C-Reactive Protein versus Erythrocyte Sedimentation Rate: Implications Among Patients with No Known Inflammatory Conditions.
BACKGROUND
Measurements of C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) are frequently ordered jointly in clinical practice.


AIM
To investigate the factors associated with discordances between CRP concentration and ESR in adults.


METHODS
We conducted a cross-sectional study of 1472 adults with no known inflammatory disorders (44.5% male; median age, 52 years; range, 18-91 years), randomly selected from a municipality in Spain. The participants underwent simultaneous measurements of ESR, serum CRP, and interleukin-6 concentrations. Alcohol consumption, smoking, and physical activity were evaluated by questionnaire. Body mass index (BMI) measurement and metabolic syndrome criteria were available for all participants.


RESULTS
Most (n = 1123, 74.9%) of the participants showed normal CRP and ESR values. Sixty-nine (4.6%) participants showed high CRP and ESR values. Seventy-two (4.8%) participants showed a discordant pattern of high ESR and normal CRP values, which was associated with age after adjusting for sex, alcohol consumption, physical activity, BMI, and the presence of metabolic syndrome (odds ratio [OR], 1.052; 95% CI, 1.034-1.071; P < .001). A total of 208 (13.8%) participants showed a discordant pattern of high CRP and normal ESR values, which was associated with BMI after adjusting for covariates (OR, 1.099; 95% CI, 1.064-1.136; P < .001). BMI appeared to be the main determinant of serum CRP concentrations in this population. Serum interleukin-6 concentrations were positively associated with the discordant pattern of high CRP and normal ESR values.


CONCLUSION
In this general adult population with no overt inflammatory disease, the discordant pattern of high ESR and normal CRP was associated with greater age, whereas the pattern of high CRP and normal ESR was associated with higher BMI.
['Alende-Castro|Vanessa|V|', 'Alonso-Sampedro|Manuela|M|', 'Fernández-Merino|Carmen|C|', 'Sánchez-Castro|Juan|J|', 'Sopeña|Bernardo|B|', 'Gude|Francisco|F|', 'Gonzalez-Quintela|Arturo|A|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D015415:Biomarkers D001799:Blood Sedimentation D015992:Body Mass Index D002097:C-Reactive Protein D003430:Cross-Sectional Studies D015444:Exercise D005260:Female D006801:Humans D008297:Male D008875:Middle Aged
C-Reactive Protein Erythrocyte Sedimentation Rate Inflammatory Disorders Age Interleukin-6 Alcohol Smoking Body Mass Index Metabolic Syndrome Sex Obesity Physical Exercise