C-reactive protein concentration in children: relationship to adiposity and other cardiovascular risk factors

Whether or not C-reactive protein (CRP) predicts heart disease in adults be cause it is a marker of damage or atherosclerosis is difficult to assess. I n children, there is no confounding with coronary disease or active smoking . We measured CRP in 699 children aged 10-11 years. CRP levels were 47% hig her in girls than boys, and rose with age by 15%/year. CRP levels were 270% (95% CI, 155-439%) higher in the top fifth than the bottom fifth of Ponder al index (weight/height(3)). After adjustment, CRP levels remained 104% (95 % CI, 23-236%) higher in the 56 children of South Asian origin. CRP was unr elated to: birth weight, height, social class, Helicobacter pylori infectio n or passive smoke exposure. CRP was correlated with several cardiovascular risk factors, but only fibrinogen (r = 0.33, P = 0.0001), HDL-cholesterol (r = -0.13, P = 0.0006), heart rate (r = 0.12, P = 0.002) and systolic bloo d pressure (r = 0.08, P = 0.02) remained statistically significant after ad justment. We conclude that adiposity is the major determinant of CRP levels in children while physical fitness has a small independent effect. The str ong relationships with fibrinogen and HDL-cholesterol suggest a role for in flammation throughout life in the development of atherosclerosis and cardio vascular disease. Longitudinal studies are needed to determine whether thes e associations reflect long term elevations of these risk factors in some i ndividuals, or short term fluctuations in different individuals. (C) 2000 E lsevier Science Ireland Ltd. Ail rights reserved.