Hk. Meier-ewert et al., Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects, CLIN CHEM, 47(3), 2001, pp. 426-430
Background: The concentration of C-reactive protein (CRP) in otherwise heal
thy subjects has been shown to predict future risk of myocardial infarction
and stroke. CRP is synthesized by the liver in response to interleukin-6,
the serum concentration of which is subject to diurnal variation.
Methods: To examine the existence of a time-of-day effect for baseline CRP
values, we determined CRP concentrations in hourly blood samples drawn from
healthy subjects (10 males, 3 females; age range, 21-35 years) during a ba
seline day in a controlled environment (8 h of nighttime sleep).
Results: Overall CRP concentrations were low, with only three subjects havi
ng CRP concentrations >2 mg/L. Comparison of raw data showed stability of C
RP concentrations throughout the 24 h studied. When compared with cutoff va
lues of CRP quintile derived from population-based studies, misclassificati
on of greater than one quintile did not occur as a result of diurnal variat
ion in any of the subjects studied. Nonparametric ANOVA comparing different
time points showed no significant differences for both raw and z-transform
ed data. Analysis for rhythmic diurnal variation using a method fitting a c
osine curve to the group data was negative.
Conclusions: Our data show that baseline CRP concentrations are not subject
to time-of-day variation and thus help to explain why CRP concentrations a
re a better predictor of vascular risk than interleukin-6. Determination of
CRP for cardiovascular risk prediction may be performed without concern fo
r diurnal variation. (C) 2001 American Association for Clinical Chemistry.