Skip to main content
Log in

C-Reactive Protein is Linked to Lower Cognitive Performance in Overweight and Obese Women

  • Published:
Inflammation Aims and scope Submit manuscript

Abstract

Our objective was to ascertain the nature of the associations between C-reactive protein (CRP) and cognition, and to examine how they are affected by gender and obesity. We evaluated 62 females and 63 males between 42 and 82 years of age. There were 20 lean females with a body mass index (BMI) of <25 kg/m2 and 42 overweight or obese females, with BMIs ≥25 kg/m2. There were 14 lean males and 49 with BMIs ≥25 kg/m2. CRP was associated with lower scores on cognitive tests of frontal lobe function among females and these associations were driven by the overweight/obese female group. In these data no associations between CRP and cognition were found among males. Obesity-associated inflammation is much more prominent in females and it appears to be associated with cognitive dysfunction, particularly of frontal lobe tasks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lee, W.-Y., J.-S. Park, S.-Y. Noh, E.-J. Rhee, K.-C. Sung, B.-S. Kim, J.-H. Kang, S.-W. Kim, M.-H. Lee, and J.-R. Park. 2004. C-reactive protein concentrations are related to insulin resistance and metabolic syndrome as defined by the ATP III report. Int. J. Cardiol. 97:101–106.

    Article  PubMed  Google Scholar 

  2. Wang, Z., and W. E. Hoy. 2007. C-reactive protein and the risk of developing type 2 diabetes in Aboriginal Australians. Diabetes Res. Clin. Pract. 76:37–43.

    Article  PubMed  CAS  Google Scholar 

  3. Han, T., C. Gonzalez-Villalpando, N. Sattar, M. Lean, K. Williams, and S. M. Haffner. 2007. Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study. Diabetes Care 25(11):2016–2021.

    Article  Google Scholar 

  4. Pearson, T. A., G. A. Mensah, R. W. Alexander, J. L. Anderson, R. O. Cannon III, M. Criqui, Y. Y. Fadl, S. P. Fortmann, Y. Hong, G. L. Myers, N. Rifai, S. C. Smith Jr., K. Taubert, R. P. Tracy, and F. Vinicor. 2003. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 107(3):499–511 (Jan).

    Article  PubMed  Google Scholar 

  5. Kushner, I., D. Rzewnicki, and D. Samols. 2006. What does minor elevation of C-reactive protein signify? Am. J. Med. 119:166.e17–166.e28.

    Article  Google Scholar 

  6. Swanson, S. J., M. M. McPeek, and R. F. Mortensen. 1989. Characteristics of the binding of human C-reactive protein (CRP) to laminin. J. Cell Biochem. 40(1):121–132 (May).

    Article  PubMed  CAS  Google Scholar 

  7. Pepys, M. B., and M. L. Baltz. 1983. Acute phase proteins with special reference to C-reactive protein and related proteins (pentaxins) and serum amyloid A protein. Adv. Immunol. 34:141–212.

    Article  PubMed  CAS  Google Scholar 

  8. Haffner, S. M. 2006. The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am. J. Cardiol. 97(2, Supplement 1):3–11 (Jan).

    Article  CAS  Google Scholar 

  9. Parikh, N. I., M. J. Pencina, T. J. Wang, K. J. Lanier, C. S. Fox, R. B. D’Agostino, and R. S. Vasan. 2007. Increasing trends in incidence of overweight and obesity over 5 decades. Am. J. Med. 120(3):242–250 (Mar).

    Article  PubMed  Google Scholar 

  10. Ye, X., Z. Yu, H. Li, O. H. Franco, Y. Liu, and X. Lin. 2007. Distributions of C-reactive protein and its association with metabolic syndrome in middle-aged and older Chinese people. J. Am. Coll. Cardiol. 49(17):1798–1805 (May).

    Article  PubMed  CAS  Google Scholar 

  11. Florez, H., S. Castillo-Florez, A. Mendez, P. Casanova-Romero, C. Larreal-Urdaneta, D. Lee, and R. Goldberg. 2006. C-reactive protein is elevated in obese patients with the metabolic syndrome. Diabetes Res. Clin. Pract. 71(1):92–100 (Jan).

    Article  PubMed  CAS  Google Scholar 

  12. Wasir, J. S., A. Misra, N. K. Vikram, R. M. Pandey, and K. Luthra. 2007. C-reactive protein, obesity, and insulin resistance in postmenopausal women in urban slums of North India. Diabetes and Metabolic Syndrome: Clinical Research and Reviews 1(2):83–89 (Jun).

