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Population-based study of high plasma C-reactive protein concentrations among the Inuit of Nunavik.

Labonté ME, Dewailly E, Chateau-Degat ML, Couture P, Lamarche B - Int J Circumpolar Health (2012)

Bottom Line: Multivariate logistic regression analysis indicated that every 1 mmHg increase in systolic BP was associated with a 3% increase in the odds of having hs-CRP concentrations ≥ 2 mg/L in the Inuit population (95% CI 1.01-1.04).The combination of older age (≥ 50 vs. <30 years) and elevated waist circumference (gender-specific cut-off values) in a multivariate logistic model was also associated with a 13.3-fold increase in the odds of having plasma hs-CRP concentrations ≥ 2 mg/L (95% CI 5.8-30.9).Sex, age, waist circumference and systolic BP are major factors that increase the risk of this inflammatory phenotype among Inuit from Nunavik, despite their different lifestyle background compared with Caucasians.

View Article: PubMed Central - PubMed

Affiliation: Institute of Nutraceuticals and Functional Foods, Laval University, Québec, QC, Canada.

ABSTRACT

Background: The shift away from traditional lifestyle in the Inuit population over the past few decades has been associated with an increased prevalence of coronary heart disease (CHD) risk factors such as obesity, high blood pressure (BP) and diabetes. However, the impact of this transition on the pro-inflammatory marker high-sensitivity C-reactive protein (hs-CRP) has not been documented.

Objectives: To examine the prevalence of elevated plasma hs-CRP concentrations in Inuit from Nunavik in the province of Quebec (Canada) and identify anthropometric, biochemical and lifestyle risk factors associated with elevated hs-CRP.

Design: A population-representative sample of 801 Inuit residents from 14 villages of Nunavik, aged between 18 and 74 years, was included in the analyses. Subjects participated in a clinical session and completed questionnaires on lifestyle. Multivariate logistic regression was used to determine risk factors for elevated hs-CRP.

Results: Elevated plasma hs-CRP concentrations (≥ 2 mg/L) were present in 32.7% (95% confidence interval (CI) 29.5-35.8) of the Inuit adult population and were more prevalent among women than among men (36.7% vs. 29.0%, p=0.007). Multivariate logistic regression analysis indicated that every 1 mmHg increase in systolic BP was associated with a 3% increase in the odds of having hs-CRP concentrations ≥ 2 mg/L in the Inuit population (95% CI 1.01-1.04). The combination of older age (≥ 50 vs. <30 years) and elevated waist circumference (gender-specific cut-off values) in a multivariate logistic model was also associated with a 13.3-fold increase in the odds of having plasma hs-CRP concentrations ≥ 2 mg/L (95% CI 5.8-30.9).

Conclusions: These data indicate that elevated hs-CRP is relatively prevalent among Inuit with values that are similar to those seen in Canadian Caucasian populations. Sex, age, waist circumference and systolic BP are major factors that increase the risk of this inflammatory phenotype among Inuit from Nunavik, despite their different lifestyle background compared with Caucasians.

