C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites

Background-Indian Asians in the United Kingdom have increased coronary hear t disease (CHD) mortality compared with European whites, but the causes are not well understood. Increased circulating concentrations of C-reactive pr otein (CRP) are an independent risk factor for CHD, Therefore, we investiga ted this marker of inflammation in healthy UK Indian Asian and European whi te men. Methods and Results-We measured serum CRP concentrations and conventional C HD risk factors in 1025 healthy male subjects (518 Indian Asians and 507 Eu ropean whites) aged 35 to 60 years who were recruited at random from genera l practitioner lists. The geometric mean CRP concentration was 17% higher ( 95% confidence interval, 3% to 33%) in Indian Asians compared with European whites. CRP values were strongly associated with conventional CHD risk fac tors, measures of obesity, and metabolic disturbances associated with insul in resistance in both racial groups. The difference in CRP concentrations b etween Indian Asians and European whites remained, after adjustment for con ventional CHD risk factors but was eliminated by an adjustment for central obesity and insulin resistance score in Asians. On the basis of these resul ts, we estimate that the processes underlying elevated CRP and/or increased CRP production itself are associated with an approximate to 14% increase i n population CHD risk among Indian Asians compared with European whites. Conclusions-CRP concentrations are higher in healthy Indian Asians than in European whites and are accounted for by greater central obesity and insuli n resistance in Indian Asians. Our results suggest that inflammation or oth er mechanisms underlying elevated CRP values may contribute to the increase d CHD risk among Indian Asians.