Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Association between C-reactive protein, metabolic cardiovascular risk factors, obesity and oral contraceptive use in young adults

International Journal of Obesity volume 28, pages 998–1003 (2004)Cite this article

Abstract

OBJECTIVE: This study sought to determine the relationship between levels of the inflammatory marker, C-reactive protein (CRP), cardiovascular risk factors and oral contraceptive use in young adults.

DESIGN: Cross-sectional study of a community cohort.

SUBJECTS: A total of 822 men and women aged 26 y.

MEASUREMENTS: CRP, body mass index (BMI), blood pressure, lipid and lipoprotein levels, smoking status, socioeconomic status, health status, and hormonal contraceptive use in women.

RESULTS: Multiple regression analysis showed that obesity was independently related to CRP with an increase in ratio CRP of 1.03 (95% CI 1.01, 1.05) for men and 1.07 (1.05, 1.09) for women associated with a 1 kg/m2 increase in BMI. In women, combined oral contraceptive use was associated with a ratio change in CRP of 1.52 (1.27, 1.82) compared with nonusers. Other independent determinants of CRP in men and women were apolipoprotein B level, systolic blood pressure and apolipoprotein A1 in men. Univariate analysis showed that the relationship between CRP and BMI, systolic blood pressure and apolipoprotein B was significantly stronger in women than men.

CONCLUSION: These findings suggest that obesity is associated with inflammation independent of other cardiovascular risk factors that may contribute to an increased risk for cardiovascular disease in men and women. Elevated CRP related to combined oral contraceptive use may influence the rate of cardiovascular events in young women.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

References

  1. Libby P, Ridker PM, Maseri A . Inflammation and atherosclerosis. Circulation 2002; 105: 1135–1143.

    Article  CAS  Google Scholar 

  2. Ridker PM . High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 2001; 103: 1813–1818.

    Article  CAS  Google Scholar 

  3. Ridker PM, Rifai N, Rose L, Buring JE, Cook NR . Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002; 347: 1557–1565.

    Article  CAS  Google Scholar 

  4. Mendall MA, Patel P, Ballam L, Strachan D, Northfield TC . C reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study. BMJ 1996; 312: 1061–1065.

    Article  CAS  Google Scholar 

  5. Ridker PM, Buring JE, Cook NR, Rifai N . C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation 2003; 107: 391–397.

    Article  Google Scholar 

  6. WHO Consultation on Obesity. Preventing and managing the global epidemic. World Health Organization: Geneva; 1997. pp 1–276.

  7. Rabkin SW, Mathewson FA, Hsu PH . Relation of body weight to development of ischemic heart disease in a cohort of young North American men after a 26 year observation period: the Manitoba Study. Am J Cardiol 1977; 39: 452–458.

    Article  CAS  Google Scholar 

  8. Tuomilehto J, Salonen JT, Marti B, Jalkanen L, Puska P, Nissinen A, Wolf E . Body weight and risk of myocardial infarction and death in the adult population of Eastern Finland. BMJ 1987; 295: 623–627.

    Article  CAS  Google Scholar 

  9. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB . Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999; 282: 2131–2135.

    Article  CAS  Google Scholar 

  10. Koenig W, Sund M, Frohlich M, Fischer HG, Lowel H, Doring A, Hutchinson WL, Pepys MB . C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992. Circulation 1999; 99: 237–242.

    Article  CAS  Google Scholar 

  11. Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW . C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999; 19: 972–978.

    Article  CAS  Google Scholar 

  12. Skouby SO, Gram J, Andersen LF, Sidelmann J, Petersen KR, Jespersen J . Hormone replacement therapy: estrogen and progestin effects on plasma C-reactive protein concentrations. Am J Obstet Gynecol 2002; 186: 969–977.

    Article  CAS  Google Scholar 

  13. Walsh BW, Paul S, Wild RA, Dean RA, Tracy RP, Cox DA, Anderson PW . The effects of hormone replacement therapy and raloxifene on C-reactive protein and homocysteine in healthy postmenopausal women: a randomized, controlled trial. J Clin Endocrinol Metab 2000; 85: 214–218.

    CAS  PubMed  Google Scholar 

  14. Pradhan AD, Manson JE, Rossouw JE, Siscovick DS, Mouton CP, Rifai N, Wallace RB, Jackson RD, Pettinger MB, Ridker PM . Inflammatory biomarkers, hormone replacement therapy, and incident coronary heart disease: prospective analysis from the Women's Health Initiative observational study. JAMA 2002; 288: 980–987.

    Article  CAS  Google Scholar 

  15. Kay DR, Bole Jr GG, Ledger WJ . Antinuclear antibodies, rheumatoid factor and C-reactive protein in serum of normal women using oral contraceptives. Arthritis Rheum 1971; 14: 239–248.

