Association between C-reactive protein levels and physical fitness in 7 to 9 year old children at poor elementary schools in Surakarta, Indonesia
Keywords:
children, C-reactive protein, physical fitness
Abstract
Background Data regarding inflammatory factors in children arenot so well developed as in adults. Higher levels of physical fitness
may be helpful in modifying the low-grade inflammatory state that
is indexed by C-reactive protein (CRP) levels.
Objective To evaluate the association of physical fitness with CRP
levels in children and to identify the possible related factors.
Methods This cross-sectional study was conducted at poor
elementary schools in Surakarta, Indonesia using a group of 217
underweight children aged from 7 to 9 years old. Physical fitness
was assessed using a modified Harvard Step Test. CRP levels were
measured using a high-sensitivity assay. The association between
physical fitness and CRP level was assessed using linear regression
analysis. Multivariate analyses were used to adjust covariates,
and statistical analyses were performed using SPSS for Windows
software version 15.0.
Results Subjects were 48% female and 52% male, and eleven
children (5%) had a CRP level > 5 mg/L. Mean fitness level and
CRP level did not differ by age and gender. Fitness level was not
inversely correlated with CRP (r=0.10, P=0.14). Physical fitness
was significantly correlated with BMI (r=0.14; P=0.04), physical
activity [0R=3.3 (95% CI 1.7 to 6.4)], and fat intake [0R=0.5
(95%Â CIÂ 0.2 to 0.9) ].
Conclusion These findings indicate that physical fitness is not
inversely correlated to CRP levels in children. However, our
study reveased an association between high fat intake and low
physical fitness as well as a significant association between
high physical activiry and physical fitness.
References
5. Fichtlscherer S, Rosenberger G, Walter DH, Breuer S,
Dimmeler S, Zeiher AM. Elevated C-reactive protein levels
and impaired endothelial vasoreactivity in patients with
coronary artery disease. Circulation. 2000;102:1000-6.
6. Hak AE, Stehouwer CDA, Bots ML, Poldrman KH, Schalwijk
CG, Westerndorp ICD, et al. Associations of C-reactive
protein with measured of obesity, insulin resistance, and
subclinical atherosclerosis in healthy, middle-aged women.
Arterioscler Thromb Vase Bioi. 1999; 19: 1986-91.
7. Koenig W, Sund M, Frohlich M, Fischer HG, Lowe! H,
Doring A, et al. C-reactive protein, a sensitive marker
of inflammation, predicts future risk of coronary heart
disease in initially healthy middle-aged men: Results from
the MONICA (Monitoring Trends and Determinants in
Cardiovascular Disease) Ausburg Cohort Study, 1984 to
1992. Circulation. 1999;99:237-42.
8. Ross R. Atherosclerosis: an inflammatory disease. N Eng! J
Med. 1999; 340:115-26.
9. Libby P, Simon DI. Inflammation and thrombosis: the clot
thickens. Circulation. 2001; 103:1718-20.
10. Cermak J, Key N, Bach R, Balla J, Jacob H, Vercellotti
G. C-reactive protein induces human peripheral blood
monocytes to synthesize tissue factor. Blood. 1993;82:
513-20.
11. Pasceri V, Willerson JT, Yeh ETH. Direct proinflammatory
effect of C-reactive protein on human endothelial cells.
Circulation. 2000; 102:2165-8.
12. Ford E, Giles W Serum C-reactive protein and fibrinogen
concentration and self-reported angina pectoris and
myocardial infarction: Findings from National Health and
Nutrition Examination Survey III. J Clin Epidemiol. 2000;
53: 95-102.
13. Ridker P, Hennekens C, BuringJ, Rifai N. C-reactive protein
and other markers of inflammation in the prediction of
cardiovascular disease in women. N Eng! J Med. 2000;342:
836-43.
14. Bao W, Srinivasan SR, Salman H. Plasma fibrinogen and
its correlates in children from a biracial community: the
Bogalusa Heart Study. Pediatr Res. 1993;33:323-6.
