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European Heart Journal Advance Access published online on February 18, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp010
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Inflammatory biomarkers, physical activity, waist circumference, and risk of future coronary heart disease in healthy men and women

Jamal S. Rana1,2,{dagger}, Benoit J. Arsenault3,4,{dagger}, Jean-Pierre Després3,5, Mélanie Côté3,4, Philippa J. Talmud6, Ewa Ninio7, J. Wouter Jukema8, Nicholas J. Wareham9, John J.P. Kastelein2, Kay-Tee Khaw10 and S. Matthijs Boekholdt2,11,*

1 Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
2 Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
3 Québec Heart Institute Hôpital, Laval Research Centre, Québec, Canada
4 Department of Anatomy and Physiology, Faculty of Medicine, Université Laval, Québec, Canada
5 Division of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
6 Division of Cardiovascular Genetics, Royal Free and University College Medical School, London, UK
7 INSERM UMRS525 (EN); UPMC Université de Paris 06 and Faculté de Médecine Pierre et Marie Curie, Paris, France
8 Department of Cardiology, Leiden University Medical Center, The Netherlands
9 Medical Research Council Epidemiology Unit, Cambridge, UK
10 Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
11 Department of Cardiology, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands

Received 29 July 2008; revised 6 January 2009; accepted 8 January 2009.

* Corresponding author. Tel: +31 20 566 6612, Fax: +31 20 566 9343, Email: s.m.boekholdt{at}amc.uva.nl

Aims: The aim of this study was to determine the contribution of physical activity and abdominal obesity to the variation in inflammatory biomarkers and incident coronary heart disease (CHD) in a European population.

Methods and results: In a prospective case–control study nested in the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort, we examined the associations between circulating levels or activity of C-reactive protein, myeloperoxidase (MPO), secretory phospholipase A2 (sPLA2), lipoprotein-associated phospholipase A2 (Lp-PLA2), fibrinogen, adiponectin, waist circumference, physical activity, and CHD risk over a 10-year period among healthy men and women (45–79 years of age). A total of 1002 cases who developed fatal or non-fatal CHD were matched to 1859 controls on the basis of age, sex, and enrolment period. Circulating levels of C-reactive protein, sPLA2 (women only), fibrinogen, and adiponectin were linearly associated with increasing waist circumference and decreasing physical activity levels. After adjusting for waist circumference, physical activity, smoking, diabetes, systolic blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol levels, and further adjusted for hormone replacement therapy in women, C-reactive protein, MPO (men only), sPLA2, fibrinogen, but not Lp-PLA2 and adiponectin were associated with an increased CHD risk.

Conclusion: Inactive participants with an elevated waist circumference were characterized by deteriorated levels of inflammatory markers. However, several inflammatory markers were associated with an increased CHD risk, independent of underlying CHD risk factors such as waist circumference and physical activity levels.

Key Words: Waist circumference • Physical activity • Inflammation • Coronary heart disease

{dagger} These authors contributed equally to the manuscript.


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