Testing for Chronic Low-level Inflammation

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C-Reactive Protein

Blood Cholesterol ScreeningA blood test called 'high-sensitive C-reactive protein' (HS CRP) can measure C-reactive protein level, which is an index of chronic inflammation and may be an even greater predictor of risk than LDL cholesterol.

Chronic inflammation increases risk of coronary heart disease and other disorders. (Ridker 2007)

CVD Risk: Low Intermediate High
CRP Level (mg/l) <1 1-3 >3

In the Physician's Health Study, men with greater than 2.11 mg/L had about 3 times the risk of suffering a heart attack compared with individuals with CRP less than 0.55 mg/L (the lowest quartile of scores).

However, intraindividual variation of CRP has shown to be significantly greater than that for cholesterol measure (DeGoma 2012).

Some medications can affect your CRP levels : birth control pills; statins; nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Advil, Motrin, others); and acetaminophen (Tylenol, others).

Other Markers

Fibrinogen

  • Optimal range (200 - 300 mg/dl)

Cytokine

  • Expensive test but can help identify specific factors that are causing systemic inflammation.
    • Tumor necrosis factor alpha (TNF-α)
    • Interleukin-1 beta (IL-1β)
    • Interleukin-6 (IL-6)
    • Interleukin-8 (IL-8)

References

DeGoma EM, French B, Dunbar RL, Allison MA, Mohler ER 3rd, Budoff MJ (2012). Intraindividual variability of C-reactive protein: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 224(1):274-9.

Ridker PM, JE Buring, N Rifai, NR Cook (2007). Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: The Reynolds Risk Score. JAMA 297(6), 611-19.


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