15. Shea S, Isasi CR, Couch S, Stare TJ, Tracy RP, Deckelbaum
R, et al. Relations of plasma fibrinogen level in children
to measures of obesity, the (G-455 ->A) mutation in the
B-fibrinogen promoter gene, and family history of ischemic
heart disease: The Columbia University BioMarkers Study.
Am] Epidemiol. 1999;150:737-74.
16. Fergusson MA, Gutin B, Owens S, Barbeau P, Tracy RP, Litaker
M. Effects of physical training and its cessation on hemostatic
system of obese children. Am J Clin Nutr. 1999; 69:1130-4.
17. Isasi CR, Stare TJ, Tracy R, Deckelbaum R, Berglund L,
Shea S. Inverse association of physical fitness with plasma
fibrinogen level in children. Am J Epidemiol. 2000; 152:
212-8.
18. Rankinen T, Rauramaa R, Vaisanen S, Penttila I, Saarikoski
S, Tuomilehto J, et al. Inverse relationship between physical
activity and plasma fibrinogen in postmenopausal women.
Atherosclerosis.1993; 102:181-6.
19. Stratton JR, Chandler WL, Schwartz RS, Cerqueira MD,
Levy WC, Kahn SE, et al. Effects of physical conditioning on
fibrinolytic variables and fibrinogen in young and old healthy
adults. Circulation.1991;83: 1692-7.
20. Geffken DF, Cushman M, Burke GL, Polak JF, Sakkinen
PA, Tracy RP. Association between physical activity and
markers of inflammation in a healthy elderly population. Am
J Epidemiol. 2001;153:242-52.
21. Hammett C, Oxenham HC, Baldi JC, Doughty RN,
Ameratunga R, French JK, et al. Effect of six months' exercise
training on C-reactive protein levels in healthy elderly
subjects. JAm Col! Cardiol. 2004;44:2411-3.
22. Crowell R, Ferris AM, Wood RJ, Joyce P, Slivka H.
Comparative effectiveness of zinc protoporphyrin and
hemoglobin concentrations in identifying iron deficiency in
a group of low-income, preschool-aged children: Practical
implications of recent illness. J Pediatr. 2006; 118:224-32.
23. Stephenson LS, Latham MC, Adams EJ, Kinoti SN, Pertet
A. Physical fitness, growth, and appetite of Kenyan school
boys with Hookworm, Trichuris trichiura, Ascaris lumbricoides
infections are improved four months after a single dose of
albendazole. J Nutr. 1993; 123:1036-46.
24. Treuth M, Butte N, Puyau M, Adolph A. Relations of parental
obesity status to physical activity and fitness of prepubertal
girls. J Pediatr. 2000; 106:e49.
25. Berkey C, Rockett H, Field AE, Gillman MW, Frazier AL,
Camargo CA Jr, Colditz GA. Activity, dietary intake, and
weight change in a longitudinal study of preadolescent and
adolescent boys and girls. J Pediatr. 2000; 105:e56.
26. Wannamethee SG, Lowe GD, Whincup PH, Rumley A,
Walker M, Lennon L. Physical activity and hemostatic and
inflammatory variables in elderly men. Circulation. 2002;
105:1785-90.
2 7. Church TS, Barlow CE, Earnest CP, Kampert JB, Priest EL,
Blair SN. Associations between cardiorespiratory fitness and
C-reactive protein in men. Arterioscler Thromb Vase Bioi.
2002;22: 1869-76.
28. Hirsch L. Hunger and malnutrition. Available from:
U RL: http: I /www. kids health. org /teen/food. fitness/nutrition/
hunger.html.
