Thursday, July 12, 2007
This presentation is part of : Health Promotion Initiatives
C-Reactive Protein & Cardiometabolic Risk among Africa-American Women
Susan J. Appel, APRN, BC, PhD and Natalie A. Floyd, MSN, APRN, BC. School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
Learning Objective #1: Define cardiometabolic risk.
Learning Objective #2: Evaluate the efficacy of C-reactive protein(CRP) as an early cardiometabolic risk marker among African-American women.

The Purpose of this study was to determine early risk markers for CVD among healthy AA women ages 19-45. We hypothesized that AA women’s risk was more closely associated with insulin sensitivity, inflammation and a prothrombotic state than dyslipidemia.

 Method: This study took place in the General Clinical Research Center of a southeastern medical center in the US, N=33. AA women age 19-45, were screened for metabolic syndrome and other CV risk factors in a fasting state and underwent a 2 –hour OGTT.  Then various criteria were compared to determine presence for the MS and other early risk markers for CVD.

 Findings: Interestingly, the NCEP guidelines only classified  n = 6 (15.8 %) women as possessing the MS. Whereas, the American Clinical Endocrinology criteria diagnosed n =12 (31.6%) as having MS. The most sensitive single predictor of CV risk was waist circumference which classified n = 18 (47.4 % ) of  women being at risk. Similarly, BMI classified n =17 (44.7%) as being at risk in the overweight to obese categories. A regression equation produced a R2 of 0.68 using Plasminogen Activator Inhibitor-1 (PAI-1) as the dependent variable with the predictors of fasting glucose, CRP, and waist circumference; waist circumference was predicted by PAI-1 with an R2 of 0.58 and C-Reactive Protein (CRP) was predicted by post-glucose with an R2 of 0.50.

 Discussion: As identified in the literature AA women’s risk for CVD is likely significantly underestimated based on the sole use of NCEP criteria. Clinicians should consider a broader definition of risk than contained within the NCEP criteria.  The inclusion of markers of inflammation (CRP) and prothrombotic factors (PAI-1) along with measures of insulin sensitivity may add to early detection of CVD risk, and ultimate reduction in the CV health disparities of these AA women.