Abstract
Introduction:
High Sensitivity C-reactive protein (HsCRP) is a non-specific marker of systemic inflammation. Elevated levels of HsCRP have been shown to be predictive of cardiovascular disease and cardiovascular related events. The relationship between HsCRP and longitudinal onset of metabolic syndrome (MetS) has not been fully elucidated, especially among U.S. Hispanics/Latinos, which is a growing diverse group in the U.S.
Objectives:
To determine whether HsCRP is associated with incident MetS among U.S. Hispanics/Latinos.
Methods:
The Hispanic Community Health Study/Study of Latinos is a longitudinal observational cohort assessing cardiovascular health among diverse U.S. Hispanics/Latinos. HsCRP was measured at visit 1 (2008-2011) using a Roche Modular Chemistry Analyzer. HsCRP was classified as low, moderate, or high, based on ACC/AHA guidelines. All MetS components (abdominal obesity, triglycerides, HDL cholesterol, blood pressure, and fasting glucose) were measured at visit 1 and visit 2 (2014-2017). MetS was defined as the presence of three or more components based on the definition from the Third Report of the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III). Participants free of MetS at visit 1 and with complete data on HsCRP and all MetS components were included (n=6,699 participants). We used Poisson regression analysis to determine whether HsCRP was associated with incident MetS after adjusting for age, follow-up time, sex, Hispanic/Latino background, income, education, marital status, employment, health insurance status, nativity, alcohol use, smoking, anxiety, CESD-10, physical activity, and diet. All analyses included sample weights and accounted for the complex survey design of the study.
Results:
Mean age was 38.2 years, 29.0% had less than a high school education, 59.7% had an income less than $30,000, and 48.4% were female. Average follow-up time was 6.1 years. In fully adjusted models, moderate vs. low HsCRP was associated with a 39% increased risk of MetS (IDR: 1.39, 95% CI: 1.13, 1.71), while high vs. low HsCRP was associated with a 109% increased risk of MetS (IDR: 2.09, 95% CI: 1.70, 2.57).
Conclusions:
Greater levels of HsCRP were associated with new onset of MetS in a diverse sample of U.S. Hispanics/Latinos. Results suggest that HsCRP may be an independent risk factor for, rather than a marker of MetS.
