Obesity Indicators and C-Reactive Protein in Indonesian Adults (More than Equal to 40 Years Old): The Indonesian Family Life Survey 5

Yeni Mahwati, Dieta Nurrika

Abstract


C-reactive protein (CRP) is the best clinical marker for systemic inflammation. Obesity is associated with increased CRP levels. Systemic inflammation is present before morbidity occurs. Research reveals that the identification of obesity indicators and CRP levels is limited among Indonesians. The present study investigated the associations between obesity indicators (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR]) and CRP levels among Indonesian adults. This cross-sectional study based on Indonesian Family Life Survey-5 2014–2015 was conducted among 3,386 adults (≥ 40 years) living in 13 provinces in Indonesia during the study period. All data were collected in 2014. Multiple logistic regression was used to estimate the odds ratio (ORs) and 95% confidence interval (95% CIs) for hs-CRP levels on obesity indicators by using underweight (BMI) and normal (WC, WHR, and WHtR) as references. Our multivariable logistic regression analysis indicated that respondents with increased WHR (OR: 1.278, 95% CI: 1.005–1.625, p-value < 0.001) were more likely to have high-risk hs-CRP levels than those with normal WHR. Compared with respondents with normal WHtR, those with increased WHtR were found associated with high-risk hs-CRP levels (OR: 1.980, 95% CI: 1.544–2.541, p-value < 0.001). Therefore, WHR and WHtR can predict central obesity, which is associated with hs-CRP levels.


Keywords


adult, c-reactive protein, obesity

Full Text:

PDF

References


 1. Ramdas J, Jella V, Ramdas J, Med JA. Elevated C reactive protein levels in obese individuals with metabolic syndromes. Int J Adv Med. 2016;3(2):162–5.

 2. Stępień M, Stępień A, Wlazeł RN, Paradowski M, Banach M, Rysz J. Obesity indices and inflammatory markers in obese non-diabetic normo- and hypertensive patients: a comparative pilot study. Lipids Health Dis [Internet]. 2014;13:1–10. Available from: http://www.lipidworld.com/content/13/1/29

 3. Shrivastava AK, Singh HV, Raizada A, Singh SK. C-reactive protein, inflammation and coronary heart disease. Egypt Hear J [Internet]. 2015;67(2):89–97. Available from: http://dx.doi.org/10.1016/j.ehj.2014.11.005

 4. Sun M, Zhang L, Chen S, Liu X, Shao X, Zou H. Association of C-reactive protein and metabolic disorder in a Chinese population. Int J Environ Res Public Health [Internet]. 2015;12(7):8228–42. Available from: www.mdpi.com/journal/ijerph

 5. Yang JS, Gerber JN, You HJ. Association between fasting insulin and high-sensitivity C reactive protein in Korean adults. BMJ Open Sport Exerc Med. 2017;3(1):1–7.

 6. Bilhorn KR, Luo Y, Lee BT, Wong ND. Protein , and Cardiovascular Disease in United States Adults. AJC [Internet]. 2012;110(10):1464–7. Available from: http://dx.doi.org/10.1016/j.amjcard.2012.06.056

 7. Ou C, Tseng Y, Lee C, Chiou Y, Hsieh K. Significant Relationship Between Serum High-density Lipoprotein Cholesterol Levels and Children With Kawasaki. J Formos Med Assoc [Internet]. 2009;108(9):719–24. Available from: http://dx.doi.org/10.1016/S0929-6646(09)60395-8

 8. Lin C, Kardia SLR, Li C, Liu C, Lai M, Lin W, et al. The Relationship of High Sensitivity C-reactive Protein to Percent Body Fat Mass, Body Mass Index, Waist-to-Hip Ratio, and Waist Circumference in a Taiwanese Population. BMC Public Health [Internet]. 2010;10(579):1–8. Available from: http://www.biomedcentral.com/1471-2458/10/579

 9. Mraović T, Radaković S, Medić DR, Dinčić D, Ostojić VT, Čairović A, et al. The Relationship Between Adiposity Parameters and C-reactive Protein Values in Overweight and Obese Women Odnos između parametara gojaznosti i vrednosti C-reaktivnog proteina kod predgojaznih i gojaznih žena. Vojn Pregl [Internet]. 2018;75(2):185–90. Available from: https://doi.org/10.2298/VSP160419208M

 10. World Health Organization. Obesity and overweight [Internet]. 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

 11. Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism Linking Diabetes Mellitus and Obesity. Diabetes, Metab Syndr Obes Targets Ther. 2014;7:587–91.

 12. Khan RJ, Harvey DJ, Leistikow BN, Haque KS. Relationship between Obesity and Coronary Heart Disease among Urban Bangladeshi Men and Women Rumana. Integr Obes Diabetes. 2015;1(3):49–55.