    Article  Google Scholar 

  13. Thorand, B., J. Baumert, A. Doring, C. Herder, H. Kolb, W. Rathmann, G. Giani, and W. Koenig. 2006. Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis 184(1):216–224 (Jan).

    Article  PubMed  CAS  Google Scholar 

  14. Rexrode, K. M., A. Pradhan, J. E. Manson, J. E. Buring, and P. M. Ridker. 2003. Relationship of total and abdominal adiposity with CRP and IL-6 in women. Ann. Epidemiol. 13(10):674–682 (Nov).

    Article  PubMed  Google Scholar 

  15. Lear, S., M. Chen, C. L. Birmingham, and J. J. Frohlich. 2003. The relationship between simple anthropometric indices and C-reactive protein: ethnic and gender differences. Metabolism 52(12):1542–1546.

    Article  PubMed  CAS  Google Scholar 

  16. Khera, A., D. McGuire, S. Murphy, H. Stanek, S. Das, W. Vongpatanasin, F. Wians, S. Grundy, and J. de Lemos. 2005. Race and gender differences in C-reactive protein levels. J. Am. Coll. Cardiol. 46(3):464–469.

    Article  PubMed  CAS  Google Scholar 

  17. Pieroni, L., J. P. Bastard, A. Piton, L. Kalil, B. Hainique, and C. Jardel. 2003. Interpretation of circulating C-reactive protein levels in adults: body mass index and gender are a must. Diabetes Metab. 29:133–138.

    Article  PubMed  CAS  Google Scholar 

  18. Kraus, V. B., T. V. Stabler, G. Luta, J. B. Renner, A. D. Dragomir, and J. M. Jordan. 2007. Interpretation of serum C-reactive protein (CRP) levels for cardiovascular disease risk is complicated by race, pulmonary disease, body mass index, gender, and osteoarthritis. Osteoarth. Cartil. 15(8):966–971 (Aug).

    Article  CAS  Google Scholar 

  19. Lakoski, S., M. Cushman, M. Criqui, T. Rundek, R. Blumenthal, R. B. D’Agostino, and D. Herrington. 2006. Gender and C-reactive protein: data from the Multiethnic Study of Atherosclerosis (MESA) cohort. Am. Heart J. 152(3):593–598.

    Article  PubMed  CAS  Google Scholar 

  20. Kluft, C. 2002. HRT effects on inflammatory markers: is chronic inflammation a contra-indication for HRT? Int. Congr. Ser. 1229:103–108.

    Article  Google Scholar 

  21. Abdullah, S. M., A. Khera, D. Leonard, S. R. Das, R. M. Canham, S. A. Kamath, G. L. Vega, S. M. Grundy, D. K. McGuire, and J. A. de Lemos. 2007. Sex differences in the association between leptin and CRP: results from the Dallas Heart Study. Atherosclerosis 195(2):404–410 (Dec).

    Article  PubMed  CAS  Google Scholar 

  22. Ferrannini, E., A. Natali, P. Bell, P. Cavallo-Perin, N. Lalic, and G. Mingrone. 1997. Insulin resistance and hypersecretion in obesity. J. Clin. Invest. 100(5):1166–1173 (Sep).

    Article  PubMed  CAS  Google Scholar 

  23. Smith, D. O., and D. LeRoith. 2004. Insulin resistance syndrome, pre-diabetes, and the prevention of type 2 diabetes mellitus. Clin. Cornerstone 6(2):7–13.

    Article  PubMed  Google Scholar 

  24. Biessels, G.-J., E. ter Braak, D. Erkelens, and R. Hijman. 2001. Cognitive function in patients with type 2 diabetes mellitus. Neurosci. Res. Commun. 28(1):11–22.

    Article  Google Scholar 

  25. Akisaki, T., T. Sakurai, T. Takata, H. Umegaki, A. Araki, S. Mizuno, S. Tanaka, Y. Ohashi, A. Iguchi, K. Yokono, and H. Ito. 2006. Cognitive dysfunction associates with white matter hyperintensities and subcortical atrophy on magnetic resonance imaging of the elderly diabetes mellitus Japanese elderly diabetes intervention trial (J-EDIT). Diabetes Metab. Res. Rev. 22(5):376–384.

