Individual and area-level determinants associated with C-reactive protein as a marker of cardiometabolic risk among adults: Results from the German National Health Interview and Examination Survey 2008-2011
High-sensitivity C-reactive protein (hsCRP) is a sensitive biomarker of systemic inflammation and is related to the development and progression of cardiometabolic diseases. Beyond individual-level determinants, characteristics of the residential physical and social environment are increasingly recog...
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| Veröffentlicht in: | PloS one 2019-02, Vol.14 (2), p.e0211774 |
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| description | High-sensitivity C-reactive protein (hsCRP) is a sensitive biomarker of systemic inflammation and is related to the development and progression of cardiometabolic diseases. Beyond individual-level determinants, characteristics of the residential physical and social environment are increasingly recognized as contextual determinants of systemic inflammation and cardiometabolic risks. Based on a large nationwide sample of adults in Germany, we analyzed the cross-sectional association of hsCRP with residential environment characteristics. We specifically asked whether these associations are observed independent of determinants at the individual level.
Data on serum hsCRP levels and individual sociodemographic, behavioral, and anthropometric characteristics were available from the German Health Interview and Examination Survey for Adults (2008-2011). Area-level variables included, firstly, the predefined German Index of Socioeconomic Deprivation (GISD) derived from the INKAR (indicators and maps on spatial and urban development in Germany and Europe) database and, secondly, population-weighted annual average concentration of particulate matter (PM10) in ambient air provided by the German Environment Agency. Associations with log-transformed hsCRP levels were analyzed using random-intercept multi-level linear regression models including 6,768 participants aged 18-79 years nested in 162 municipalities.
No statistically significant association of PM10 exposure with hsCRP was observed. However, adults residing in municipalities with high compared to those with low social deprivation showed significantly elevated hsCRP levels (change in geometric mean 13.5%, 95%CI 3.2%-24.7%) after adjusting for age and sex. The observed relationship was independent of individual-level educational status. Further adjustment for smoking, sports activity, and abdominal obesity appeared to markedly reduce the association between area-level social deprivation and hsCRP, whereas all individual-level variables contributed significantly to the model.
Area-level social deprivation is associated with higher systemic inflammation and the potentially mediating role of modifiable risk factors needs further elucidation. Identifying and assessing the source-specific harmful components of ambient air pollution in population-based studies remains challenging. |
| doi_str_mv | 10.1371/journal.pone.0211774 |
| format | Article |
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Data on serum hsCRP levels and individual sociodemographic, behavioral, and anthropometric characteristics were available from the German Health Interview and Examination Survey for Adults (2008-2011). Area-level variables included, firstly, the predefined German Index of Socioeconomic Deprivation (GISD) derived from the INKAR (indicators and maps on spatial and urban development in Germany and Europe) database and, secondly, population-weighted annual average concentration of particulate matter (PM10) in ambient air provided by the German Environment Agency. Associations with log-transformed hsCRP levels were analyzed using random-intercept multi-level linear regression models including 6,768 participants aged 18-79 years nested in 162 municipalities.
No statistically significant association of PM10 exposure with hsCRP was observed. However, adults residing in municipalities with high compared to those with low social deprivation showed significantly elevated hsCRP levels (change in geometric mean 13.5%, 95%CI 3.2%-24.7%) after adjusting for age and sex. The observed relationship was independent of individual-level educational status. Further adjustment for smoking, sports activity, and abdominal obesity appeared to markedly reduce the association between area-level social deprivation and hsCRP, whereas all individual-level variables contributed significantly to the model.