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Related in: MedlinePlus

Odds ratio (OR) for elevated high-sensitivity C-reactive protein (hs-CRP) concentrations according to the combined impact of age and waist circumference.Note: A significant age*waist circumference multiplicative interaction (p interaction = 0.04) was found on the odds of having elevated hs-CRP concentrations (≥2.0 mg/L) among the Nunavik Inuit population, using a multivariate logistic regression model. To illustrate the interaction, 6 groups were created based on the combination of different strata of age (<30, 30–49, ≥50 years) and waist circumference (low/high) and were simultaneously entered into a logistic model, with the combination of age <30 years and low waist circumference as the reference group (OR = 1). OR and 95% confidence intervals (in parentheses) were obtained for each group and are adjusted for high-density lipoprotein cholesterol, triacylglycerol (log transformed), insulin (log transformed), systolic blood pressure (BP), diastolic BP, sex and smoking. Positive associations of female sex and systolic BP with elevated hs-CRP concentrations remained significant in this model (p ≤ 0.01). High waist circumference cut-offs were ≥90 cm in men and ≥80 cm in women, as suggested by the International Diabetes Federation (11). *OR significantly higher than the reference group, p ≤ 0.0003.
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Figure 0003: Odds ratio (OR) for elevated high-sensitivity C-reactive protein (hs-CRP) concentrations according to the combined impact of age and waist circumference.Note: A significant age*waist circumference multiplicative interaction (p interaction = 0.04) was found on the odds of having elevated hs-CRP concentrations (≥2.0 mg/L) among the Nunavik Inuit population, using a multivariate logistic regression model. To illustrate the interaction, 6 groups were created based on the combination of different strata of age (<30, 30–49, ≥50 years) and waist circumference (low/high) and were simultaneously entered into a logistic model, with the combination of age <30 years and low waist circumference as the reference group (OR = 1). OR and 95% confidence intervals (in parentheses) were obtained for each group and are adjusted for high-density lipoprotein cholesterol, triacylglycerol (log transformed), insulin (log transformed), systolic blood pressure (BP), diastolic BP, sex and smoking. Positive associations of female sex and systolic BP with elevated hs-CRP concentrations remained significant in this model (p ≤ 0.01). High waist circumference cut-offs were ≥90 cm in men and ≥80 cm in women, as suggested by the International Diabetes Federation (11). *OR significantly higher than the reference group, p ≤ 0.0003.

Mentions: A 2-way multiplicative interaction was observed between age and waist circumference on the odds of having elevated plasma hs-CRP concentrations (p interaction=0.04) in a multivariate logistic model that adjusted for HDL-C, TG (log transformed), insulin (log transformed), systolic BP, diastolic BP, sex and smoking. This interaction is presented graphically in Fig. 3 using combinations of different strata of age (<30, 30–49, ≥50 years) and waist circumference (low/high based on sex-specific cut-points). The combination of older age (≥50 vs. <30 years) and abdominal obesity (≥90 cm in men and ≥80 cm in women vs. normal waist) was associated with a 13.3-fold increase in the odds of having high hs-CRP concentrations (95% CI 5.8–30.9, p<0.0001) independent of other risk factors associated with high hs-CRP concentrations.


Population-based study of high plasma C-reactive protein concentrations among the Inuit of Nunavik.

Labonté ME, Dewailly E, Chateau-Degat ML, Couture P, Lamarche B - Int J Circumpolar Health (2012)

Odds ratio (OR) for elevated high-sensitivity C-reactive protein (hs-CRP) concentrations according to the combined impact of age and waist circumference.Note: A significant age*waist circumference multiplicative interaction (p interaction = 0.04) was found on the odds of having elevated hs-CRP concentrations (≥2.0 mg/L) among the Nunavik Inuit population, using a multivariate logistic regression model. To illustrate the interaction, 6 groups were created based on the combination of different strata of age (<30, 30–49, ≥50 years) and waist circumference (low/high) and were simultaneously entered into a logistic model, with the combination of age <30 years and low waist circumference as the reference group (OR = 1). OR and 95% confidence intervals (in parentheses) were obtained for each group and are adjusted for high-density lipoprotein cholesterol, triacylglycerol (log transformed), insulin (log transformed), systolic blood pressure (BP), diastolic BP, sex and smoking. Positive associations of female sex and systolic BP with elevated hs-CRP concentrations remained significant in this model (p ≤ 0.01). High waist circumference cut-offs were ≥90 cm in men and ≥80 cm in women, as suggested by the International Diabetes Federation (11). *OR significantly higher than the reference group, p ≤ 0.0003.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475996&req=5

