IMPORTANCE OF C-REACTIVE PROTEIN (C-RP) DETERMINATION AS A PREDICTOR OF RISK IN AN OVERWEIGHT OR OBESE POPULATION

• Published in: Annals of nutrition and metabolism 2017-10, Vol.71 (Suppl. 2), p.978
• Main Authors: Presner, Natalia, Pandolfo, Marcela, Dupraz, Hernán, Weisstaub, Adriana Ruth, Felipoff, Ana Lía, González, Claudio D, Cúneo, Aldo, Rivera, Santiago, Zago, Liliana, González, Carlos A
• Format: Article
• Language: English
• Subjects: Adults; Body weight; Body weight loss; C-reactive protein; Cerebral infarction; Diabetes; Diabetes mellitus; Eating behavior; Exercise; Heart attacks; Insulin; Metabolic disorders; Metabolic syndrome; Myocardial infarction; Nutrient deficiency; Nutrition; Obesity; Overweight; Patients; Proteins; Research projects; Statistical analysis; Statistical significance
• ISSN: 0250-6807; 1421-9697
• DOI: 10.1159/000480486

Background and objectives: To analyze the ability of C-RP to predict death or cardiovascular events (myocardial infarction or stroke) or development of diabetes, after 3 years, in an overweight or obese population, with or without metabolic syndrome (MS) defined by ATPIII and IDF. Methods: In the framework of a research project on the relationship between nutritional deficiencies and obesity, 175 overweight or obese adults (mean age: 52.3 + 13.8), both genders were studied. We evaluated C-RP and the presence of MS at time 0 (T0). These patients then entered a weight loss program characterized by healthy eating and exercise guidelines for 6 months. After 3 years, 109 of the patients were contacted again by telephone and major events they suffered during that period were recorded. Results: Among the 13 patients who had events, 53.8% had MS, and 46.15% lacked this condition. The difference was not statistically significant (p=0.5524). In T0 it was observed that, among patients with and without MS, there was no statistically significant difference in the C-RP value (p=0.2352 and p=0.1478 defined by ATPIII and IDF, respectively). Among patients who developed events, a prevalence of elevated C-RP was observed. We performed the ROC curve between C-RP and event development and observed an AUC of 0.734. Analyzing the cut-off points it was found that a C-RP > 5 predicted the occurrence of events in a statistically significant way (p=0.0095; RR: 4.388, CI: 95%: 1.444 to 13.277; Sensitivity: 69.2%; Specificity: 70.8%). Among the 109 patients who were contacted after 3 years, 24.32 % of the ones who had C-RP > 5 developed events; and just 5.55 % of the ones who had C-RP 5, did. The definition of MS according to ATPIII and IDF is associated with insulin resistance and obesity, but is not necessarily related to C-RP levels. Therefore, seeing that events are significantly related to a C-RP > 5, we consider that a better definition of MS as a prognostic marker should incorporate it.