Journal of Endocrinological Investigation

, Volume 36, Issue 8, pp 642–647 | Cite as

Correlation of C-reactive protein level and obesity in Chinese adults and children: A meta-analysis

  • Y. Zhao
  • G. LvEmail author
Original Article


This meta-analysis evaluated the correlations between C-reactive protein (CRP) and obesity in Chinese adults and children. We searched three Chinese databases [Wanfang, WEIPU, and Chinese National Knowledge Infrastructure (CNKI)] in addition to Pub Med. The search was restricted to only Chinese studies published online before January 9, 2013. Data from 28 articles were independently abstracted by two reviewers. The articles’ characteristics were abstracted as follows: 1) first author name; 2) year of publication; 3) study population; 4) sample size; 5) sex, age, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and CRP level of the study population; 6) Pearson correlation coefficients, Spearman correlation coefficients, or odds ratios between CRP level and obesity. The metaanalysis was conducted to pool the Pearson correlation coefficients using a random-effects model. The pooled Pearson correlation coefficient between CRP and BMI was 0.45 [95% confidence interval (CI): 0.33–0.56] in Chinese adults and 0.46 (95% CI: 0.31–0.62) in Chinese children, and the pooled Pearson correlation coefficient was 0.32 (95% CI: 0.24–0.40) in the general Chinese population and 0.53 (95% CI: 0.42–0.64) in the obese Chinese population. Significant correlation was thus found between CRP and obesity in Chinese adults and children.