    Article  CAS  Google Scholar 

  16. Connell EB, Connell JT . C-reactive protein in pregnancy and contraception. Am J Obstet Gynecol 1971; 110: 633–639.

    Article  CAS  Google Scholar 

  17. Kluft C, Leuven JAG, Helmerhorst FM, Krans HMJ . Pro-inflammatory effects of oestrogens during use of oral contraceptives and hormone replacement treatment. Vasc Pharmacol 2002; 39: 149–154.

    Article  CAS  Google Scholar 

  18. Engel HJ, Engel E, Lichtlen PR . Coronary atherosclerosis and myocardial infarction in young women: role of oral contraceptives. Eur Heart J 1983; 4: 1–6.

    Article  CAS  Google Scholar 

  19. Silva PA, Stanton WR (eds). From child to adult: the Dunedin Multidisciplinary Health and Development Study. Oxford University Press: Auckland; 1996.

    Google Scholar 

  20. Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M, Morgenstern BZ . Human blood pressure determination by sphygmomanometry. Circulation 1993; 88: 2460–2470.

    Article  CAS  Google Scholar 

  21. Elley WB, Irving JC . The Elley–Irving socio-economic index 1981 census revision. N Z J Educ Stud 1985; 29: 115–128.

    Google Scholar 

  22. Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G . Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. BMJ 1984; 288: 1401–1404.

    Article  CAS  Google Scholar 

  23. Hubert HB, Feinleib M, McNamara PM, Castelli WP . Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67: 968–977.

    Article  CAS  Google Scholar 

  24. Despres JP, Lemieux I, Prud'homme D . Treatment of obesity: need to focus on high risk abdominally obese patients. BMJ 2001; 322: 716–720.

    Article  CAS  Google Scholar 

  25. Heinrich PC, Castell JV, Andus T . Interleukin-6 and the acute phase response. Biochem J 1990; 265: 621–636.

    Article  CAS  Google Scholar 

  26. Ziccardi P, Nappo F, Giugliano G, Esposito K, Marfella R, Cioffi M, D'Andrea F, Molinari AM, Giugliano D . Reduction of inflammatory cytokine concentrations and improvement of endothelial functions in obese women after weight loss over one year. Circulation 2002; 105: 804–809.

    Article  CAS  Google Scholar 

  27. Festa A, D'Agostino Jr R, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP, Haffner SM . The relation of body fat mass and distribution to markers of chronic inflammation. Int J Obes Relat Metab Disord 2001; 25: 1407–1415.

    Article  CAS  Google Scholar 

  28. Gallagher D, Visser M, Sepulveda D, Pierson RN, Harris T, Heymsfield SB . How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? Am J Epidemiol 1996; 143: 228–239.

    Article  CAS  Google Scholar 

  29. Godsland IF, Winkler U, Lidegaard O, Crook D . Occlusive vascular diseases in oral contraceptive users. Epidemiology, pathology and mechanisms. Drugs 2000; 60: 721–869.

    Article  CAS  Google Scholar 

  30. Tchernof A, Lamarche B, Prud'Homme D, Nadeau A, Moorjani S, Labrie F, Lupien PJ, Despres JP . The dense LDL phenotype: association with plasma lipoprotein levels, visceral obesity, and hyperinsulinemia in men. Diabetes Care 1996; 19: 629–637.

    Article  CAS  Google Scholar 

  31. Lamarche B, Tchernof A, Mauriege P, Cantin B, Dagenais GR, Lupien PJ, Despres JP . Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. JAMA 1998; 279: 1955–1961.

    Article  CAS  Google Scholar 

  32. Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella R, Giugliano D . Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. JAMA 2003; 289: 1799–1804.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank the Dunedin Study members, Unit research staff, Air New Zealand and the study founder Phil Silva. The Dunedin Multidisciplinary Health and Development Research Unit is supported by the New Zealand Health Research Council. Data collection was supported by grants from the National Heart Foundation of New Zealand and the University of Otago (Otago Research Grant).

Author information

Authors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand

    M J A Williams

  2. Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand

    S M Williams, B J Milne, R J Hancox & R Poulton

Authors
  1. M J A Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S M Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B J Milne
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R J Hancox
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R Poulton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M J A Williams.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Williams, M., Williams, S., Milne, B. et al. Association between C-reactive protein, metabolic cardiovascular risk factors, obesity and oral contraceptive use in young adults. Int J Obes 28, 998–1003 (2004). https://doi.org/10.1038/sj.ijo.0802713

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802713

Keywords

  • inflammation
  • hormones
  • lipids

This article is cited by

Search

Advanced search

Quick links