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Cited by 2,494Adipokines, Inflammation, and Metabolic DiseasesObesity, Physical Activity, DietCardiovascular Disease and Adiposity

Elevated C-reactive protein levels in overweight and obese adults

Visser, Marjolein·1999·JAMA
DOI 10.1001/jama.282.22.2131
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Abstract

CONTEXT: Human adipose tissue expresses and releases the proinflammatory cytokine interleukin 6, potentially inducing low-grade systemic inflammation in persons with excess body fat. OBJECTIVE: To test whether overweight and obesity are associated with low-grade systemic inflammation as measured by serum C-reactive protein (CRP) level. DESIGN AND SETTING: The Third National Health and Nutrition Examination Survey, representative of the US population from 1988 to 1994. PARTICIPANTS: A total of 16616 men and nonpregnant women aged 17 years or older. MAIN OUTCOME MEASURES: Elevated CRP level of 0.22 mg/dL or more and a more stringent clinically raised CRP level of more than 1.00 mg/dL. RESULTS: Elevated CRP levels and clinically raised CRP levels were present in 27.6% and 6.7% of the population, respectively. Both overweight (body mass index [BMI], 25-29.9 kg/m2) and obese (BMI, > or =30 kg/m2) persons were more likely to have elevated CRP levels than their normal-weight counterparts (BMI, <25 kg/m2). After adjustment for potential confounders, including smoking and health status, the odds ratio (OR) for elevated CRP was 2.13 (95% confidence interval [CI], 1.56-2.91) for obese men and 6.21 (95% CI, 4.94-7.81) for obese women. In addition, BMI was associated with clinically raised CRP levels in women, with an OR of 4.76 (95% CI, 3.42-6.61) for obese women. Waist-to-hip ratio was positively associated with both elevated and clinically raised CRP levels, independent of BMI. Restricting the analyses to young adults (aged 17-39 years) and excluding smokers, persons with inflammatory disease, cardiovascular disease, or diabetes mellitus and estrogen users did not change the main findings. CONCLUSION: Higher BMI is associated with higher CRP concentrations, even among young adults aged 17 to 39 years. These findings suggest a state of low-grade systemic inflammation in overweight and obese persons.

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  • In children, organised leisure-time exercise is negatively correlated with serum IL-6 independent of adiposity and fat localisation.

    “Organised leisure-time exercise (assessed by a questionnaire) in children has shown negative correlations with serum IL-6 concentrations, independently of adiposity and fat localisation (256) , and in 10-year-old children, a borderline significant negative association was observed between CRP and self-reported physical activity, independently of ponderal index (47) .”

    From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [256]

  • Obese patients may have more LV diastolic dysfunction, increased sympathetic activity and inflammation, and increased fatty infiltration of the atria.

    “Obese patients may have more LV diastolic dysfunction, increased sympathetic activity and inflammation, and increased fatty infiltration of the atria.”

    From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [295]

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Authors
Visser, M.
Affiliations
Vrije Universiteit Amsterdam (NL)
Corresponding author
Visser, Marjolein
ORCID
Visser, Marjolein
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
1999-12-08
Volume
282
Issue
22
Pages
2131
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.282.22.2131
OpenAlex
W2130766522
Cited by
2,494
References
48
Citations by year
2026: 60 · 2025: 87 · 2024: 73 · 2023: 66 · 2022: 79 · 2021: 111 · 2020: 100 · 2019: 75 · 2018: 96 · 2017: 78 · 2016: 101 · 2015: 107 · 2014: 100 · 2013: 134 · 2012: 100
FWCI
35.66
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Keywords
C-reactive protein, obesity, overweight, low-grade inflammation, interleukin-6, adipose tissue, body mass index, waist-to-hip ratio, sex differences, young adults, chronic inflammation
MeSH terms
Adult, Aged, Arthritis, Rheumatoid, C-Reactive Protein, Cardiovascular Diseases, Diabetes Mellitus, Female, Health Surveys, Humans, Inflammation, Male, Middle Aged, Obesity, Body Mass Index, Logistic Models, Diabetes Complications

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