Association between obesity, high-sensitivity C-reactive protein ≥2 mg/L, and subclinical atherosclerosis: Implications of JUPITER from the multi-ethnic study of atherosclerosis

Michael J. Blaha, Juan J. Rivera, Matthew J. Budoff, Ron Blankstein, Arthur Agatston, Daniel H. O'Leary, Mary Cushman, Susan Lakoski, Michael H. Criqui, Moyses Szklo, Roger S. Blumenthal, Khurram Nasir

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Objective- High-sensitivity C-reactive protein (hsCRP) levels are closely associated with abdominal obesity, metabolic syndrome, and atherosclerotic cardiovascular disease. The Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial has encouraged using hsCRP ≥2 mg/L to guide statin therapy; however, the association of hsCRP and atherosclerosis, independent of obesity, remains unknown. Methods and Results- We studied 6760 participants from the Multi-Ethnic Study of Atherosclerosis (MESA). Participants were stratified into 4 groups: nonobese/low hsCRP, nonobese/high hsCRP, obese/low hsCRP, and obese/high hsCRP. Using multivariable logistic and robust linear regression, we described the association with subclinical atherosclerosis, using coronary artery calcium (CAC) and carotid intima-media thickness (cIMT). Mean body mass index was 28.3±5.5 kg/m, and median hsCRP was 1.9 mg/L (0.84 to 4.26). High hsCRP, in the absence of obesity, was not associated with CAC and was mildly associated with cIMT. Obesity was strongly associated with CAC and cIMT independently of hsCRP. When obesity and high hsCRP were both present, there was no evidence of multiplicative interaction. Similar associations were seen among 2083 JUPITER-eligible individuals. Conclusion- High hsCRP, as defined by JUPITER, was not associated with CAC and was mildly associated with cIMT in the absence of obesity. In contrast, obesity was associated with both measures of subclinical atherosclerosis independently of hsCRP status.

Original languageEnglish (US)
Pages (from-to)1430-1438
Number of pages9
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume31
Issue number6
DOIs
StatePublished - Jun 1 2011

Keywords

  • coronary artery disease
  • electron beam computed tomography
  • epidemiology
  • obesity
  • vascular biology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Blaha, M. J., Rivera, J. J., Budoff, M. J., Blankstein, R., Agatston, A., O'Leary, D. H., Cushman, M., Lakoski, S., Criqui, M. H., Szklo, M., Blumenthal, R. S., & Nasir, K. (2011). Association between obesity, high-sensitivity C-reactive protein ≥2 mg/L, and subclinical atherosclerosis: Implications of JUPITER from the multi-ethnic study of atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, 31(6), 1430-1438. https://doi.org/10.1161/ATVBAHA.111.223768