Figure 0003: Odds ratio (OR) for elevated high-sensitivity C-reactive protein (hs-CRP) concentrations according to the combined impact of age and waist circumference.Note: A significant age*waist circumference multiplicative interaction (p interaction = 0.04) was found on the odds of having elevated hs-CRP concentrations (≥2.0 mg/L) among the Nunavik Inuit population, using a multivariate logistic regression model. To illustrate the interaction, 6 groups were created based on the combination of different strata of age (<30, 30–49, ≥50 years) and waist circumference (low/high) and were simultaneously entered into a logistic model, with the combination of age <30 years and low waist circumference as the reference group (OR = 1). OR and 95% confidence intervals (in parentheses) were obtained for each group and are adjusted for high-density lipoprotein cholesterol, triacylglycerol (log transformed), insulin (log transformed), systolic blood pressure (BP), diastolic BP, sex and smoking. Positive associations of female sex and systolic BP with elevated hs-CRP concentrations remained significant in this model (p ≤ 0.01). High waist circumference cut-offs were ≥90 cm in men and ≥80 cm in women, as suggested by the International Diabetes Federation (11). *OR significantly higher than the reference group, p ≤ 0.0003.
Mentions: A 2-way multiplicative interaction was observed between age and waist circumference on the odds of having elevated plasma hs-CRP concentrations (p interaction=0.04) in a multivariate logistic model that adjusted for HDL-C, TG (log transformed), insulin (log transformed), systolic BP, diastolic BP, sex and smoking. This interaction is presented graphically in Fig. 3 using combinations of different strata of age (<30, 30–49, ≥50 years) and waist circumference (low/high based on sex-specific cut-points). The combination of older age (≥50 vs. <30 years) and abdominal obesity (≥90 cm in men and ≥80 cm in women vs. normal waist) was associated with a 13.3-fold increase in the odds of having high hs-CRP concentrations (95% CI 5.8–30.9, p<0.0001) independent of other risk factors associated with high hs-CRP concentrations.

Bottom Line: Multivariate logistic regression analysis indicated that every 1 mmHg increase in systolic BP was associated with a 3% increase in the odds of having hs-CRP concentrations ≥ 2 mg/L in the Inuit population (95% CI 1.01-1.04).The combination of older age (≥ 50 vs. <30 years) and elevated waist circumference (gender-specific cut-off values) in a multivariate logistic model was also associated with a 13.3-fold increase in the odds of having plasma hs-CRP concentrations ≥ 2 mg/L (95% CI 5.8-30.9).Sex, age, waist circumference and systolic BP are major factors that increase the risk of this inflammatory phenotype among Inuit from Nunavik, despite their different lifestyle background compared with Caucasians.

View Article: PubMed Central - PubMed

Affiliation: Institute of Nutraceuticals and Functional Foods, Laval University, Québec, QC, Canada.

ABSTRACT

Background: The shift away from traditional lifestyle in the Inuit population over the past few decades has been associated with an increased prevalence of coronary heart disease (CHD) risk factors such as obesity, high blood pressure (BP) and diabetes. However, the impact of this transition on the pro-inflammatory marker high-sensitivity C-reactive protein (hs-CRP) has not been documented.

Objectives: To examine the prevalence of elevated plasma hs-CRP concentrations in Inuit from Nunavik in the province of Quebec (Canada) and identify anthropometric, biochemical and lifestyle risk factors associated with elevated hs-CRP.

Design: A population-representative sample of 801 Inuit residents from 14 villages of Nunavik, aged between 18 and 74 years, was included in the analyses. Subjects participated in a clinical session and completed questionnaires on lifestyle. Multivariate logistic regression was used to determine risk factors for elevated hs-CRP.

Results: Elevated plasma hs-CRP concentrations (≥ 2 mg/L) were present in 32.7% (95% confidence interval (CI) 29.5-35.8) of the Inuit adult population and were more prevalent among women than among men (36.7% vs. 29.0%, p=0.007). Multivariate logistic regression analysis indicated that every 1 mmHg increase in systolic BP was associated with a 3% increase in the odds of having hs-CRP concentrations ≥ 2 mg/L in the Inuit population (95% CI 1.01-1.04). The combination of older age (≥ 50 vs. <30 years) and elevated waist circumference (gender-specific cut-off values) in a multivariate logistic model was also associated with a 13.3-fold increase in the odds of having plasma hs-CRP concentrations ≥ 2 mg/L (95% CI 5.8-30.9).

Conclusions: These data indicate that elevated hs-CRP is relatively prevalent among Inuit with values that are similar to those seen in Canadian Caucasian populations. Sex, age, waist circumference and systolic BP are major factors that increase the risk of this inflammatory phenotype among Inuit from Nunavik, despite their different lifestyle background compared with Caucasians.

Show MeSH
Related in: MedlinePlus