29. Lucier E, Alton I. The underweight adolescent. Available
from: URL: http: / /www.epi. umn.edu/let/ pubs(img(adol-ch8. pdf
30. Bagnall A. Nutrition and feeding in individuals wih
neuromuscular conditions. Available from: URL:http:// www.
muscular-dystrofJhy.org/document. rm?id-911
31. Rogers IS, Emmett PM, ALSPAC Study Team. Fat content
of the diet among preschool children in Southwest Britain :
II. Relationship with growth, blood lipids, and iron status. J
Pediatr. 2001;108:p.e49.
32. Meleady R, Branigan M. Preventing Cardiovascular
Disease Statement on ChildhoodNutrition. Available
from: URL: http: I /www. iris heart. ie (iopen24/ pub /factsheets(
nutrition _children. pdf
33. Luepker RV, Perry CL, McKinlay SM. Outcomes of a field trial
to improve children's dietary patterns and physical activity.
JAMA. 1996;275:768-76.
34. Silveira LR, Hirabara SM, Alberici LC, Lambertucci RH, Peres
CM, Takahashi HK, et al. Effect oflipid infusion on metabolism
and force of rat skeletal muscles during intense contractions.
Cellular Physiology and Biochemistry. 2007; 20:213-26.
35. Das T, Sen AK, KempfT, Pramanik SR, Mandai C, Mandai
C. Induction of glycosylation in human C-reactive protein
under different pathological conditions. Biochem J. 2003;373:
345-55.
36. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein,
the metabolic syndrome, and risk of incident cardiovascular
events: an 8-year follow-up of 14,719 initially healthy
American women. Circulation. 2003;107:391-7.
37. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris
TB. Elevated C-reactive protein levels in overweight and
obese adults. JAMA. 1999;282:2131-5.
38. Ford ES, Galuska DA, Gillespie C, Will JC, Giles WH, Dietz
WH. C-reactive protein and body mass index in children:
findings from the Third National Health and Nutrition
Examination Survey, 1988-1994. J Pediatr. 2001:138:
486-92.
39. Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M,
Marfella R, et al. Effect of weight loss and lifestyle changes
on vascular inflammatory markers in obese women: a
randomized trial. JAMA. 2003;289: 1799-804.
40. Heilbronn LK, Noakes M, Clifton PM. Energy restriction
and weight loss on very-low-fat diets reduce C-reactive
protein concentrations in obese, healthy women. Arterioscler
Thromb Vase Bioi. 2001:21:968-70.
41. Verma S, Wang CH, Weisel RD, Badiwala MY, Li SH, Fedak
PW, et al. Hyperglycemia potentiates the proatherogenic
effects of C-reactive portein: reversal with rosiglitazone. J
Mol Cell Cardiol. 2003;35:417-9.
Dimmeler S, Zeiher AM. Elevated C-reactive protein levels
and impaired endothelial vasoreactivity in patients with
coronary artery disease. Circulation. 2000;102:1000-6.
6. Hak AE, Stehouwer CDA, Bots ML, Poldrman KH, Schalwijk
CG, Westerndorp ICD, et al. Associations of C-reactive
protein with measured of obesity, insulin resistance, and
subclinical atherosclerosis in healthy, middle-aged women.
Arterioscler Thromb Vase Bioi. 1999; 19: 1986-91.
7. Koenig W, Sund M, Frohlich M, Fischer HG, Lowe! H,
Doring A, et al. C-reactive protein, a sensitive marker
of inflammation, predicts future risk of coronary heart
disease in initially healthy middle-aged men: Results from
the MONICA (Monitoring Trends and Determinants in
Cardiovascular Disease) Ausburg Cohort Study, 1984 to
1992. Circulation. 1999;99:237-42.
8. Ross R. Atherosclerosis: an inflammatory disease. N Eng! J
Med. 1999; 340:115-26.
9. Libby P, Simon DI. Inflammation and thrombosis: the clot
thickens. Circulation. 2001; 103:1718-20.
10. Cermak J, Key N, Bach R, Balla J, Jacob H, Vercellotti
G. C-reactive protein induces human peripheral blood
monocytes to synthesize tissue factor. Blood. 1993;82:
513-20.