C-reactive protein obesity 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Keller KB, Lemberg L. Obesity and the metabolic syndrome. Am J Crit Care 2003, 12: 167–70.PubMedGoogle Scholar
  2. 2.
    Wang Y, Yang W. CRP and metabolic syndrome. SYXNFWGBZZ 2007, 15: 482–5 (in chinese).Google Scholar
  3. 3.
    Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 2004, 350: 1387–97.PubMedCrossRefGoogle Scholar
  4. 4.
    Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999, 19: 972–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Khera, A, McGuire DK, Murphy SA, et al. Race and gender differences in C-reactive protein levels. J Am Coll Cardiol 2005, 46: 464–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Zhang Y, Gao Y, Tan A, et al. Endogenous sex hormones and C-reactive protein in healthy Chinese men. Clin Endocrinol (Oxf) 2013, 78: 60–6.CrossRefGoogle Scholar
  7. 7.
    Ohsawa M, Okayama A, Nakamura, et al. CRP levels are elevated in smokers but unrelated to the number of cigarettes and are decreased by long-term smoking cessation in male smokers. Prev Med 2005, 41: 651–6.PubMedCrossRefGoogle Scholar
  8. 8.
    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.PubMedCrossRefGoogle Scholar
  9. 9.
    Choi J, Joseph L, Pilote L. Obesity and C-reactive protein in various populations: a systematic review and meta-analysis. Obes Rev, 2013, 14: 232–44.PubMedCrossRefGoogle Scholar
  10. 10.
    Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vanden-Broucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007, 370: 1453–7.CrossRefGoogle Scholar
  11. 11.
    Xu W. The relationship between high sensitivity C reaction protein and ApoB, ApoB/ApoA1 ration in general population of Chongqing. Chongqing: Chongqing Medical University. 2010, 1–48 (in chinese).Google Scholar
  12. 12.
    Li G, Zheng Q. Relationship between insulin resistance and serum high sensitivity C-reactive protein, blood lipids level in adult with simple obesity. Int J Lab Med 2012, 33: 1587–9 (in Chinese).Google Scholar
  13. 13.
    Yu D, Gao X, Zhao Naiqing SX, Jiang S, Jang X, Pan B. Relationship of C-reactive protein to metabolic syndrome in obese subject, Fudan Univ J Med Sci 2002, 29: 45–9 (in Chinese).Google Scholar
  14. 14.
    Fang F. Study of serum of levels of IL-6/CRP and their relationship with insulin resistant in Metabolic syndrome. Nan Ning: Guangxi Medical University. 2008, 1–50 (in Chinese).Google Scholar
  15. 15.
    Ling H. CRP concentration in obesity and its relation with insulin resistance. Clin Focus 2004, 19: 748–50 (in Chinese).Google Scholar
  16. 16.
    Chen L. Association between serum interleukin-10(IL-10) and high sensitive C reactive protein (hs-CRP) in military old men with metabolic syndrome. Chang Sha: Central South University. 2007, 1–42 (in Chinese).Google Scholar
  17. 17.
    Luo Y, Li X, Lv Z, Chen L, Qin S. Serum TNF-α, IL-6, CRP concentrations in over-weight and obesity persons. Sichuan Med J 2008, 29: 658–60 (in Chinese).Google Scholar
  18. 18.
    Wang C, Pei H, Jin H, Qiu M. Relationships between TNF-α, IL-6, CRP and obesity in population with overweight and obesity. Tianjing Med J 2007, 35: 332–4 (in Chinese).Google Scholar
  19. 19.
    Yang K, Liu H, Ma J. Evaluate the relationship between Obesity related index of 126 male adults and hyper sensitive C-reactive protein. Int J Lab Med 2012, 33: 484–5 (in Chinese).Google Scholar
  20. 20.
    Liu Q, Zhang L, Zhang W. Evaluate the relationship among Serum C-reactive protein,IL-16, resistin and obesity. Xinjiang Med 2012, 42: 32–4 (in Chinese).Google Scholar
  21. 21.
    Wang X, Jing X, Zhang J. Correlation study of serum inflammatory factor level and type 2 diabetes of obese people. China Med Herald 2008, 5: 29–30 (in Chinese).Google Scholar
  22. 22.
    Li J, Li C, Xue Y. Serum hyper sensitive C-reactive protein level and insulin resistance of obesity patients. Guangdong Med J 2007, 28: 1102–4 (in Chinese).Google Scholar
  23. 23.
    Li H, Zou D, Guo P. Changes of serum C-reactive protein levels in patients with simple obesity. Acad J Sec Med Univ 2003, 24: 1272–3 (in Chinese).Google Scholar
  24. 24.
    Li W. Serum concentration of high-sensitivity C-reactive protein and its significance in children with simple obesity and metabolism syndrome. Clin J Mod Drug App 2009, 3: 24–6 (in Chinese).Google Scholar
  25. 25.
    Huang X, Xiao Y, Deng Y, et al. Study on relativity of children obesity and metabolism syndrome. China J Mod Med 2005, 5: 2475–8 (in Chinese).Google Scholar
  26. 26.
    Xiao Y, Huang X, Deng Y, et al. Correlation of obesity with C-reactive protein, leptin and insulin sensitive index in Cjildren. Chin J Contemp Pediatr 2006, 8: 24–6 (in Chinese).Google Scholar
