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Association of Lipid and Inflammatory Markers with C-Reactive Protein in Cardiovascular Risk Assessment for Primary Prevention by Snežana Jovičić, Svetlana Ignjatović, Marijana Dajak, Ranka Kangrga, Nada Majkić-Singh

Background: High-sensitivity C-reactive protein (hsCRP) has been recognized as an independent marker of cardiovascular risk. Since atherosclerosis is a multifactorial disease, the aim of this study was to determine association between hsCRP and other markers of inflammation and dyslipidemia.
Materials and Methods: In 242 healthy volunteers, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), nonHDL-C, triglycerides (TG) and hsCRP were measured using Olympus AU2700. Apolipoprotein A-I (apoAI), apolipoprotein B (apo B), lipoprotein (a) (Lp(a)), haptoglobin, α1-acid glycoprotein (A1AGP), C3 and C4 complement components were determined on Architect c8000, and serum amyloid A (SAA) and fibrinogen on BN II nephelometer and ACL 7000, respectively.
Results: Significant (P < 0.05) partial Pearson’s correlation coefficients were found between hsCRP and TC (r = 0.172), nonHDL-C (r = 0.182), LDL-C (r = 0.154), apoB (r = 0.167), fibrinogen (r = 0.411), SAA (r = 0.493), A1AGP (r = 0.462), haptoglobin (r = 0.310), C3 (r = 0.349) and C4 (r = 0.371). In multiple regression analysis, BMI, SAA, A1AGP, fibrinogen and nonHDL-C showed independent correlation with hsCRP. Multinomial logistic regression analysis demonstrated that BMI, nonHDL, fibrinogen and SAA were strong predictors of hsCRP concentration. Odds ratios for intermediate and high risk categories compared with the low risk category were 1.177 (1.033–1.341) and 1.289 (1.091–1.523), 1.515 (1.021–2.249) and 2.062 (1.246–3.411), 2.241 (1.268–3.959) and 7.123 (3.259–15.568), and 1.387 (1.179–1.632) and 1.691 (1.397–2.047), for BMI, nonHDL-C, fibrinogen and SAA, respectively.
Conclusion: The prediction of risk for future cardiac events based on hsCRP concentration, which is the recom- mended parameter for improving cardiovascular risk stratification, might be complemented with the information about BMI, nonHDL-C, fibrinogen and SAA.

DOI: Clin. Lab. 2009;55:411-419