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The association of body mass index, waist and hip circumference, and waist–hip ratio with Chlamydia pneumoniae IgG antibodies and high-sensitive C-reactive protein at 31 years of age in Northern Finland Birth Cohort 1966



Viruses and bacteria like Chlamydia pneumoniae and Helicobacter pylori have been suggested to have a role in pathogenesis of overweight and obesity.


We studied whether C. pneumoniae-specific IgG antibodies are associated with elevated body mass index (BMI), waist and hip circumference, and/or waist–hip ratio (WHR), and whether the risk is more pronounced in the simultaneous presence of an ongoing inflammation as measured by elevated high-sensitive C-reactive protein (hsCRP) levels.

Subjects and methods:

Our study population was derived from the Northern Finland Birth Cohort 1966 (NFBC1966), a general population sample of 12 058 live-born children. This cross-sectional study consisted of 5044 persons at 31 years of age. Serum C. pneumoniae IgG titers were measured by microimmunofluorescence test, and hsCRP levels by immunoenzymometric assay.


C. pneumoniae IgG positivity (titer 32), both alone and jointly with elevated hsCRP (1.64 mg l−1, an upper quartile), was found to significantly associate with elevated BMI in the whole study population and with elevated hip and waist circumference in women, yet no association with WHR was seen. The analyses were adjusted for sex (when appropriate), smoking, socioeconomic position, glucose, insulin, high- and low-density lipoprotein cholesterols, triglycerides, leukocytes and pulse pressure.


These findings suggest that especially in women, persistent C. pneumoniae infection may be associated with overweight/obesity, independently of more traditional risk factors.

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  1. WHO. Obesity and overweight. In Fact Sheet No. 311. World Health Organization, 2006.

  2. Bessesen DH . Update on obesity. J Clin Endocrinol Metab 2008; 93: 2027–2034.

    Article  CAS  PubMed  Google Scholar 

  3. Atkinson RL . Viruses as an etiology of obesity. Mayo Clin Proc 2007; 82: 1192–1198.

    Article  PubMed  Google Scholar 

  4. van Ginneken V, Sitnyakowsky L, Jeffery JE . Infectobesity: viral infections (especially with human adenovirus-36: Ad-36) may be a cause of obesity. Med Hypotheses 2009; 72: 383–388.

    Article  PubMed  Google Scholar 

  5. Ekesbo R, Nilsson PM, Lindholm LH, Persson K, Wadström T . Combined seropositivity for H. pylori and C. pneumoniae is associated with age, obesity and social factors. J Cardiovasc Risk 2000; 7: 191–195.

    Article  CAS  PubMed  Google Scholar 

  6. Lajunen T, Vikatmaa P, Bloigu A, Ikonen T, Lepäntalo M, Pussinen PJ et al. Chlamydial LPS and high-sensitivity CRP levels in serum are associated with an elevated body mass index in patients with cardiovascular disease. Innate Immun 2008; 14: 375–382.

    Article  CAS  PubMed  Google Scholar 

  7. Karppinen J, Mikkonen P, Kurunlahti M, Tervonen O, Paldanius M, Vasari P et al. Chronic Chlamydia pneumoniae infection increases the risk of occlusion of lumbar segmental arteries of patients with sciatica: a 3-year follow-up study. Spine 2003; 28: E284–E289.

    PubMed  Google Scholar 

  8. Thjodleifsson B, Olafsson I, Gislason D, Gislason T, Jögi R, Janson C . Infections and obesity: a multinational epidemiological study. Scand J Infect Dis 2008; 40: 381–386.

    Article  CAS  PubMed  Google Scholar 

  9. Fernández-Real JM, Ferri MJ, Vendrell J, Ricart W . Burden of infection and fat mass in healthy middle-aged men. Obesity (Silver Spring) 2007; 15: 245–252.

    Article  Google Scholar 

  10. Marrie TJ, Peeling RW, Reid T, De Carolis E . Chlamydia species as a cause of community-acquired pneumonia in Canada. Eur Respir J 2003; 21: 779–784.

    Article  CAS  PubMed  Google Scholar 

  11. Nabipour I, Vahdat K, Jafari SM, Pazoki R, Sanjdideh Z . The association of metabolic syndrome and Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, and herpes simplex virus type 1: the Persian Gulf Healthy Heart Study. Cardiovasc Diabetol 2006; 5: 25.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Dart AM, Martin JL, Kay S . Association between past infection with Chlamydia pneumoniae and body mass index, low-density lipoprotein particle size and fasting insulin. Int J Obes Relat Metab Disord 2002; 26: 464–468.

