From the Guidelines
Yes, obesity increases C-reactive protein (CRP) levels in the body. According to a study published in Circulation in 2004 1, obesity is associated with an increase in circulating inflammatory markers, including CRP and cytokines. Adipose tissue itself is a likely source of these excess cytokines, and interleukin-6 (IL-6) stimulates the production of CRP by the liver. The key points to consider are:
- The increase in inflammatory markers is associated with insulin resistance and is an important predictor of atherosclerotic events
- Weight reduction decreases plasma CRP concentration, with the decrease in CRP directly related to the amount of weight loss, fat mass, and change in waist circumference 1
- Decreases in plasma IL-6, IL-18, P-selectin, and tumor necrosis factor concentrations have also been reported after weight loss in subjects who are obese 1 This highlights the importance of addressing excess weight to reduce systemic inflammation and improve overall health.
From the Research
Association between Obesity and CRP Levels
- Obesity has been consistently associated with elevated levels of C-reactive protein (CRP), a marker of inflammation and predictor of cardiovascular risk 2, 3, 4, 5, 6.
- Studies have shown that higher body mass index (BMI) is associated with higher CRP concentrations, even among young adults aged 17 to 39 years 2.
- The association between obesity and CRP is stronger in women and North Americans/Europeans 3.
- Visceral adipose tissue mass is also associated with increased CRP levels in patients with manifest vascular diseases 6.
Mechanisms underlying the Association
- Human adipose tissue expresses and releases proinflammatory cytokines, such as interleukin 6, which can induce low-grade systemic inflammation in persons with excess body fat 2.
- Adipose tissue inflammation is a major contributor to increased CRP in obesity, with subcutaneous adipose tissue (SAT) contributing more to the pro-inflammatory milieu than visceral adipose tissue (VAT) 4, 5.
- The expression of pro-inflammatory genes is substantially higher in SAT than in VAT in individuals with morbid obesity 5.
Clinical Implications
- Elevated CRP levels are present in 27.6% of the population, and clinically raised CRP levels are present in 6.7% of the population 2.
- Obesity is associated with a state of low-grade systemic inflammation, which can increase the risk of cardiovascular disease and other metabolic complications 2, 3, 4, 5, 6.
- Weight loss, such as that achieved through bariatric surgery, can lead to a decrease in CRP levels and a reduction in inflammation 4.