Clinical InvestigationPrevention and RehabilitationSix-year change in high-sensitivity C-reactive protein and risk of diabetes, cardiovascular disease, and mortality
Section snippets
Study population
The Atherosclerosis Risk in Communities (ARIC) study is a community-based cohort of 15,792 participants who were originally recruited from 1987 to 1989 from 4 field centers in the United States: Forsyth County, NC; Jackson, MS; suburban Minneapolis, MN; and Washington County, MD.29 Participants were invited to return for 4 follow-up examinations in 1990 to 1992, 1993 to 1995, 1996 to 1998, and 2011 to 2013 (response rates were 93%, 86%, 80%, and 65%, respectively). All procedures were approved
Results
The mean age of participants was approximately 57 years at visit 2 and 63 years at visit 4. Nearly half of the study population had sustained low/moderate hs-CRP, and 29% had sustained elevated hs-CRP during the 6-year period (Table I). Of the 6,385 persons with low/moderate hs-CRP at visit 2, 76% also had low/moderate hs-CRP at visit 4, 6 years later. Of the 3,775 persons with elevated hs-CRP at visit 2, 77% also had elevated hs-CRP at visit 4. Visit 2 and visit 4 hs-CRP were highly correlated
Discussion
We observed that hs-CRP measured at a single time point was associated with an approximately 40% to 50% increased risk of diabetes, cardiovascular events, and death for nearly 15 years of follow-up. Furthermore, persons with sustained elevations in hs-CRP were at the highest relative risk for CVD and mortality. Large increases in and sustained elevations in hs-CRP that surpassed the 3-mg/L threshold were strongly associated with increased risk of future diabetes. Similarly, the more proximal
Disclosures
Dr Ballantyne received support from Roche Diagnostics and is a coinvestigator on a provisional patent filed by Roche for use of biomarkers in heart failure prediction. Drs Selvin and Ballantyne have served on a Roche Advisory Board.
Acknowledgements
The authors thank the staff and participants of the ARIC study for their important contributions. Reagents for the C-reactive protein assays in visit 2 samples were donated by Roche Diagnostics.
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Cited by (0)
This work was presented at the American Heart Association Epidemiology and Prevention and Nutrition, Physical Activity and Metabolism 2014 Scientific Sessions, held in San Francisco, CA; March 18-21, 2014.
C.M. Parrinello is supported by National Institutes of Health/National Heart, Lung, and Blood Institute Cardiovascular Epidemiology Training Grant T32HL007024. This research was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases Grant R01DK089174. The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C).