Inflammation and Its Associations and Influences in a Healthy Population

Jun 18, 2019
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Authors:
Madssen E, Skaug EA, Wisløff U, Ellingsen Ø, Videm V.
Citation:
Inflammation Is Strongly Associated With Cardiorespiratory Fitness, Sex, BMI, and the Metabolic Syndrome in a Self-reported Healthy Population: HUNT3 Fitness Study. Mayo Clin Proc 2019;94:803-10.
Summary By:
Wendy L. Mercier, ACNP, PhD, EP-C

Study Questions:

Are C-reactive protein (CRP), neopterin, and lactoferrin associated with endothelial dysfunction and low cardiorespiratory fitness in adults who are healthy compared with those with metabolic syndrome (MetS)?

Methods:

The participants were self-reported healthy adults from the population-based cross-sectional HUNT3 (Nord-Trøndelag Health Study). Of the 4,631 total participants, 740 met the criteria for MetS, and 692 were age- and sex-matched healthy controls. Measurements included venous blood for lipids (total cholesterol, high-density lipoproteins cholesterol, triglycerides), glucose, creatinine, CRP, neopterin and lactoferrin (released by activated macrophages and neutrophils respectively), fitness level (by treadmill peak oxygen consumption [VO2peak] plus self-report), flow-mediated dilation (FMD) (% dilation from baseline of the brachial artery by 3-point echocardiology system), smoking history, heart rate, and blood pressure. Data were analyzed by multivariate linear regression for associations between the inflammatory biomarkers and VO2peak, FMD, and MetS.

Results:

CRP was strongly and negatively associated with VO2peak and positively associated with MetS (more so in men) and body mass index (BMI) (more so in women). Lactoferrin was positively associated with MetS, but no associations existed between lactoferrin and VO2peak or FMD. No associations existed between neopterin and either VO2peak or FMD.

Conclusions:

Systemic inflammation as measured by CRP level was associated with low cardiorespiratory fitness in adults with and without MetS. The associations were influenced by sex and BMI but independent of endothelial function (FMD). CRP appears to be a more useful inflammation marker than lactoferrin or neopterin.

Perspective:

Low cardiorespiratory fitness should be considered an important contributing factor to systemic inflammation and, therefore, atherosclerotic risk. Lifestyle interventions that improve aerobic fitness and lower BMI (particularly in women) may positively affect CRP levels in healthy individuals and those with MetS.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Heart Failure and Cardiomyopathies, Sports and Exercise Cardiology, Lipid Metabolism, Novel Agents, Heart Failure and Cardiac Biomarkers

Keywords: Inflammation, Biomarkers, Pharmacological, Oxygen Consumption, Dilatation, Metabolic Syndrome, Neopterin, Lactoferrin, Body Mass Index, Sex, Physical Fitness, Self Report, Cross-Sectional Studies


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