    Article  CAS  PubMed  Google Scholar 

  13. Saikku P . The epidemiology and significance of Chlamydia pneumoniae. J Infect 1992; 25 (Suppl 1): 27–34.

    Article  PubMed  Google Scholar 

  14. Hogan RJ, Mathews SA, Mukhopadhyay S, Summersgill JT, Timms P . Chlamydial persistence: beyond the biphasic paradigm. Infect Immun 2004; 72: 1843–1855.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Saikku P . Chlamydia pneumoniae - an update on clinical disease. In: Schachter J, Christiansen G, Clarke IN, Hammerschlag M, Kaltenboeck B, Kuo CC et al. (eds). Proceedings of the Tenth International Symposium on Human Chlamydial Infections; Antalaya, Turkey. Grafmat Basin ve Reklam Sanayi Tic. Ltd, STI Publisher: Istanbul, pp 443–453.

  16. Saikku P . Epidemiology of Chlamydia pneumoniae in atherosclerosis. Am Heart J 1999; 138 (Part 2): S500–S503.

    Article  CAS  PubMed  Google Scholar 

  17. Leinonen M, Saikku P . Evidence for infectious agents in cardiovascular disease and atherosclerosis. Lancet Infect Dis 2002; 2: 11–17.

    Article  PubMed  Google Scholar 

  18. Mussa FF, Chai H, Wang X, Yao Q, Lumsden AB, Chen C . Chlamydia pneumoniae and vascular disease: an update. J Vasc Surg 2006; 43: 1301–1307.

    Article  PubMed  Google Scholar 

  19. Bouwman JJ, Visseren FL, Bouter KP, Diepersloot RJ . Infection-induced inflammatory response of adipocytes in vitro. Int J Obes (Lond) 2008; 32: 892–901.

    Article  CAS  Google Scholar 

  20. Shi Y, Liu Y, Murdin A, Raudonikiene-Mancevski A, Ayach BB, Yu Z et al. Chlamydophila pneumoniae inhibits differentiation of progenitor adipose cells and impairs insulin signaling. J Infect Dis 2008; 197: 439–448.

    Article  CAS  PubMed  Google Scholar 

  21. 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  PubMed  Google Scholar 

  22. 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  PubMed  Google Scholar 

  23. Cancello R, Clément K . Is obesity an inflammatory illness? Role of low-grade inflammation and macrophage infiltration in human white adipose tissue. BJOG 2006; 113: 1141–1147.

    Article  CAS  PubMed  Google Scholar 

  24. Yudkin JS, Kumari M, Humphries SE, Mohamed-Ali V . Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link? Atherosclerosis 2000; 148: 209–214.

    Article  CAS  PubMed  Google Scholar 

  25. Ross R . Atherosclerosis--an inflammatory disease. N Engl J Med 1999; 340: 115–126.

    Article  CAS  PubMed  Google Scholar 

  26. Ritchie SA, Connell JM . The link between abdominal obesity, metabolic syndrome and cardiovascular disease. Nutr Metab Cardiovasc Dis 2007; 17: 319–326.

    Article  CAS  PubMed  Google Scholar 

  27. Kaftan AH, Kaftan O . Coronary artery disease and infection with chlamydia pneumonia. Jpn Heart J 2000; 41: 165–172.

    Article  CAS  PubMed  Google Scholar 

  28. Koziolek M, Krzyzanowska-Swiniarska B, Maczynska I, Miazgowski T, Giedrys-Kalemba S . The association between past Chlamydia pneumoniae infection and markers of chronic inflammation in obese women. Eur J Clin Microbiol Infect Dis 2008; 27: 415–421.

    Article  CAS  PubMed  Google Scholar 

  29. Blanc P, Corsi AM, Gabbuti A, Peduzzi C, Meacci F, Olivieri F et al. Chlamydia pneumoniae seropositivity and cardiovascular risk factors: The InCHIANTI Study. J Am Geriatr Soc 2004; 52: 1626–1631.

    Article  PubMed  Google Scholar 

  30. Stanger OH, Semmelrock HJ, Rehak P, Tiran B, Meinitzer A, Rigler B et al. Hyperhomocyst(e)inemia and Chlamydia pneumoniae IgG seropositivity in patients with coronary artery disease. Atherosclerosis 2002; 162: 157–162.

    Article  CAS  PubMed  Google Scholar 

  31. Koh WP, Taylor MB, Hughes K, Chew SK, Fong CW, Phoon MC et al. Seroprevalence of IgG antibodies against Chlamydia pneumoniae in Chinese, Malays and Asian Indians in Singapore. Int J Epidemiol 2002; 31: 1001–1007.

