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2019-02-08Zeitschriftenartikel DOI: 10.25646/5923
Individual and area-level determinants associated with C-reactive protein as a marker of cardiometabolic risk among adults: Results from the German National Health Interview and Examination Survey 2008-2011
dc.contributor.authorSteppuhn, Henriette
dc.contributor.authorLaußmann, Detlef
dc.contributor.authorBaumert, Jens
dc.contributor.authorKroll, Lars
dc.contributor.authorLampert, Thomas
dc.contributor.authorPlaß, Dietrich
dc.contributor.authorScheidt-Nave, Christa
dc.contributor.authorHeidemann, Christin
dc.date.accessioned2019-03-05T08:11:23Z
dc.date.available2019-03-05T08:11:23Z
dc.date.issued2019-02-08none
dc.identifier.other10.1371/journal.pone.0211774
dc.identifier.urihttp://edoc.rki.de/176904/5958
dc.description.abstractBackground High-sensitivity C-reactive protein (hsCRP) is a sensitive biomarker of systemic inflammation and is related to the development and progression of cardiometabolic diseases. Beyond individual-level determinants, characteristics of the residential physical and social environment are increasingly recognized as contextual determinants of systemic inflammation and cardiometabolic risks. Based on a large nationwide sample of adults in Germany, we analyzed the cross-sectional association of hsCRP with residential environment characteristics. We specifically asked whether these associations are observed independent of determinants at the individual level. Methods Data on serum hsCRP levels and individual sociodemographic, behavioral, and anthropometric characteristics were available from the German Health Interview and Examination Survey for Adults (2008–2011). Area-level variables included, firstly, the predefined German Index of Socioeconomic Deprivation (GISD) derived from the INKAR (indicators and maps on spatial and urban development in Germany and Europe) database and, secondly, population-weighted annual average concentration of particulate matter (PM10) in ambient air provided by the German Environment Agency. Associations with log-transformed hsCRP levels were analyzed using random-intercept multi-level linear regression models including 6,768 participants aged 18–79 years nested in 162 municipalities. Results No statistically significant association of PM10 exposure with hsCRP was observed. However, adults residing in municipalities with high compared to those with low social deprivation showed significantly elevated hsCRP levels (change in geometric mean 13.5%, 95%CI 3.2%-24.7%) after adjusting for age and sex. The observed relationship was independent of individual-level educational status. Further adjustment for smoking, sports activity, and abdominal obesity appeared to markedly reduce the association between area-level social deprivation and hsCRP, whereas all individual-level variables contributed significantly to the model. Conclusions Area-level social deprivation is associated with higher systemic inflammation and the potentially mediating role of modifiable risk factors needs further elucidation. Identifying and assessing the source-specific harmful components of ambient air pollution in population-based studies remains challenging.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleIndividual and area-level determinants associated with C-reactive protein as a marker of cardiometabolic risk among adults: Results from the German National Health Interview and Examination Survey 2008-2011none
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:0257-176904/5958-3
dc.identifier.doihttp://dx.doi.org/10.25646/5923
dc.type.versionpublishedVersionnone
local.edoc.container-titlePLOS Onenone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211774none
local.edoc.container-publisher-namePublic Library of Sciencenone
local.edoc.container-reportyear2019none
local.edoc.container-year2019none
local.edoc.container-firstpage1none
local.edoc.container-lastpage17none
local.edoc.rki-departmentEpidemiologie und Gesundheitsmonitoringnone
dc.description.versionPeer Reviewednone

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