The relationship between traditional cardiovascular risk factors, body composition and C-reactive protein amongst 19 to 60 year old black women

Sonja Coetzee

The prevalence of obesity has increased dramatically in the past decade. This foreshadows an increase in the rates of morbidity and mortality from obesity related diseases. The high prevalence of coronary heart disease (CHD) is a problem throughout the world as well as in South Africa The process of urbanisation of Africans from rural to urban areas is exposing the African population to Western lifestyles, with an increase in the incidence of CHD being reported. Research is more frequently proposing that obesity may be seen as a factor linking elevated C-reactive protein (CRP) concentrations and atherosclerosis. CRP is an acute phase reactant and a sensitive marker for acute and chronic inflammation of diverse causes. This poses the question of whether the increased risk of diabetes, CHD and many other chronic diseases in the obese might be explained by a state of chronic systemic inflammation. The purpose of this study was, therefore, firstly to determine whether there is an association between CRP concentrations and body composition in 19 to 60 year old black women. Partial Pearson correlations coefficients were used to determine associations between CRP and several body composition variables. Body mass index (BMI), waist circumference, percentage body fat and waist-hip-ratio (WHR) were all significantly correlated with CRP throughout the anthropometric spectrum. An analysis of variance (ANOVA) with a Games-Howell post hoc test was done to determine statistically significant differences among the different categories within each of the body composition variables. Significant differences (p < 0.05) were found within the categories of all the measured body composition variables, except for the various WHR categories. During a signal detection analysis, BMI was identified as the best predictor of increased CRP concentrations at a cut-off point of 27.68 kg/m2. The second purpose of this study was to assess the relationship of CRP to traditional cardiovascular risk factors in the study's population sample of 19 to 60 year old black women. Pearson correlation coefficients were used to analyse log-normalized CRP concentrations as the dependent variable in relation to several variables which form part of the traditional risk factors for CHD. All of the variables were significantly correlated with CRP at the level of p ≤ 0.05, except for total cholesterol and low-density lipoprotein cholesterol. BMI, percentage body fat and fibrinogen levels were associated with InCRP at a practically significant level of r ≥ 0.5. BMI and fibrinogen were also found to be independently associated with InCRP with p ≤ 0.05 during a forward stepwise multiple linear regression analysis. Within this study's population sample, it was found that those women who presented with six traditional risk factors had a three to five-fold increase in CRF' concentrations compared to women with three or less risk factors. Further research is required to determine appropriate intervention programmes which could prevent or reduce the incidence of CHD among the obese by means of weight-loss, therefore, potentially lowering elevated CRP concentrations.

The relationship between traditional cardiovascular risk factors, body composition and C-reactive protein amongst 19 to 60 year old black women

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