 13. Choi J, Joseph L, Pilote L. Etiology and Pathophysiology/Obesity Comorbidities Obesity and C-reactive Protein in Various Populations: A Systematic Review and Meta-analysis. Obes Rev [Internet]. 2013;14:232–44. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.12003

 14. Kemenkes RI. Riskesdas 2018 [Internet]. Jakarta; 2018. Available from: https://www.depkes.go.id

 15. Pengpid S, Peltzer K. The Prevalence of Underweight, Overweight/Obesity and Their Related Lifestyle Factors in Indonesia, 2014–15. AIMS Public Heal [Internet]. 2017;4(6):633–49. Available from: http://www.aimspress.com/journal/aimsph%0A

 16. Roemling C, Qaim M. Obesity Trends and Determinants in Indonesia. Appetite [Internet]. 2012;58(3):1005–13. Available from: http://dx.doi.org/10.1016/j.appet.2012.02.053

 17. Nur Azizah A, Sulchan M. Kadar C-Reactive Protein (Crp) Pada Remaja Putri Stunted Obesity Di Pedesaan Jepara. J Nutr Coll [Internet]. 2016;5(2):71–6. Available from: http://ejournal-s1.undip.ac.id/index.php/jnc

 18. Hastuti P, Martantiningtyas DC, Karita D, Tasmini, Sadewa AH. Association of-174 g>c Interleukin-6 Gene Polymorphism with Interleukin-6 and C-Reactive Protein Levels and Obesity: A Case–control Study among People/Residents of Western Indonesia. Med J Malaysia. 2019;74(5):400–4.

 19. Strauss J, Witoelar Fi, Sikoki B. The Fifth Wave of the Indonesia Family Life Survey : Overview and Field Report Volume 1 [Internet]. Vol. 1. 2016. Available from: https://www.rand.org

 20. Hussain MA, Al Mamun A, Reid C, Huxley RR. Prevalence, Awareness, Treatment and Control of Hypertension in Indonesian Adults Aged ≥40 Years: Findings from the Indonesia Family Life Survey (IFLS). PLoS One. 2016;11(8):1–16.

 21. World Health Organization. Appropriate Body-Mass Index for Asian Populations and its Implications for Policy and Intervention Strategies. Lancet [Internet]. 2004;363:157–63. Available from: https://doi.org/10.1016/S0140-6736(03)15268-3

 22. World Health Organization. Waist circumference and waist–hip ratio: report of a WHO expert consultation [Internet]. 2009. 14 p. Available from: %0Awhqlibdoc.who.int.

 23. Hu P, Herningtyas EH, Strauss J, Crimmins E, Kim JK. WORKING PAPER IFLS C-Reactive Protein Data User Guide. 2013;(October).

 24. Mahwati Y. Determinants of Multimorbidity among The Elderly Determinan Multimorbiditas pada Populasi Usia Lanjut di Indonesia. J Kesehat Masy Nas [Internet]. 2014;9(2):187–93. Available from: http://journal.fkm.ui.ac.id/kesmas/article/view/516.

 25. Lapaice E, Maione S, Patti L, Cipriano P, Rivellese AA, Riccardi G, et al. Elevated C-Reactive Protein Independent of BMI in Healthy Nonobese People. 2009;32(9):1734–6.

 26. Firdous S, Lodhi MOK, Siddique K. The Trends of CRP Levels at Different Waist-to-Hip Ratios Among Normotensive Overweight and Obese Patients : A Pilot Study. J Coll Physicians Surg Pakistan. 2016;26(3):191–4.

 27. Lavanya K, Ramamoorthi K, Acharya R V., Madhyastha SP. Association between overweight, obesity in relation to serum Hs-CRP levels in adults 20-70 years. J Clin Diagnostic Res. 2017;11(12):OC32–5.

 28. Silva JP da, Lima RPA, Pereira D de C, Silva CS de O, Gonçalves M da CR, Filho MB, et al. Association Between Waist-to-Height Ratio , Isolated and Combined Morbidities and C-Reactive Protein in the Elderly : A Clinical-Epidemiological Study. Int J Environ Res Public Heal. 2014;11(June):9595–606.

 29. Ikeoka D, Mader JK, Pieber TR. Adipose tissue, inflammation and cardiovascular disease. Rev Assoc Med Bras. 2010;56(1):116–21.

 30. Gharakhanlou R, Farzad B, Agha-Alinejad H, Steffen LM, Bayati M. Anthropometric Measures as Predictors of Cardiovascular Disease Risk Factors in the Urban Population of Iran. Arq Bras Cardiol. 2012;98(2):126–35.

 31. Shen S, Lu Y, Qi H, Li F, Shen Z, Wu L, et al. Waist-to-Height Ratio is an Effective Indicator for Comprehensive Cardiovascular Health. Sci Rep [Internet]. 2017;7:1–7. Available from: http://dx.doi.org/10.1038/srep43046

 32. Anchuelo AC, Martínez-Larrad MT, Serrano-García Í, Pérez CF, Serrano-Ríos M. Body fat Anthropometric Indexes: Which of Those Identify Better High Cardiovascular Risk Subjects? A Comparative Study in Spanish population. PLoS One. 2019;14(5):1–13.

 33. Choi DH, Hur YI, Kang JH, Kim K, Cho YG, Hong SM, et al. Usefulness of the waist Circumference-to-Height Ratio in Screening for Obesity and Metabolic Syndrome Among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2010–2014. Nutrients. 2017;9(3).

 34. Xu J, Xu T, Bu X, Peng H, Li H, Zhang M, et al. The Predictive Value of Waist-to-Height Ratio for Ischemic Stroke in a Population-Based Prospective Cohort Study among Mongolian Men in China. PLoS One. 2014;9(10):1–6.




DOI: http://dx.doi.org/10.21109/kesmas.v15i4.3296

Refbacks

  • There are currently no refbacks.