Associação entre a dosagem da proteína c reativa ultra sensível e fatores de risco cardiovascular em idosos projeto Bambuí

Abstract

Background: Evidence from laboratory, clinical and epidemiological studies has been accumulated in recent years correlating low-grade inflammation and atherosclerosis. The distribution of hs-CRP (ultra-sensitive C-reactive protein) in populations with different age groups, particularly the elderly and their correlation with selected risk factors may help to improve its clinical utility in predicting cardiovascular risk. Objectives: To evaluate the distribution of hs-CRP and its association with cardiovascular risk factors in the population from study Bambuí, older than 59 years , at the baseline point. Methods: The baseline survey in the study cohort comprised 1606 individuals residing in Bambuí (Minas Gerais, Brazil), representing 92% of the total, over the age of 60 years. hs-CRP was determined by the immunonephelometry method in serum sample of 1470 elderly, after 12 hours of fasting and stored at 70 ° Celsius. The values were associated with selected cardiovascular risk variables: body mass, blood pressure, smoking, physical inactivity, total cholesterol, HDL and triglycerides. To rule out evident inflammatory processes, we excluded values above 10mg / L. The comparison of data between genders was performed using Student's t test to compare means and chi-square to compare proportions. The association between hs-CRP value and the independent variables was assessed by multiple linear regression adjusted for age. Results: The distribution of hs-CRP values in the population was log-normal. The mean and standard deviation values were 3.03 mg/L (±2.50) for both genders. Women were found to have higher CRP mean levels (3.62 ±2.58 mg/L) than men (3.39 ±2.56 mg/L) (p<0,001).. In men, only the variables total cholesterol, glucose and diabetes mellitus had a positive association with hs-CRP values. In the group of elderly women CRP levels associated with age, HDL cholesterol greater than 50mg/dL, LDL cholesterol, diastolic blood pressure and triglycerides. The body mass index had positive association with hs-CRP (p <0.001) for both sexes. The score of the Framingham risk score, according to traditional criteria was associated positively with the ranges of hs-CRP. The categories of the score were significantly different. Conclusion: These results indicate that significant gender differences exist in the population distribution of hs-CRP. Further research is needed to evaluate if new set of cut points based in ethnic or gender should be established to assess the risk of future coronary events. Elderly at risk of low and intermediate Framinham, diabetics, men with normal lipids and hypertensive women can benefit from the addition of hsCRP in predicting coronary events. The inclusion of hsCRP at Bambuí Cohort Study baseline will enable future analysis that may confirm these results through the longitudinal observation of this cohort.