Area-level social deprivation is associated with higher systemic inflammation and the potentially mediating role of modifiable risk factors needs further elucidation. Identifying and assessing the source-specific harmful components of ambient air pollution in population-based studies remains challenging.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0211774</identifier><identifier>PMID: 30735532</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Adults ; Aged ; Air pollution ; Air pollution research ; Analysis ; Anthropometry ; Bioindicators ; Biology and Life Sciences ; Biomarkers ; Body measurements ; C-reactive protein ; C-Reactive Protein - metabolism ; Cholesterol ; Cross-Sectional Studies ; Databases, Factual ; Deprivation ; Development and progression ; Diabetes ; Environmental Exposure - adverse effects ; Epidemiology ; Ethics ; Female ; Germany ; Health risks ; Heart Diseases - blood ; Heart Diseases - epidemiology ; Heart Diseases - etiology ; Humans ; Inflammation ; Laboratories ; Longitudinal Studies ; Male ; Medicine and Health Sciences ; Mental health ; Metabolic Diseases - blood ; Metabolic Diseases - epidemiology ; Metabolic Diseases - etiology ; Middle Aged ; Models, Biological ; Municipalities ; Neighborhoods ; Nitrogen dioxide ; Obesity ; Particulate emissions ; Particulate matter ; Particulate Matter - adverse effects ; People and places ; Pollution ; Population studies ; Proteins ; Regression analysis ; Regression models ; Risk analysis ; Risk Factors ; Smoking ; Social environment ; Social Sciences ; Sports ; Statistical analysis ; Studies ; Urban development ; Urban planning ; Weight control</subject><ispartof>PloS one, 2019-02, Vol.14 (2), p.e0211774</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Steppuhn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Steppuhn et al 2019 Steppuhn et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-cb5be6a9e63767e87192696c834fd2389aa42a94b69a91491b7ae3237433446b3</citedby><cites>FETCH-LOGICAL-c692t-cb5be6a9e63767e87192696c834fd2389aa42a94b69a91491b7ae3237433446b3</cites><orcidid>0000-0002-8652-3368</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368296/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368296/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2101,2927,23865,27865,27923,27924,53790,53792,79471,79472</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30735532$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Shiels, Paul Gerard</contributor><creatorcontrib>Steppuhn, Henriette</creatorcontrib><creatorcontrib>Laußmann, Detlef</creatorcontrib><creatorcontrib>Baumert, Jens</creatorcontrib><creatorcontrib>Kroll, Lars</creatorcontrib><creatorcontrib>Lampert, Thomas</creatorcontrib><creatorcontrib>Plaß, Dietrich</creatorcontrib><creatorcontrib>Scheidt-Nave, Christa</creatorcontrib><creatorcontrib>Heidemann, Christin</creatorcontrib><title>Individual and area-level determinants associated with C-reactive protein as a marker of cardiometabolic risk among adults: Results from the German National Health Interview and Examination Survey 2008-2011</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>High-sensitivity C-reactive protein (hsCRP) is a sensitive biomarker of systemic inflammation and is related to the development and progression of cardiometabolic diseases. Beyond individual-level determinants, characteristics of the residential physical and social environment are increasingly recognized as contextual determinants of systemic inflammation and cardiometabolic risks. Based on a large nationwide sample of adults in Germany, we analyzed the cross-sectional association of hsCRP with residential environment characteristics. We specifically asked whether these associations are observed independent of determinants at the individual level.
Data on serum hsCRP levels and individual sociodemographic, behavioral, and anthropometric characteristics were available from the German Health Interview and Examination Survey for Adults (2008-2011). Area-level variables included, firstly, the predefined German Index of Socioeconomic Deprivation (GISD) derived from the INKAR (indicators and maps on spatial and urban development in Germany and Europe) database and, secondly, population-weighted annual average concentration of particulate matter (PM10) in ambient air provided by the German Environment Agency. Associations with log-transformed hsCRP levels were analyzed using random-intercept multi-level linear regression models including 6,768 participants aged 18-79 years nested in 162 municipalities.
No statistically significant association of PM10 exposure with hsCRP was observed. However, adults residing in municipalities with high compared to those with low social deprivation showed significantly elevated hsCRP levels (change in geometric mean 13.5%, 95%CI 3.2%-24.7%) after adjusting for age and sex. The observed relationship was independent of individual-level educational status. Further adjustment for smoking, sports activity, and abdominal obesity appeared to markedly reduce the association between area-level social deprivation and hsCRP, whereas all individual-level variables contributed significantly to the model.