    Article  PubMed  Google Scholar 

  26. Strachan, M., I. Deary, F. Ewing, and B. Frier. 1997. Is type II diabetes associated with an increased risk of cognitive dysfunction? A critical review of published studies. Diabetes Care 20(3):438–445.

    Article  PubMed  CAS  Google Scholar 

  27. Vanhanen, M., K. Koivisto, L. Karjalainen, E. L. Helkala, M. Laakso, H. Soininen, and P. Riekkinen, Sr. 1997. Risk for non-insulin-dependent diabetes in the normoglycaemic elderly is associated with impaired cognitive function. NeuroReport. 8(6):1527–1530.

    Article  PubMed  CAS  Google Scholar 

  28. Convit, A. 2005. Links between cognitive impairment in insulin resistance: an explanatory model. Neurobiol. Aging 26(1, Supplement 1):31–35 (Dec).

    Article  PubMed  CAS  Google Scholar 

  29. Gold, S. M., I. Dziobek, V. Sweat, A. Tirsi, K. Rogers, H. Bruehl, W. Tsui, S. Richardson, E. Javier, and A. Convit. 2007. Hippocampal damage and memory impairments as possible early brain complications of type 2 diabetes. Diabetologia 50(4):711–719.

    Article  PubMed  CAS  Google Scholar 

  30. Convit, A., O. T. Wolf, C. Tarshish, and M. J. de Leon. 2003. Reduced glucose tolerance is associated with poor memory performance and hippocampal atrophy among normal elderly. Proc. Natl. Acad. Sci. U. S. A. 100(4):2019–2022.

    Article  PubMed  CAS  Google Scholar 

  31. Gunstad, J., R. H. Paul, R. A. Cohen, D. F. Tate, M. B. Spitznagel, and E. Gordon. 2007. Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Compr. Psychiatry 48(1):57–61.

    Article  PubMed  Google Scholar 

  32. Weisell, R. C. 2002. Body mass index as an indicator of obesity. Asia Pac. J. Clin. Nutr. 11(Suppl 8):S681–S684.

    Article  Google Scholar 

  33. Jeong, S. K., H. S. Nam, M. H. Son, E. J. Son, and K. H. Cho. 2005. Interactive effect of obesity indexes on cognition. Dement. Geriatr. Cogn. Disord. 19(2–3):91–96.

    Article  PubMed  Google Scholar 

  34. Elias, M. F., P. K. Elias, L. M. Sullivan, P. A. Wolf, and R. B. D’Agostino. 2005. Obesity, diabetes and cognitive deficit: the Framingham Heart Study. Neurobiol. Aging 26(1, Supplement 1):11–16 (Dec).

    Article  PubMed  CAS  Google Scholar 

  35. Cournot, M., J. C. Marquie, D. Ansiau, C. Martinaud, H. Fonds, J. Ferrieres, and J. B. Ruidavets. 2006. Relation between body mass index and cognitive function in healthy middle-aged men and women. Neurol. 67(7):1208–1214 (Oct).

    Article  CAS  Google Scholar 

  36. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 285(19):2486–2497 (May).

  37. Komulainen, P., T. A. Lakka, M. Kivipelto, M. Hassinen, E. L. Helkala, I. Haapala, A. Nissinen, and R. Rauramaa. 2007. Metabolic syndrome and cognitive function: a population-based follow-up study in elderly women. Dement. Geriatr. Cogn. Disord. 23(1):29–34.

    Article  PubMed  Google Scholar 

  38. Yaffe, K., A. Kanaya, K. Lindquist, E. M. Simonsick, T. Harris, R. I. Shorr, F. A. Tylavsky, and A. B. Newman. 2004. The metabolic syndrome, inflammation, and risk of cognitive decline. JAMA 292(18):2237–2242 (Nov).

    Article  PubMed  CAS  Google Scholar 

  39. Dik, M. G., C. Jonker, H. C. Comijs, D. J. Deeg, A. Kok, K. Yaffe, and B. W. Penninx. 2007. Contribution of metabolic syndrome components to cognition in older persons. Diabetes Care 30:2655–2660 (Jun).

    Article  PubMed  Google Scholar 

  40. Kuo, H. K., C. J. Yen, C. H. Chang, C. K. Kuo, J. H. Chen, and F. Sorond. 2005. Relation of C-reactive protein to stroke, cognitive disorders, and depression in the general population: systematic review and meta-analysis. Lancet Neurol. 4(6):371–380 (Jun).

