Background
C-reactive protein (CRP) is a nonspecific, but sensitive marker of systemic immune response. Many studies have suggested that CRP levels are associated with obesity and cardiovascular risk factors not only in adults, but also in children. We assessed the inter-relationships between CRP, obesity, and cardiovascular risk factors in Korean children aged 7 years old. Methods: A total of 126 children (40 overweight and 86 normal weight children) were recruited from seven elementary schools in Seoul and Gyeonggi-do. Physical examinations including various obesity parameters were done. Fasting and post-prandial venous blood was withdrawn for the chemistry. The hsCRP was measured by the Nephelometry. Results: The hsCRP was associated with body weight, body fat (%), body mass index (BMI), waist circumferences, hip circumferences and waist/hip ratio (P＜0.05). From the lowest to the highest quartile groups of hsCRP, mean fasting insulin levels (2.7⁑3.1μIU/mL, 2.6⁑2.1μIU/mL, 3.4⁑3.7μIU/mL, and 4.2⁑3.6μIU/mL, respectively)(P＜0.05) and HOMA-IR levels (0.60⁑0.70, 0.59⁑0.49, 0.74⁑0.84, and 0.95⁑0.83, respectively)(P＜0.05) increased. Serum lipid profiles were not associated with the hsCRP levels. Conclusion: In children aged 7 years old, the hsCRP was significantly associated with obesity and cardiovascular risk factors. (J Korean Acad Fam Med 2007;28:509-514)

Background
: C-reactive protein (CRP) is one of the increasing plasma proteins in inflammatory diseases and tissue necrosis and recent evidence show that increased elevated levels of CRP are associated with an increased risk of coronary heart disease (CHD) and obesity. To investigate the relationship of obesity and CRP, we evaluated the correlation of CRP with obesity index in healthy adults.

Methods : The subjects included 1,926 healthy adults (1,168 men and 758 women) who visited the Health Promotion Center of a general hospital from May to December 2004. We excluded subjects who had inflammatory diseases, and investigated based on age, physical examination, blood pressure, fasting plasma glucose, serum lipid profile, percentage of body fat, and body mass index (BMI). CRP was analyzed by method of Turbid Immuno Assay (TIA) which has high sensitivity-CRP. We evaluated serum level of CRP in relation to %body fat, BMI, and clustering of metabolic risk factors.

Results : Comparing the median CRP with the percentage of body fat, BMI, clustering of metabolic risk factors the value of CRP significantly increased according to increase in %body fat BMI and metabolic risk factor (P＜0.001). The proportion of elevated CRP levels (≥0.22 mg/dL) was increased as %body fat, BMI, and clustering of metabolic risk factor increased. The Odds Ratios for elevated levels of CRP were 1.5 (95% CI 1.0∼2.1) in men and 2.9 (95% CI 1.7∼4.8) in women for subjects with obesity (BMI≥25 kg/m²), 2.0 (95% CI 1.3∼2.9) in men with more than 25% %body fat, and 2.5 (95% CI 1.4∼4.1) in women with more than 30% %body fat.

Conclusion : As %body fat increased, the proportion of elevated CRP (≥0.22 mg/dL) level increased in men and women. We conclude that obesity is related with CRP.

Background
: C-reactive protein is a substance that elevates when there is an abnormal metabolic reaction or inflammatory condition. Some researchers in Korea reported different results about the association between smoking and CRP. In this study, the relationship between CRP and various smoking characteristics among Korean men was investigated.

Methods : Data were analyzed in healthy men, who had visited a health promotion center in a university hospital from September, 2003 to December, 2003. CRP was quantitatively analyzed by high sensitivity-CRP. Elevated CRP (≥2.2 mg/L) level in relation to various smoking characteristics were studied and multiple logistic regression analysis for elevated CRP (≥2.2 mg/L) level was conducted.

Results : The number of current smokers was 893, past smokers 550, and non-smokers 413. The association between smoking status, daily smoking amount, duration of smoking (P=0.031, P=0.003, P=0.034) and elevated CRP level was shown by chi-square test. After multiple logistic regression analysis for risk factors, elevated CRP level was shwon to be associated with daily smoking amount in the current smokers, body fat percentage, WBC count and HDL-cholesterol. The odds ratios for elevated CRP level by smoking amount were 2.32 (95% confidence interval 1.11∼4.85) in those who smoked 10∼19 cigarettes per day, 3.54 (95% confidence interval 1.64∼7.63) in those who smoked more than 20 cigarettes per day compared to those who smoked less than 10 cigarettes per day.

Conclusion : Among current smokers, elevated CRP level was associated with daily smoking amount in the current smokers, This is the first study to report the relationship between CRP level and smoking behaviors among Korean men.

Background
: Obesity has been proposed as a risk factor for cardiovascular diseases. CRP has been proposed as an independent risk factor for cardiovascular diseases, and has been associated with body weight and body fatness. It has been known that weight reduction reduces CRP. We examined the hypothesis that weight loss can reduce plasma CRP levels in Korean, obese premenopausal women.

Methods : In a sample of 36 Korean obese (BMI 25.00 ∼47.02 kg/m²), premenopausal (22∼48 years) women, we measured hsCRP, plasma lipid profiles, blood glucose, body weight, body mass indexes, body fatness and intraabdominal body fat area. A 12-week weight reduction program was conducted in 36 obese women. When the program was finished, fat distribution, hsCRP and lipid profile test was repeated. The effects of weight loss on CRP levels were tested by means of paired t-test and nonparametric Wilcoxon signed rank test.

Results : We found that plasma CRP level was positively associated with body weight, body mass index, body fatness, CT-measured abdominal visceral and subcutaneous fat area. After a 12-week weight loss protocol, the average weight loss was 7.97±3.46 kg (P＜0.0001) with loss of fat mass 5.29±0.59 kg, and 1.98±1.20 kg lean body mass. Plasma CRP levels were both positively associated with plasma CRP level reductions (P=0.0437).