  27. 27.
    Zhou X, Sun Y, Zhou L. A comparative study on the levels of CRP and IL-6 in peripheral blood of adolescents between normal-weight over-weight and obesity. JPMT 2008, 15: 2739–41 (in Chinese).Google Scholar
  28. 28.
    Li C, Jiang D, Sun JH et al. Changes of leptin resistance, blood lipids and inflammatory response before and after the exercise therapy in children with obesity. Chin J Contemp Pediatr 2012, 12: 40–2 (in Chinese).Google Scholar
  29. 29.
    Lv J, Yang X, Jing S. Correlation of obesity with hypersensitive C-reaction protein and tumor necrosis factor-alpha in children, Jiangsu Med J 2008, 34: 142–3 (in Chinese).Google Scholar
  30. 30.
    Xue M, Zhang X, Jiang D, Pan Y. The clinical significance of serum high-sensitivity C-reactive protein, leptin, soluble leptin receptor and Insulin in obese children. J Chinese Microcirculation 2009, 13: 397–8, 404 (in Chinese).Google Scholar
  31. 31.
    Liang G, Wang S, Shao D, et al. The level and relationship between leptin, adiponectin, free fatty acids and high-sensitive C reactive protein in simple overweight, obese adolescents. J Med Res 2007, 6: 58–63 (in Chinese).Google Scholar
  32. 32.
    Du W, Zhao R, Zhou Y. Changes of levels of high sensitivity C-reactive protein and insulin in children with obesity and their clinical significance. J Appl Clin Pediatr 2012, 2727: 1133–6 (in Chinese).Google Scholar
  33. 33.
    Yu H, Lou K, Liu X, Sun K, Hui R. Study on the relationship between C-reaction protein levels and obesity. Mol Card Chin 2005, 5: 609–12 (in Chinese).Google Scholar
  34. 34.
    Zhang J, Wu Z, Liu W, Wu W, Yuan R, Wang Y. Relationship of C-reactive protein to traditional cardiovascular risk factors. J Clin Med Prac 2006, 10: 57–9 (in Chinese).Google Scholar
  35. 35.
    Guo Z, Hu X, Chen F, Wu M. Study on C-reactive protein and the risk factors of traditional coronary heart disease. Clin J Epidemiol 2007, 28: 1064–8 (in Chinese).Google Scholar
  36. 36.
    Zhao Y, Wang R, Ma X, et al. Distribution of C-reactive protein and its association with cardiovascular risk factors in a population-based sample of Chinese. Dis Markers 2010, 28: 333–42 (in Chinese).PubMedCentralPubMedCrossRefGoogle Scholar
  37. 37.
    Villegas R, Xiang YB, Cai H, et al. Lifestyle determinants of C-reactive protein in middle-aged, urban Chinese men. Nutr Metab Cardiovasc Dis 2012, 22: 223–30.PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Hotamisligil GS. Inflammatory pathways and insulin action. Int J Obes Relat Metab Disord 2003, 27(Suppl 3): S53–5.PubMedCrossRefGoogle Scholar
  39. 39.
    Sun Bo, LI Hui, Wang Ning. Obesity and chronic inflammation. J Biol 2012, 29: 88–90 (in Chinese).Google Scholar
  40. 40.
    Kovacs A, Green F, Hansson LO, et al. A novel common sigle nucleotide polymorphism in the promoter region of the C-reactive protein gene associated with the plasma concentration of C-reactive protein. Atherosclerosis 2005, 178: 193–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Kirby JB, Liang L, Chen HJ, Wang Y. Race, place, and obesity: the complex relationships among community racial/ethnic composition, individual race/ethnicity, and obesity in the United States. Am J Public Health 2012, 102: 1572–8.PubMedCrossRefGoogle Scholar
  42. 42.
    Khoo CM, Sairazi S, Taslim S, et al. Ethnicity modifies the relationships of insulin resistance, inflammation, and adiponectin with obesity in a multiethnic Asian population. Diabetes Care 2011, 34: 1120–6.PubMedCentralPubMedCrossRefGoogle Scholar
  43. 43.
    Retnakaran R, Hanley AJ, Connelly PW, Harris SB, Zinman B. Elevated C-reactive protein in native Canadian children: an ominous early complication of childhood obesity. Diabetes Obes Metab 2006, 8: 483–91.PubMedCrossRefGoogle Scholar
  44. 44.
    Shu Y, He S, Chen X, et al. Relations between fasting serum lipids and high-sensitivity C-reactive protein level in Chengdu residents. Chin J Cardiol 2012, 40: 125–9 (in Chinese).Google Scholar
  45. 45.
    Horlick M. Body mass index in childhood—measuring a moving target. J Clin Endocrinol Metab 2001, 86: 4059–60.PubMedGoogle Scholar
  46. 46.
    Toprak D, Toprak A, Chen W, Xu JH, Srinivasan S, Berenson GS. Adiposity in childhood is related to C-reactive protein and adiponectin in young adulthood: from the Bogalusa Heart Study. Obesity (Silver Spring) 2011, 19: 185–90.CrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2013

Authors and Affiliations

  1. 1.Department of Laboratory Medicine, The First Affiliated Hospital, College of MedicineZhejiang UniversityHangzhouChina

Personalised recommendations