Month: January 2015

Inflammation and Weight

I’m often on the receiving end of a lot of well-intended but ultimately dead-end New Year’s resolutions.

Most of my friends resolve to lose weight. Some resolve to eat more vegetables. Many would like to start cooking more at home to save money and eat healthier. Several mom friends I’ve met are determined to take back control of their children’s wayward, kid-food diets.

People always seem to ask, how do you plan on losing weight? Will you exercise three times per week? Will you stop keeping cookies in the house? How much weight will you need to lose in order to have achieved your goal?

How will you go about eating more vegetables? Will you join a gym? Will you order a salad for lunch every Monday, Wednesday and Friday?

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Recent studies suggests that increased weight correlates with inflammation which may lead to serious health problems. An accumulation of clinical evidence shows that markers of inflammation correlate with coronary risk. For example, plasma levels of C-Reactive Protein (CRP), as measured by a high-sensitivity assay (hsCRP), prospectively predicts the risk of myocardial infarction (MI). CRP also correlate with the outcomes in patients with acute coronary syndromes.

In contrast to several other novel risk factors, CRP adds predictive information to that derived from already established risk factors i.e. sedentary life style, high LDL, low HDL etc… as well as those included in the Framingham score.

CLICK HERE to asses your risk http://www.mdcalc.com/framingham-coronary-heart-disease-risk-score/

Even though recent Mendelian randomization studies do not support a causal role for CRP in cardiovascular disease, CRP serves as a validated biomarker of risk but probably not as a direct contributor to pathogenesis.

Elevations in acute phase reactants such as CRP and fibrinogen reflect the overall inflammatory burden. There are various proinflammatory cytokines that drive CRP production and may represent a stimulus to elevation of inflammatory markers which are seen especially in overweight individuals.

Indeed, CRP levels rise with body mass index. Weight reduction lowers CRP levels, which lowers inflammation.

There is intriguing evidence that suggests lipid-lowering therapy such as HMG-CoA reductase inhibitors otherwise known as -statins  reduces coronary events in part by muting the inflammatory aspects of the pathogenesis of atherosclerosis. For example, in one trial called the “JUPITER” trial (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin trial) a prescribed analysis showed that those who achieved lower levels of both LDL and CRP had better clinical outcomes than did those who only reached the lower level of either the inflammatory marker or the atherogenic lipoprotein.

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Conclusion:

  1. An accumulation of clinical evidence shows that markers of inflammation correlate with coronary risk.
  2. Increased weight correlates with inflammation which may lead to serious health problems.
  3. plasma levels of C-Reactive Protein (CRP), as measured by a high-sensitivity assay (hsCRP) prospectively predicts the risk of myocardial infarction (MI).
  4. CRP also correlate with the outcomes in patients with acute coronary syndromes.

 

 

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