    Article  PubMed  Google Scholar 

  32. Falck G, Gnarpe J, Hansson LO, Svärdsudd K, Gnarpe H . Comparison of individuals with and without specific IgA antibodies to Chlamydia pneumoniae: respiratory morbidity and the metabolic syndrome. Chest 2002; 122: 1587–1593.

    Article  PubMed  Google Scholar 

  33. Karinen L, Leinonen M, Bloigu A, Paldanius M, Koskela P, Saikku P et al. Maternal serum Chlamydia pneumoniae antibodies and CRP levels in women with preeclampsia and gestational hypertension. Hypertens Pregnancy 2008; 27: 143–158.

    Article  CAS  PubMed  Google Scholar 

  34. Roivainen M, Viik-Kajander M, Palosuo T, Toivanen P, Leinonen M, Saikku P et al. Infections, inflammation, and the risk of coronary heart disease. Circulation 2000; 101: 252–257.

    Article  CAS  PubMed  Google Scholar 

  35. Rantakallio P . Groups at risk in low birth weight infants and perinatal mortality. Acta Paediatr Scand 1969; 58 (S193): 5–71.

    Article  Google Scholar 

  36. Järvelin MR, Sovio U, King V, Lauren L, Xu B, McCarthy MI et al. Early life factors and blood pressure at age 31 years in the 1966 northern Finland birth cohort. Hypertension 2004; 44: 838–846.

    Article  PubMed  Google Scholar 

  37. Sugiuchi H, Uji Y, Okabe H, Irie T, Uekama K, Kayahara N et al. Direct measurement of high-density lipoprotein cholesterol in serum with polyethylene glycol-modified enzymes and sulfated alpha-cyclodextrin. Clin Chem 1995; 41: 717–723.

    CAS  PubMed  Google Scholar 

  38. Wieland H, Seidel D . A simple specific method for precipitation of low density lipoproteins. J Lipid Res 1983; 24: 904–909.

    CAS  PubMed  Google Scholar 

  39. Wang S . The microimmunofluorescence test for Chlamydia pneumoniae infection: technique and interpretation. J Infect Dis 2000; 181 (Suppl 3): S421–S425.

    Article  CAS  PubMed  Google Scholar 

  40. Kalayoglu MV, Byrne GI . A Chlamydia pneumoniae component that induces macrophage foam cell formation is chlamydial lipopolysaccharide. Infect Immun 1998; 66: 5067–5072.

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Kalayoglu MV, Byrne GI . Induction of macrophage foam cell formation by Chlamydia pneumoniae. J Infect Dis 1998; 177: 725–729.

    Article  CAS  PubMed  Google Scholar 

  42. Cocchiaro JL, Kumar Y, Fischer ER, Hackstadt T, Valdivia RH . Cytoplasmic lipid droplets are translocated into the lumen of the Chlamydia trachomatis parasitophorous vacuole. Proc Natl Acad Sci USA 2008; 105: 9379–9384.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Hyvärinen K, Tuomainen AM, Laitinen K, Bykov IL, Törmäkangas L, Jauhiainen M et al. Chronic Chlamydia pneumoniae infection induces liver steatosis in APOE-deficient mive. Abstracts of the 76th Congress of the European Atherosclerosis Society, June 10-13, 2007, Helsinki, Finland. Atheroscler Suppl 2007; 8: 23.

    Article  Google Scholar 

  44. Dowell SF, Peeling RW, Boman J, Carlone GM, Fields BS, Guarner J et al. Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada). Clin Infect Dis 2001; 33: 492–503.

    Article  CAS  PubMed  Google Scholar 

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This study was supported by the Academy of Finland (Microbes and Man, MicMan project, Salve consortium No 129418), the Biocenter Oulu (Molecular Determinants of the Metabolic Syndrome, MetSyn consortium), the Sigrid Juselius Foundation, the Finnish Funding Agency for Technology and Innovation (TEKES).

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Correspondence to T Lajunen.

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Lajunen, T., Bloigu, A., Paldanius, M. et al. The association of body mass index, waist and hip circumference, and waist–hip ratio with Chlamydia pneumoniae IgG antibodies and high-sensitive C-reactive protein at 31 years of age in Northern Finland Birth Cohort 1966. Int J Obes 35, 1470–1478 (2011).

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  • Chlamydia pneumoniae
  • C-reactive protein
  • overweight
  • body mass index
  • waist–hip ratio


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