Prevalence and Contributors to Low-grade Inflammation in Three U.S. Populations of Reproductive Age Women

Lindsey A. Sjaarda; Rose G. Radin; Chandra Swanson; Daniel L. Kuhr; Sunni L. Mumford; Noya Galai; Robert M. Silver; Jean Wactawski-Wende; Neil J. Perkins; Enrique F. Schisterman

doi:10.1111/ppe.12409

Prevalence and Contributors to Low-grade Inflammation in Three U.S. Populations of Reproductive Age Women

Lindsey A. Sjaarda, Rose G. Radin, Chandra Swanson, Daniel L. Kuhr, Sunni L. Mumford, Noya Galai, Robert M. Silver, Jean Wactawski-Wende, Neil J. Perkins, Enrique F. Schisterman

Department of Statistics

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Inflammation, measured by high-sensitivity C-reactive protein (hsCRP), is linked to adverse reproductive outcomes. However, prevalence and predictors of low-grade inflammation are poorly understood among reproductive age women. Therefore, the current aim was to characterize: (i) the prevalence of elevated hsCRP and (ii) whether the association of various demographic, anthropometric, life style, and metabolic characteristics with higher hsCRP varies across populations of reproductive age women with varying risk profiles for adverse reproductive outcomes. Methods: Bivariate analysis of characteristics among women ages 18–40 having hsCRP <2.0 vs. ≥2.0 mg/L in the BioCycle Study (N = 259), the Effects of Aspirin in Gestation and Reproduction Trial (EAGeR) (N = 1228), and the National Health and Nutrition Examination Survey (NHANES; N = 2173) were conducted. Multivariable regression analysis estimated the association of all characteristics to hsCRP within each cohort. Results: Prevalence of hsCRP≥2 mg/L ranged from 20 to 40%. Age, BMI, waist circumference, blood pressure, lipids, glucose, and insulin were frequently higher in women with hsCRP ≥2 mg/L. In multivariable models, however, only adiposity (BMI, waist circumference) was independently associated with hsCRP within all three cohorts. Some variables showed cohort-specific associations with higher hsCRP: white race (EAGeR), higher fasting glucose (BioCycle), and lesser education and employment (NHANES). The total characteristics explained 28–46% of the variation in hsCRP across the three cohorts. Conclusions: Low-grade inflammation was common, including among predominantly non-obese women, affecting from 20 to 40% of reproductive age women. Given the potential to reduce inflammation through inexpensive, widely available therapies, examination of the impact of chronic inflammation on reproductive and pregnancy outcomes, as well as preventive interventions, are now needed.

Original language	English
Pages (from-to)	55-67
Number of pages	13
Journal	Paediatric and Perinatal Epidemiology
Volume	32
Issue number	1
DOIs	https://doi.org/10.1111/ppe.12409
State	Published - Jan 2018

Bibliographical note

Publisher Copyright:
© 2017 This article is a U.S. Government work and is in the public domain in the USA.

Keywords

C-reactive protein
fertility
inflammation
obesity
population health
premenopausal women
reproductive age

ASJC Scopus subject areas

Epidemiology
Pediatrics, Perinatology, and Child Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/ppe.12409

Cite this

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title = "Prevalence and Contributors to Low-grade Inflammation in Three U.S. Populations of Reproductive Age Women",

abstract = "Background: Inflammation, measured by high-sensitivity C-reactive protein (hsCRP), is linked to adverse reproductive outcomes. However, prevalence and predictors of low-grade inflammation are poorly understood among reproductive age women. Therefore, the current aim was to characterize: (i) the prevalence of elevated hsCRP and (ii) whether the association of various demographic, anthropometric, life style, and metabolic characteristics with higher hsCRP varies across populations of reproductive age women with varying risk profiles for adverse reproductive outcomes. Methods: Bivariate analysis of characteristics among women ages 18–40 having hsCRP <2.0 vs. ≥2.0 mg/L in the BioCycle Study (N = 259), the Effects of Aspirin in Gestation and Reproduction Trial (EAGeR) (N = 1228), and the National Health and Nutrition Examination Survey (NHANES; N = 2173) were conducted. Multivariable regression analysis estimated the association of all characteristics to hsCRP within each cohort. Results: Prevalence of hsCRP≥2 mg/L ranged from 20 to 40%. Age, BMI, waist circumference, blood pressure, lipids, glucose, and insulin were frequently higher in women with hsCRP ≥2 mg/L. In multivariable models, however, only adiposity (BMI, waist circumference) was independently associated with hsCRP within all three cohorts. Some variables showed cohort-specific associations with higher hsCRP: white race (EAGeR), higher fasting glucose (BioCycle), and lesser education and employment (NHANES). The total characteristics explained 28–46% of the variation in hsCRP across the three cohorts. Conclusions: Low-grade inflammation was common, including among predominantly non-obese women, affecting from 20 to 40% of reproductive age women. Given the potential to reduce inflammation through inexpensive, widely available therapies, examination of the impact of chronic inflammation on reproductive and pregnancy outcomes, as well as preventive interventions, are now needed.",

keywords = "C-reactive protein, fertility, inflammation, obesity, population health, premenopausal women, reproductive age",

author = "Sjaarda, {Lindsey A.} and Radin, {Rose G.} and Chandra Swanson and Kuhr, {Daniel L.} and Mumford, {Sunni L.} and Noya Galai and Silver, {Robert M.} and Jean Wactawski-Wende and Perkins, {Neil J.} and Schisterman, {Enrique F.}",

note = "Publisher Copyright: {\textcopyright} 2017 This article is a U.S. Government work and is in the public domain in the USA.",

year = "2018",

month = jan,

doi = "10.1111/ppe.12409",

language = "English",

volume = "32",

pages = "55--67",

journal = "Paediatric and Perinatal Epidemiology",

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T1 - Prevalence and Contributors to Low-grade Inflammation in Three U.S. Populations of Reproductive Age Women

AU - Sjaarda, Lindsey A.