11. Pasceri V, Willerson JT, Yeh ETH. Direct proinflammatory
effect of C-reactive protein on human endothelial cells.
Circulation. 2000; 102:2165-8.
12. Ford E, Giles W Serum C-reactive protein and fibrinogen
concentration and self-reported angina pectoris and
myocardial infarction: Findings from National Health and
Nutrition Examination Survey III. J Clin Epidemiol. 2000;
53: 95-102.
13. Ridker P, Hennekens C, BuringJ, Rifai N. C-reactive protein
and other markers of inflammation in the prediction of
cardiovascular disease in women. N Eng! J Med. 2000;342:
836-43.
14. Bao W, Srinivasan SR, Salman H. Plasma fibrinogen and
its correlates in children from a biracial community: the
Bogalusa Heart Study. Pediatr Res. 1993;33:323-6.
15. Shea S, Isasi CR, Couch S, Stare TJ, Tracy RP, Deckelbaum
R, et al. Relations of plasma fibrinogen level in children
to measures of obesity, the (G-455 ->A) mutation in the
B-fibrinogen promoter gene, and family history of ischemic
heart disease: The Columbia University BioMarkers Study.
Am] Epidemiol. 1999;150:737-74.
16. Fergusson MA, Gutin B, Owens S, Barbeau P, Tracy RP, Litaker
M. Effects of physical training and its cessation on hemostatic
system of obese children. Am J Clin Nutr. 1999; 69:1130-4.
17. Isasi CR, Stare TJ, Tracy R, Deckelbaum R, Berglund L,
Shea S. Inverse association of physical fitness with plasma
fibrinogen level in children. Am J Epidemiol. 2000; 152:
212-8.
18. Rankinen T, Rauramaa R, Vaisanen S, Penttila I, Saarikoski
S, Tuomilehto J, et al. Inverse relationship between physical
activity and plasma fibrinogen in postmenopausal women.
Atherosclerosis.1993; 102:181-6.
19. Stratton JR, Chandler WL, Schwartz RS, Cerqueira MD,
Levy WC, Kahn SE, et al. Effects of physical conditioning on
fibrinolytic variables and fibrinogen in young and old healthy
adults. Circulation.1991;83: 1692-7.
20. Geffken DF, Cushman M, Burke GL, Polak JF, Sakkinen
PA, Tracy RP. Association between physical activity and
markers of inflammation in a healthy elderly population. Am
J Epidemiol. 2001;153:242-52.
21. Hammett C, Oxenham HC, Baldi JC, Doughty RN,
Ameratunga R, French JK, et al. Effect of six months' exercise
training on C-reactive protein levels in healthy elderly
subjects. JAm Col! Cardiol. 2004;44:2411-3.
22. Crowell R, Ferris AM, Wood RJ, Joyce P, Slivka H.
Comparative effectiveness of zinc protoporphyrin and
hemoglobin concentrations in identifying iron deficiency in
a group of low-income, preschool-aged children: Practical
implications of recent illness. J Pediatr. 2006; 118:224-32.
23. Stephenson LS, Latham MC, Adams EJ, Kinoti SN, Pertet
A. Physical fitness, growth, and appetite of Kenyan school
boys with Hookworm, Trichuris trichiura, Ascaris lumbricoides
infections are improved four months after a single dose of
albendazole. J Nutr. 1993; 123:1036-46.
24. Treuth M, Butte N, Puyau M, Adolph A. Relations of parental
obesity status to physical activity and fitness of prepubertal
girls. J Pediatr. 2000; 106:e49.
25. Berkey C, Rockett H, Field AE, Gillman MW, Frazier AL,
Camargo CA Jr, Colditz GA. Activity, dietary intake, and
weight change in a longitudinal study of preadolescent and
adolescent boys and girls. J Pediatr. 2000; 105:e56.
