Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects
Abstract
BACKGROUND: The concentration of C-reactive protein (CRP) in otherwise healthy 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 baseline day in a controlled environment (8 h of nighttime sleep). RESULTS: Overall CRP concentrations were low, with only three subjects having CRP concentrations >2 mg/L. Comparison of raw data showed stability of CRP concentrations throughout the 24 h studied. When compared with cutoff values of CRP quintile derived from population-based studies, misclassification of greater than one quintile did not occur as a result of diurnal variation in any of the subjects studied. Nonparametric ANOVA comparing different time points showed no significant differences for both raw and z-transformed data. Analysis for rhythmic diurnal variation using a method fitting a cosine 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 are a better predictor of vascular risk than interleukin-6. Determination of CRP for cardiovascular risk prediction may be performed without concern for diurnal variation.
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Reports on diurnal variability of C-reactive protein are few and inconsistent: some report no diurnal variance, whereas others find increased morning levels.
“Reports on diurnal variability of CRP are few and inconsistent: some report no diurnal variance,85 whereas others find increased morning levels.86”
From Interacting epidemics? Sleep curtailment, insulin resistance, and obesity (2012) · cites this paper as [85]
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- Authors
- Meier-Ewert, H. K., Ridker, P. M., Rifai, N., Price, N., Dinges, D. F., & Mullington, J. M.
- Affiliations
- Lahey Hospital and Medical Center (US)
- Brigham and Women's Hospital (US)
- Boston Children's Hospital (US)
- University of Pennsylvania (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Meier-Ewert, Hans K
- Venue
- Clinical Chemistry
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-03-01
- Volume
- 47
- Issue
- 3
- Pages
- 426-430
- ISSN
- 0009-9147 (ISSN-L)
- 1530-8561
- OpenAlex
- W2163553356
- Cited by
- 410
- References
- 33
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 10 · 2023: 10 · 2022: 9 · 2021: 19 · 2020: 16 · 2019: 11 · 2018: 10 · 2017: 15 · 2016: 12 · 2015: 15 · 2014: 12 · 2013: 19 · 2012: 26
- FWCI
- 19.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Clinical Chemistry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (R00040)
- National Heart, Lung, and Blood Institute (R01HL058755, HL-58755)
- National Institute of Mental Health (MH48300)
- National Institute of Nursing Research (NR04281, R01NR004281)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- C-reactive protein, diurnal variation, time of day effects, interleukin-6, cardiovascular risk prediction, healthy volunteers, nocturnal sleep, inflammatory markers
- MeSH terms
- Adult, C-Reactive Protein, Circadian Rhythm, Female, Humans, Immunoassay, Male, Reference Values
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