    Article  PubMed  CAS  Google Scholar 

  41. Bruehl, H., M. Rueger, I. Dziobek, V. Sweat, A. Tirsi, E. Javier, A. Arentoft, O. T. Wolf, and A. Convit. 2007. Hypothalamic–pituitary–adrenal axis dysregulation and memory impairments in Type 2 diabetes. J. Clin. Endocrinol. Metab. 92(7):2439–2445 (Jul).

    Article  PubMed  CAS  Google Scholar 

  42. Executive Summary of the Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. J. Am. Diet Assoc. 98(10):1178–1191 (Oct).

  43. Raz, N., K. M. Rodrigue, and J. D. Acker. 2003. Hypertension and the brain: vulnerability of the prefrontal regions and executive functions. Behav. Neurosci. 117(6):1169–1180 (Dec).

    Article  PubMed  Google Scholar 

  44. Lezak, M. D. 1995. Neuropsychological Assessment. 3rd ed. Oxford University Press, New York.

    Google Scholar 

  45. Hamilton, M. 1960. A rating scale for depression. J. Neurol. Neurosurg. Psychiatry 23:56–62.

    PubMed  CAS  Google Scholar 

  46. Ansell, B., K. Watson, R. Weiss, and G. Fonarow. 2003. hsCRP and HDL Effects of Statins Trial (CHEST): rapid effect of statin therapy on C-reactive protein and high-density lipoprotein levels. Heart Dis. 5:2–7.

    Article  PubMed  CAS  Google Scholar 

  47. Hanefeld, M., N. Marx, A. Pfutzner, W. Baurecht, G. Lubben, E. Karagiannis, U. Stier, and T. Forst. 2007. Anti-inflammatory effects of pioglitazone and/or simvastatin in high cardiovascular risk patients with elevated high sensitivity C-reactive protein: the PIOSTAT Study. J. Am. Coll. Cardiol. 49(3):290–297 (Jan).

    Article  PubMed  CAS  Google Scholar 

  48. Kinlay, S. 2007. Low-density lipoprotein-dependent and -independent effects of cholesterol-lowering therapies on C-reactive protein. J. Am. Coll. Cardiol. 49(20):2003–2009.

    Article  PubMed  CAS  Google Scholar 

  49. Kritchevsky, S. B., M. Cesari, and M. Pahor. 2005. Inflammatory markers and cardiovascular health in older adults. Cardiovasc. Res. 66(2):265–275 (May).

    Article  PubMed  CAS  Google Scholar 

  50. Neisser, U., G. Boodoo, T. J. Bouchard, A. W. Boykin, N. Brody, S. J. Ceci, D. F. Halpern, J. C. Loehlin, R. Perloff, R. J. Sternberg, and S. Urbina. 1996. Intelligence: knowns and unknowns. Am. Psychol. 51(2):77–101 (Feb).

    Article  Google Scholar 

  51. Barzilai, N., G. Atzmon, C. A. Derby, J. M. Bauman, and R. B. Lipton. 2006. A genotype of exceptional longevity is associated with preservation of cognitive function. Neurol. 67:2170–2175.

    Article  CAS  Google Scholar 

  52. Ramlawi, B., J. L. Rudolph, S. Mieno, J. Feng, M. Boodhwani, K. Khabbaz, S. E. Levkoff, E. R. Marcantonio, C. Bianchi, and F. W. Sellke. 2006. C-reactive protein and inflammatory response associated to neurocognitive decline following cardiac surgery. Surgery 140(2):221–226 (Aug).

    Article  PubMed  Google Scholar 

  53. Mathew, J. P., M. V. Podgoreanu, H. P. Grocott, W. D. White, R. W. Morris, M. Stafford-Smith, G. B. Mackensen, C. S. Rinder, J. A. Blumenthal, D. A. Schwinn, and M. F. Newman. 2007. Genetic variants in P-selectin and C-reactive protein influence susceptibility to cognitive decline after cardiac surgery. J. Am. Coll. Cardiol. 49(19):1934–1942 (May).

    Article  PubMed  CAS  Google Scholar 

  54. de Luca, C., and J. M. Olefsky. 2006. Stressed out about obesity and insulin resistance. Nat. Med. 12(1):41–42 (Jan).