26. Wannamethee SG, Lowe GD, Whincup PH, Rumley A,
Walker M, Lennon L. Physical activity and hemostatic and
inflammatory variables in elderly men. Circulation. 2002;
105:1785-90.
2 7. Church TS, Barlow CE, Earnest CP, Kampert JB, Priest EL,
Blair SN. Associations between cardiorespiratory fitness and
C-reactive protein in men. Arterioscler Thromb Vase Bioi.
2002;22: 1869-76.
28. Hirsch L. Hunger and malnutrition. Available from:
U RL: http: I /www. kids health. org /teen/food. fitness/nutrition/
hunger.html.
29. Lucier E, Alton I. The underweight adolescent. Available
from: URL: http: / /www.epi. umn.edu/let/ pubs(img(adol-ch8. pdf
30. Bagnall A. Nutrition and feeding in individuals wih
neuromuscular conditions. Available from: URL:http:// www.
muscular-dystrofJhy.org/document. rm?id-911
31. Rogers IS, Emmett PM, ALSPAC Study Team. Fat content
of the diet among preschool children in Southwest Britain :
II. Relationship with growth, blood lipids, and iron status. J
Pediatr. 2001;108:p.e49.
32. Meleady R, Branigan M. Preventing Cardiovascular
Disease Statement on ChildhoodNutrition. Available
from: URL: http: I /www. iris heart. ie (iopen24/ pub /factsheets(
nutrition _children. pdf
33. Luepker RV, Perry CL, McKinlay SM. Outcomes of a field trial
to improve children's dietary patterns and physical activity.
JAMA. 1996;275:768-76.
34. Silveira LR, Hirabara SM, Alberici LC, Lambertucci RH, Peres
CM, Takahashi HK, et al. Effect oflipid infusion on metabolism
and force of rat skeletal muscles during intense contractions.
Cellular Physiology and Biochemistry. 2007; 20:213-26.
35. Das T, Sen AK, KempfT, Pramanik SR, Mandai C, Mandai
C. Induction of glycosylation in human C-reactive protein
under different pathological conditions. Biochem J. 2003;373:
345-55.
36. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein,
the metabolic syndrome, and risk of incident cardiovascular
events: an 8-year follow-up of 14,719 initially healthy
American women. Circulation. 2003;107:391-7.
37. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris
TB. Elevated C-reactive protein levels in overweight and
obese adults. JAMA. 1999;282:2131-5.
38. Ford ES, Galuska DA, Gillespie C, Will JC, Giles WH, Dietz
WH. C-reactive protein and body mass index in children:
findings from the Third National Health and Nutrition
Examination Survey, 1988-1994. J Pediatr. 2001:138:
486-92.
39. Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M,
Marfella R, et al. Effect of weight loss and lifestyle changes
on vascular inflammatory markers in obese women: a
randomized trial. JAMA. 2003;289: 1799-804.
40. Heilbronn LK, Noakes M, Clifton PM. Energy restriction
and weight loss on very-low-fat diets reduce C-reactive
protein concentrations in obese, healthy women. Arterioscler
Thromb Vase Bioi. 2001:21:968-70.
41. Verma S, Wang CH, Weisel RD, Badiwala MY, Li SH, Fedak
PW, et al. Hyperglycemia potentiates the proatherogenic
effects of C-reactive portein: reversal with rosiglitazone. J
Mol Cell Cardiol. 2003;35:417-9.
Published
2009-04-30
How to Cite
1.
Lilisianawati L, Lestari E, Hadianto D, Sari M, Lestarina L, Salimo H. Association between C-reactive protein levels and physical fitness in 7 to 9 year old children at poor elementary schools in Surakarta, Indonesia. PI [Internet]. 30Apr.2009 [cited 19Apr.2024];49(2):75-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/460
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Received 2016-09-05
Accepted 2016-09-05
Published 2009-04-30
Accepted 2016-09-05
Published 2009-04-30
