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CRP

Lipoprotein(a) Level Linked to Risk of Coronary Events – (03-15-01)

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Lipoprotein(a) Level Linked to Risk of Coronary Events

We’ve talked about “nontraditional” risk factors for cardiovascular disease such as homocysteine, CRP, fibrinogen and lipoprotein a. This study closely examined the role that lipoprotein a plays in relation to heart disease and found that the risk of high levels is greater when other cardiovascular risk factors are also present, such as low HDL, high LDL and hypertension. Could we envision a better way to express the importance of a global approach to heart disease? The one-cause-one-cure idea can be thrown out the window when it comes to chronic diseases such as heart disease, arthritis, diabetes, osteoporosis and cancer.

J Am Coll Cardiol 2001;37:434-439 Perhaps ending a longstanding controversy, a new population-based study connects elevated levels of lipoprotein(a) with increased coronary risk in middle-aged men, especially those with high LDL cholesterol levels, low HDL cholesterol levels, hypertension and/or other risk factors. Dr. Arnold von Eckardstein, from the Westfalische Wilhelms-Universitat Munster, Germany, and colleagues collected data on 788 men, 35 to 65 years of age, who participated in the Prospective Cardiovascular Munster study. Over 10 years of follow-up, the researchers evaluated levels of lipoprotein(a) as well as traditional cardiovascular risk factors. During that period, 44 men experienced myocardial infarctions, while the remaining 744 subjects survived without a major coronary event or stroke, according to the research team’s report in the Journal of the American College of Cardiology for February. Dr. von Eckardstein’s group found a 2.7 times increased risk for coronary events among men whose lipoprotein(a) levels were 0.2 g/L or more, compared with subjects with lower levels. The risk was especially prominent in men with LDL cholesterol levels of 4.1 mmol/L or more (relative risk 2.6), and men with HDL cholesterol of 0.9 mmol/L or less (relative risk 8.3). The risk was also strongly associated with hypertension (relative risk 3.2). “Because lipoprotein(a) increases the risk of coronary events strongly depending on the presence of additional coronary risk factors, it is imperative to strictly control additional risk factors in individuals with elevated lipoprotein(a),” Dr. von Eckardstein and colleagues conclude.

 

Low Circulating Vitamin B6 Is Associated With Elevation of the CRP – (06-21-01)

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Low Circulating Vitamin B6 Is Associated With Elevation of the CRP

Many of the B vitamins have a large impact on our health in a variety of ways. This article suggests that B6 has a direct ability to lower inflammatory markers. And, since inflammation has been tied to so many of today’s chronic diseases, a multivitamin complex along with a diet complete with fresh fruits, veggies and whole grains will go a long way in preventative medicine. As an aside, this study used P-5-P…the active form of vitamin B6. When B6 is taken in, it has to go to the liver to be phosphorylated and this puts extra work on the liver. P-5-P is probably the most bioavailable form of B6.

Circulation — Abstracts: Friso et al. 103 (23): 2788

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Lp(A) Levels and ApoE4 Allele Predictive of Coronary Events in Men – (03-05-01)

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Lp(A) Levels and ApoE4 Allele Predictive of Coronary Events in Men

The Lp(a) marker has been used in many functional medicine lab’s coronary risk profiles for years now. And to that homocysteine, cholesterol, CRP, fibrinogen and several others and you get a very good picture of cardiovascular risk. Remember that many of today’s chronic diseases have more than one contributing factor–do you think checking only one factor (cholesterol) is anywhere near all we need to be doing these days to evaulate cardiovascular risk? I’ve got a better idea–save the money on the lab tests and just start leading a healthy lifestyle…

Am J Med 2001;110:22-32,71-72 Adjusted multivariate analysis revealed cholesterol level, diabetes, smoking status, diastolic blood pressure, Apo-AI, age, and Lp(a) as independent risk factors for cardiac events. Dr. Seed and colleagues found that “coronary events were lowest in the group with Lp(a) levels below 2.9 mg/dL (the 25th percentile), highest in those with levels higher than 26.3 mg/dL (the 75th percentile), and intermediate in the group with levels of 2.9 to 26.3 mg/dL.” In the second study, Dr. Angelo Scuteri and colleagues, from the National Institutes of Health, in Baltimore, measured apoE genotypes in 730 men and women who participated in the Baltimore Longitudinal Study of Aging. The researchers identified the apoE4 allele in 200 subjects. On follow-up, 104 of the 730 subjects had coronary events. These events were significantly more frequent in subjects with the apoE4 allele (20%) than in those without it (12%), Dr. Scuteri’s team reports. “In a multivariate model, apoE4 was an independent predictor of coronary events in men (risk ratio 2.9), but not in women (risk ratio 0.9),” they note. Dr. Scuteri and colleagues also found that cholesterol levels did not appear to mediate the association. Despite the findings of these two studies, Dr. Peter W. F. Wilson, from Boston University School of Medicine, maintains that there is nothing definitive about using these markers as predictors of cardiac events. In an accompanying editorial, he writes that “improvement in vascular disease risk prediction with apoE allele determination is marginal [and] for Lp(a), the situation is [even] more murky.”

