Rates of cardiovascular and renal disease in Australian Aboriginal communities are high, but we do not know the contribution of inflammation to these diseases in this setting. In the present study, we sought to examine the distribution of C-reactive protein (CRP) and other markers of inflammation and their relationships with cardiovascular risk markers and renal disease in a remote Australian Aboriginal community. The study included 237 adults (58% of the adult population) in a remote Aboriginal community in the Northern Territory of Australia. Main outcome measures were CRP, fibrinogen and IgG concentrations, blood pressure (BP), presence of diabetes, lipids, albuminuria, seropositivity to three common micro-organisms, as well as carotid intima-media thickness (IMT). Serum concentrations of CRP [7 (5–13) mg/l; median (inter-quartile range)] were markedly increased and were significantly correlated with fibrinogen and IgG concentrations and inversely correlated with serum albumin concentration. Higher CRP concentrations were associated with IgG seropositivity to Helicobacter pylori and Chlamydia pneumoniae and higher IgG titre for cytomegalovirus. Higher CRP concentrations were associated with the following: the 45–54-year age group, female subjects, the presence of skin sores, higher body mass index, waist circumference, BP, glycated haemoglobin and greater albuminuria. CRP concentrations increased with the number of cardiovascular risk factors, carotid IMT and albuminuria independently of other risk factors. These CRP concentrations were markedly higher than described in other community settings and are probably related, in a large part, to chronic and repeated infections. Their association with markers of cardiovascular risk and renal disease are compatible with the high rates of cardiovascular and renal disease in this community, and provide more evidence of strong links between these conditions, through a shared background of infection/inflammation. This suggests that a strong focus on prevention and management of infections will be important in reducing these conditions, in addition to interventions directed at more traditional risk factors.
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Research Article|
February 01 2004
C-reactive protein, cardiovascular risk, and renal disease in a remote Australian Aboriginal community
Stephen McDONALD;
*Menzies School of Health Research, Casuarina, Northern Territory 0810, Australia
†Northern Territory Clinical School, Flinders University of South Australia, Royal Darwin Hospital, PO Box 41326, Casuarina Northern Territory 0810, Australia
‡The Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Woodville South, South Australia 5011 Australia
Correspondence: Dr S. McDonald, ANZDATA Registry, The Queen Elizabeth Hospital, 28 Woodville Rd, Woodville South, Adelaide SA 5011, Australia (e-mail [email protected]).
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Graeme MAGUIRE;
Graeme MAGUIRE
*Menzies School of Health Research, Casuarina, Northern Territory 0810, Australia
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Natalia DUARTE;
Natalia DUARTE
§Cardiovascular Genetics Laboratory, Prince of Wales Hospital and the University of New South Wales, Sydney, New South Wales 2031, Australia
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Xing Li WANG;
Xing Li WANG
§Cardiovascular Genetics Laboratory, Prince of Wales Hospital and the University of New South Wales, Sydney, New South Wales 2031, Australia
∥Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 6550 Fannin, Houston, TX 77030, U.S.A.
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Wendy HOY
Wendy HOY
*Menzies School of Health Research, Casuarina, Northern Territory 0810, Australia
¶Centre for Chronic Disease, Department of Medicine, University of Queensland, Royal Brisbane Hospital, Herston, Queensland 4029, Australia
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Publisher: Portland Press Ltd
Received:
May 21 2003
Revision Received:
July 22 2003
Accepted:
September 04 2003
Accepted Manuscript online:
September 04 2003
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2004 The Biochemical Society
2004
Clin Sci (Lond) (2004) 106 (2): 121–128.
Article history
Received:
May 21 2003
Revision Received:
July 22 2003
Accepted:
September 04 2003
Accepted Manuscript online:
September 04 2003
Citation
Stephen McDONALD, Graeme MAGUIRE, Natalia DUARTE, Xing Li WANG, Wendy HOY; C-reactive protein, cardiovascular risk, and renal disease in a remote Australian Aboriginal community. Clin Sci (Lond) 1 February 2004; 106 (2): 121–128. doi: https://doi.org/10.1042/CS20030186
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