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- BMI, body mass index
- CHD, coronary heart disease
- CRP, C reactive protein
- DEPCAT, deprivation score
- WOSCOPS, West of Scotland coronary prevention study
Social deprivation is a major factor in health inequality. In the UK residence in a socially deprived area is associated with an increase in mortality from coronary heart disease (CHD).1 A positive association between the incidence of CHD and residence in a socially deprived neighbourhood has also been observed in the USA.2
Inflammation is important in the development of atherosclerosis, plaque rupture, and thrombosis leading to myocardial infarction. An increase in the plasma concentration of C reactive protein (CRP), within the reference range for the population but below the threshold that indicates clinically significant inflammation, is an independent risk factor for CHD.3 It is also a predictor for the development of diabetes mellitus4—a major cause of vascular disease. We have investigated the relation between the plasma CRP concentration and social deprivation in two large study populations.
METHODS AND RESULTS
CRP was measured by an enzyme linked immunoassay, with a lower limit of the working range of 0.1 mg/l, calibrated with the international reference standard (CRM 470-CAP/IFCC; lot 91/0619) and thus yielded results comparable with other major studies.3 CRP measurements were available for 5245 men aged 45–64 years on recruitment in 1989–91 to the WOSCOPS (West of Scotland coronary prevention study).4 The second population were men (n = 941) and women (n = …
D O’R conceived of measuring C reactive protein (CRP) in both studies, wrote the first and final versions of the paper, and is the guarantor. D O’R, M N U, G C M W, and C J P conceived of the idea of analysing the relation between CRP and deprivation. G C M W conceived of the Midspan family study, M N U was the principal investigator, and A M performed the statistical analysis for Midspan. C J P was Study Director for WOSCOPS, M C coordinated CRP analysis, and M R and J N performed the statistical analysis for WOSCOPS.
C reactive protein analyses were funded by British Heart Foundation grant PG/97160
Conflict of interest: None
Ethics: Both the WOSCOPS and Midspan family study were approved by local research ethics committees
Independence of researchers: This research was carried out and the manuscript was written independently and without input or influence from the funder.