AU - Radin, Rose G.

AU - Swanson, Chandra

AU - Kuhr, Daniel L.

AU - Mumford, Sunni L.

AU - Galai, Noya

AU - Silver, Robert M.

AU - Wactawski-Wende, Jean

AU - Perkins, Neil J.

AU - Schisterman, Enrique F.

PY - 2018/1

Y1 - 2018/1

N2 - Background: Inflammation, measured by high-sensitivity C-reactive protein (hsCRP), is linked to adverse reproductive outcomes. However, prevalence and predictors of low-grade inflammation are poorly understood among reproductive age women. Therefore, the current aim was to characterize: (i) the prevalence of elevated hsCRP and (ii) whether the association of various demographic, anthropometric, life style, and metabolic characteristics with higher hsCRP varies across populations of reproductive age women with varying risk profiles for adverse reproductive outcomes. Methods: Bivariate analysis of characteristics among women ages 18–40 having hsCRP <2.0 vs. ≥2.0 mg/L in the BioCycle Study (N = 259), the Effects of Aspirin in Gestation and Reproduction Trial (EAGeR) (N = 1228), and the National Health and Nutrition Examination Survey (NHANES; N = 2173) were conducted. Multivariable regression analysis estimated the association of all characteristics to hsCRP within each cohort. Results: Prevalence of hsCRP≥2 mg/L ranged from 20 to 40%. Age, BMI, waist circumference, blood pressure, lipids, glucose, and insulin were frequently higher in women with hsCRP ≥2 mg/L. In multivariable models, however, only adiposity (BMI, waist circumference) was independently associated with hsCRP within all three cohorts. Some variables showed cohort-specific associations with higher hsCRP: white race (EAGeR), higher fasting glucose (BioCycle), and lesser education and employment (NHANES). The total characteristics explained 28–46% of the variation in hsCRP across the three cohorts. Conclusions: Low-grade inflammation was common, including among predominantly non-obese women, affecting from 20 to 40% of reproductive age women. Given the potential to reduce inflammation through inexpensive, widely available therapies, examination of the impact of chronic inflammation on reproductive and pregnancy outcomes, as well as preventive interventions, are now needed.

AB - Background: Inflammation, measured by high-sensitivity C-reactive protein (hsCRP), is linked to adverse reproductive outcomes. However, prevalence and predictors of low-grade inflammation are poorly understood among reproductive age women. Therefore, the current aim was to characterize: (i) the prevalence of elevated hsCRP and (ii) whether the association of various demographic, anthropometric, life style, and metabolic characteristics with higher hsCRP varies across populations of reproductive age women with varying risk profiles for adverse reproductive outcomes. Methods: Bivariate analysis of characteristics among women ages 18–40 having hsCRP <2.0 vs. ≥2.0 mg/L in the BioCycle Study (N = 259), the Effects of Aspirin in Gestation and Reproduction Trial (EAGeR) (N = 1228), and the National Health and Nutrition Examination Survey (NHANES; N = 2173) were conducted. Multivariable regression analysis estimated the association of all characteristics to hsCRP within each cohort. Results: Prevalence of hsCRP≥2 mg/L ranged from 20 to 40%. Age, BMI, waist circumference, blood pressure, lipids, glucose, and insulin were frequently higher in women with hsCRP ≥2 mg/L. In multivariable models, however, only adiposity (BMI, waist circumference) was independently associated with hsCRP within all three cohorts. Some variables showed cohort-specific associations with higher hsCRP: white race (EAGeR), higher fasting glucose (BioCycle), and lesser education and employment (NHANES). The total characteristics explained 28–46% of the variation in hsCRP across the three cohorts. Conclusions: Low-grade inflammation was common, including among predominantly non-obese women, affecting from 20 to 40% of reproductive age women. Given the potential to reduce inflammation through inexpensive, widely available therapies, examination of the impact of chronic inflammation on reproductive and pregnancy outcomes, as well as preventive interventions, are now needed.

KW - C-reactive protein

KW - fertility

KW - inflammation

KW - obesity

KW - population health

KW - premenopausal women

KW - reproductive age

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U2 - 10.1111/ppe.12409

DO - 10.1111/ppe.12409

M3 - Article

C2 - 28913889

AN - SCOPUS:85029542778

SN - 0269-5022

VL - 32

SP - 55

EP - 67

JO - Paediatric and Perinatal Epidemiology

JF - Paediatric and Perinatal Epidemiology

IS - 1

ER -

Prevalence and Contributors to Low-grade Inflammation in Three U.S. Populations of Reproductive Age Women

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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