Conclusion : Obesity and adiposity influenced significantly on plasma CRP in Korean premenopausal women on cross sectional basis. Moreover, 12-week caloric restriction induced weight loss decreased plasma CRP levels. Weight loss represents an intervention to reduce plasma CRP and can mediate to reduce cardiovascular disease risk in Korean obese premenopausal women.

Background
: There are several reports that vitamin C is one of antioxidants and can be used to protect cardiovascular diseases. Inflammation plays a major role in atherosclerosis, and the measurement of inflammatory markers such as high-sensitivity C-reactive protein (hs- CRP) may provide methods for risk prediction and reveal independent risk factors of cardiovascular diseases. The purpose of our study was to assess the correlation between vitamin C intake and plasma hs-CRP concentration.

Methods : The study subjects consisted of 2,012 individuals who underwent periodic health examination in a university hospital in Busan from June 2002 to January 2003. The subjects were questioned concerning their past medical history, alcohol intake, smoking status, physical activity. Body mass index, abdominal circumference, blood pressure, fasting glucose, lipid profile, general blood test, and hs-CRP were measured. The exclusive responsible dietitian evaluated the average calorie intake and vitamin C intake by food frequency questionnaire. To quantify the correlation between vitamin C intake and plasma hs-CRP concentration, Pearson correlation coefficient and Spearman correlation coefficient were presented.

Results : The vitamin C index (r=-0.051, P＜0.05) and the vitamin C intake per calorie intake (r=-0.075, P＜0.01) showed a significant correlation with the plasma hs-CRP level. The vitamin C intake and the vitamin C intake per calorie intake were significantly correlated with the plasma hs-CRP level after adjusting for sex, age, body mass index and smoking status.

Conclusion : These findings suggest that there was a significant correlation between the vitamin C intake and the hs-CRP concentration. Therefore, inflammatory status is higher in a person who takes small amount of vitamin C than a person who takes it plentifully. The former is presumed to have a higher risk of cardiovascular diseases thereafter.

Background
: Vascular endothelial dysfunction (VED) plays a pivotal role in the pathogenesis of atherosclerosis and is associated with insulin resistance and with visceral obesity. Therefore, in this study the predicting factor of vascular endothelial dysfunction was investigated in healthy premenopausal obese women by pulse-wave analysis (PWA) combined with provocative pharmacological testing.

Methods : Thirty three obese women (BMI≥25), aged 20∼45 y and 25 age-matched control subjects (BMI; 18.5∼22.9) were examined. All women were sedentary (＜1 hr/wk of physical activity), non-smoker and were excluded if they had type 2 diabetes melitus, hypertension, hyperlipidemia, cardiovascular disease, or acute inflammatory disease and were studied in folicullar phase of the cycle, within the first week after cessation of menstrual bleeding. They underwent determination of anthropometric measurements, metabolic variables, adipose tissue regional distribution, and endothelial function by performing pulse-wave analysis (PWA) combined with provocative pharmacological testing.

Results : Augmentation Index (AIx) fell significantly after the administration of salbutamol, which causes endothelium-dependent vasodilatation, but response was significantly reduced in obese women compared with controls (10.28 6.72% vs 17.2 6.84%, P=0.0003). The change in after Nitroglycerin, which causes endothelium-independent vasodilatation, did not differ significantly (30.86 9.67% vs 30.6 10.11%, P=0.9172). In our obese subjects, visceral adipose tissue area was independently a significant predictor of vascular endothelial dysfunction (β= 0.1381, P=0.0038, Adj-R2=0.348).

Conclusion : Increased abdominal adiposity is a powerful independent predictor of VED in obese healthy women. Future studies of vascular endothelial function should account for the independent effects of abdominal fat.

Background
: C-reactive protein (hereinafter CRP) is a substance that is elevated in large quantities when there is an abnormal metabolic reaction or an inflammatory condition. Many researches have identified the substance as a prognostic and an independent risk factor responsible for cardiovascular disease. More recently, many studies have shown that obesity is associated with low-grade systemic inflammation. This study was attempted to illustrate the relationship between obesity and CRP regarding Korean men who were applied by different standards of obesity.

Methods : The subjects included 15,353 men who had visited one health promotion center from May, 2001 to December, 2001, were randomly selected as the total addressable population. We excluded 389 men who were observed to have inflammatory conditions, according to the results of the general chemical and physical diagnosis. Among 15,353 Korean men 14,964 were examined. CRP was quantitatively analyzed by the method of Nephelometry as high sensitivity-CRP. CRP values in relation to age, BMI, clustering of metabolic risk factors were studied, and multiple logistic regression analysis was conducted to identify correlation between obesity and CRP value.

Results : We compared the median values of CRP of each group divided by age, BMI, and clustering of metabolic risk factors. As a matter of the fact, the more age, BMI, and clustering of metabolic risk factors increased, the more the value of CRP significantly increased (P＜0.0001). We operationally defined incremented CRP value as CRP of 0.22 mg/dl or more, and conducted multiple logistic regression analysis with the parameters of age, BMI, and obesity related diseases. Consequently, when fasting blood glucose and total cholesterol were high or HDL was low, the risk of CRP increasing was significantly high. Also, when the age was more than 60 or BMI was greater than 25 kg/m², which was categorized as obese, the risk regarding increase in CRP was significantly high.

Conclusion : Obesity is independently related to increase in CRP in Korean men. Which suggests that low-grade systemic inflammation exists in obese people. Furthermore, our study showed that old age, high level of blood glucose, high level of cholesterol, and low level of HDL have correlation with increase in CRP.