Area-level social deprivation is associated with higher systemic inflammation and the potentially mediating role of modifiable risk factors needs further elucidation. Identifying and assessing the source-specific harmful components of ambient air pollution in population-based studies remains challenging.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Aged</subject><subject>Air pollution</subject><subject>Air pollution research</subject><subject>Analysis</subject><subject>Anthropometry</subject><subject>Bioindicators</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers</subject><subject>Body measurements</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cholesterol</subject><subject>Cross-Sectional Studies</subject><subject>Databases, Factual</subject><subject>Deprivation</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Environmental Exposure - adverse 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steppuhn, Henriette</au><au>Laußmann, Detlef</au><au>Baumert, Jens</au><au>Kroll, Lars</au><au>Lampert, Thomas</au><au>Plaß, Dietrich</au><au>Scheidt-Nave, Christa</au><au>Heidemann, Christin</au><au>Shiels, Paul Gerard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Individual and area-level determinants associated with C-reactive protein as a marker of cardiometabolic risk among adults: Results from the German National Health Interview and Examination Survey 2008-2011</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-02-08</date><risdate>2019</risdate><volume>14</volume><issue>2</issue><spage>e0211774</spage><pages>e0211774-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>High-sensitivity C-reactive protein (hsCRP) is a sensitive biomarker of systemic inflammation and is related to the development and progression of cardiometabolic diseases. Beyond individual-level determinants, characteristics of the residential physical and social environment are increasingly recognized as contextual determinants of systemic inflammation and cardiometabolic risks. Based on a large nationwide sample of adults in Germany, we analyzed the cross-sectional association of hsCRP with residential environment characteristics. We specifically asked whether these associations are observed independent of determinants at the individual level.
Data on serum hsCRP levels and individual sociodemographic, behavioral, and anthropometric characteristics were available from the German Health Interview and Examination Survey for Adults (2008-2011). Area-level variables included, firstly, the predefined German Index of Socioeconomic Deprivation (GISD) derived from the INKAR (indicators and maps on spatial and urban development in Germany and Europe) database and, secondly, population-weighted annual average concentration of particulate matter (PM10) in ambient air provided by the German Environment Agency. Associations with log-transformed hsCRP levels were analyzed using random-intercept multi-level linear regression models including 6,768 participants aged 18-79 years nested in 162 municipalities.
No statistically significant association of PM10 exposure with hsCRP was observed. However, adults residing in municipalities with high compared to those with low social deprivation showed significantly elevated hsCRP levels (change in geometric mean 13.5%, 95%CI 3.2%-24.7%) after adjusting for age and sex. The observed relationship was independent of individual-level educational status. Further adjustment for smoking, sports activity, and abdominal obesity appeared to markedly reduce the association between area-level social deprivation and hsCRP, whereas all individual-level variables contributed significantly to the model.
Area-level social deprivation is associated with higher systemic inflammation and the potentially mediating role of modifiable risk factors needs further elucidation. Identifying and assessing the source-specific harmful components of ambient air pollution in population-based studies remains challenging.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30735532</pmid><doi>10.1371/journal.pone.0211774</doi><tpages>e0211774</tpages><orcidid>https://orcid.org/0000-0002-8652-3368</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-02, Vol.14 (2), p.e0211774 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2177679431 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; PAIS Index; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Adults Aged Air pollution Air pollution research Analysis Anthropometry Bioindicators Biology and Life Sciences Biomarkers Body measurements C-reactive protein C-Reactive Protein - metabolism Cholesterol Cross-Sectional Studies Databases, Factual Deprivation Development and progression Diabetes Environmental Exposure - adverse effects Epidemiology Ethics Female Germany Health risks Heart Diseases - blood Heart Diseases - epidemiology Heart Diseases - etiology Humans Inflammation Laboratories Longitudinal Studies Male Medicine and Health Sciences Mental health Metabolic Diseases - blood Metabolic Diseases - epidemiology Metabolic Diseases - etiology Middle Aged Models, Biological Municipalities Neighborhoods Nitrogen dioxide Obesity Particulate emissions Particulate matter Particulate Matter - adverse effects People and places Pollution Population studies Proteins Regression analysis Regression models Risk analysis Risk Factors Smoking Social environment Social Sciences Sports Statistical analysis Studies Urban development Urban planning Weight control |
| title | Individual and area-level determinants associated with C-reactive protein as a marker of cardiometabolic risk among adults: Results from the German National Health Interview and Examination Survey 2008-2011 |
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