High-Dose Vit E Reduces Serum Levels of CRP in Diabetes – (11-29-00)

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High-Dose Vit E Reduces Serum Levels of CRP in Diabetes

It is not surprising that Vit E may have the potential to lower the risk of heart disease in diabetics. What is surprising is that this study actually used levels considered therapeutic by researchers…1200 IU/day.

Free Radic Biol Med 2000;8:790-792 Results of a new study of type-2 diabetics indicate that high-dose vitamin E reduces levels of C-reactive protein (CRP), a marker of inflammation and a predictor of cardiovascular disease. “High dose vitamin E in all three groups reduced inflammation as seen by low levels of C-reactive protein, which we measured by a new highly sensitive assay,” Dr. Jialal told Reuters Health. The researchers also saw lower levels of the pro-inflammatory cytokine, interleuken-6, which drives CRP. Both markers, Dr. Jialal explained, have previously been shown to be predictors of heart disease and stroke. “We have shown that you can modulate these markers in diabetics, which has great implications, given that in diabetes you have at least a 2-fold increased prevalence of stroke and heart attacks,” he added.

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CRP, Interleukin 6, and Risk of Developing Type 2 Diabetes Mellitus – (07-23-01)

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CRP, Interleukin 6, and Risk of Developing Type 2 Diabetes Mellitus

Inflammation plays a key role in many of today’s chronic diseases and lifestyle changes to lower overall inflammatory burden will cut across disease risk for a variety of diseases. Identifying and avoiding food allergies, choosing a more plant based diet over animal based, adequate fruit and veggie intake and exercise are just a few of the ways to lower inflammation. Of interesting note is that insulin is generally considered a proinflammatory hormone (with the exception of a few studies that suggest an anti-inflammatory action in certain instances)…it is possible that increasing inflammation is one way in which high insulin promotes diabetes.

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Physical Activity and Inflammation in Middle-aged and Older US Adults – (06-24-02)

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Physical Activity and Inflammation in Middle-aged and Older US Adults

This study finds that exercise lowers overall levels of CRP, a marker of chronic inflammation. This is really not an unexpected result;moderate exercise is a key component to a natural approach to any disease process since most diseases have an inflammatory component.

Relationship Between Physical Activity and Inflammation Among Apparently Healthy Middle-aged and Older US Adults.

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CRP binds both oxidized LDL, apoptotic cells through common ligand – (09-26-02)

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CRP binds both oxidized LDL, apoptotic cells through common ligand

CRP is now widely accepted as an independent risk factor for heart disease (at least it is by those of us that don’t rely on the drug companies as a sole source of continuing medical information….), but whether it was a marker or played a direct role was unknown. This article begins to identify CRP as playing a direct role. I have seen interventions such as exercise and avoidance of refined carbs lower CRP levels dramatically.

Chang et al., 10.1073/pnas.192399699

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Novel Cardiovascular Risk Factors: Do They Add Value to Your Practice? – (01-27-03)

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Novel Cardiovascular Risk Factors: Do They Add Value to Your Practice?

These people never cease to amaze me. Here is the overview of this editorial: CRP is known to be a risk factor for CVD…There is not enough evidence to support interventions to lower CRP levels….We don’t know how to lower CRP levels….So, overall it’s a worthless approach and we should focus of stuff that has been proven (i.e. pharmaceuticals to lower cholesterol levels). Maybe I’m being a little cynical here, but I am now checking CRP levels whenever I order labs on patients and using approaches such as avoidance of refined carbs and exercise to lower levels. In my opinion, there is a large body of evidence suggesting that inflammation plays a major role in CVD and CRP is just one marker of inflammation. Evaluatiog and addressing CRP levels makes alot of sense to me.

Editorials – January 15, 2003 – American Family Physician

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