hsCRP (>3 mg/L) was greater among women with compared to those without MetS (adjusted relative risk [ARR] 1.70, 95% confidence interval [CI] 1.05-2.73, P=0.03) and was statistically significantly higher in the hypertensive (ARR 2.16 95% CI 1.01-4.62, P=0.04) but not in the normotensive (ARR 1.46, 95% CI 0.93-2.28) group. CONCLUSION: Increased risk of elevated hsCRP postpartum can guide longitudinal mechanistic and intervention studies to reduce postpartum cardiovascular morbidity in women with MetS, especially after pre-eclampsia or GHT.
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