    Article  PubMed  CAS  Google Scholar 

  55. Johnson, J. L., C. A. Slentz, B. D. Duscha, G. P. Samsa, J. S. McCartney, J. A. Houmard, and W. E. Kraus. 2004. Gender and racial differences in lipoprotein subclass distributions: the STRRIDE study. Atherosclerosis 176(2):371–377 (Oct).

    Article  PubMed  CAS  Google Scholar 

  56. Abdullah, S. M., A. Khera, D. Leonard, S. R. Das, R. M. Canham, S. A. Kamath, G. L. Vega, S. M. Grundy, D. K. McGuire, and J. A. de LemosSex differences in the association between leptin and CRP: results from the Dallas Heart Study. Atherosclerosis 195(2):404–410.

    Article  PubMed  CAS  Google Scholar 

  57. Molina, M. J., A. M. Mayor, A. E. Franco, C. A. Morell, M. A. Lopez, and L. M. Vila. 2007. Prevalence of systemic lupus erythematosus and associated comorbidities in Puerto Rico. J. Clin. Rheumatol. 13(4):202–204 (Aug).

    Article  PubMed  Google Scholar 

  58. Racial/ethnic differences in the prevalence and impact of doctor-diagnosed arthritis—United States, 2002. MMWR Morb Mortal Wkly Rep. 54(5):119–123 (Feb).

    Google Scholar 

  59. Linares, L. F., J. J. Gomez-Reino, P. E. Carreira, L. Morillas, and I. Ibero. 1986. C-reactive protein (CRP) levels in systemic lupus erythematosus (SLE). Clin. Rheumatol. 5(1):66–69 (Jan).

    Article  PubMed  CAS  Google Scholar 

  60. Popkova, T. V., A. N. Khelkovskaia, E. S. Mach, E. N. Aleksandrova, A. A. Novikov, D. S. Novikova, and E. L. Nasonov. 2007. Cardiovascular diseases in rheumatoid arthritis. Ter. Arkh. 79(5):9–14.

    PubMed  CAS  Google Scholar 

  61. Urowitz, M. B., and D. D. Gladman. 2007. Atherosclerosis and lupus—the SLICC study. Lupus. 16(12):925–928.

    Article  PubMed  CAS  Google Scholar 

  62. Assous, N., E. Touze, C. Meune, A. Kahan, and Y. Allanore. 2007. Cardiovascular disease in rheumatoid arthritis: single-center hospital-based cohort study in France. Jt. Bone Spine 74(1):66–72 (Jan).

    Article  Google Scholar 

  63. Shucard, J. L., J. J. Gaines, J. Ambrus Jr., and D. W. Shucard. 2007. C-reactive protein and cognitive deficits in systemic lupus erythematosus. Cogn. Behav. Neurol. 20(1):31–37 (Mar).

    Article  PubMed  Google Scholar 

  64. Nandula, S. R., S. Amarnath, A. Molinolo, B. C. Bandyopadhyay, B. Hall, C. M. Goldsmith, C. Zheng, J. Larsson, T. Sreenath, W. Chen, I. S. Ambudkar, S. Karlsson, B. J. Baum, and A. B. Kulkarni. 2007. Female mice are more susceptible to developing inflammatory disorders due to impaired transforming growth factor beta signaling in salivary glands. Arthritis Rheum. 56(6):1798–1805 (Jun).

    Article  PubMed  CAS  Google Scholar 

  65. Pradhan, A. D., J. E. Manson, J. E. Rossouw, D. S. Siscovick, C. P. Mouton, N. Rifai, R. B. Wallace, R. D. Jackson, M. B. Pettinger, and P. M. Ridker. 2002. Inflammatory biomarkers, hormone replacement therapy, and incident coronary heart disease: prospective analysis from the Women’s Health Initiative observational study. JAMA 288(8):980–987 (Aug).

    Article  PubMed  CAS  Google Scholar 

  66. Singh, U., S. Devaraj, J. Vasquez-Vivar, and I. Jialal. 2007. C-reactive protein decreases endothelial nitric oxide synthase activity via uncoupling. J. Mol. Cell Cardiol. 43(6):780–791 (Dec).

    Article  PubMed  CAS  Google Scholar 

  67. Jialal, I., S. Devaraj, and S. K. Venugopal. 2004. C-reactive protein: risk marker or mediator in atherothrombosis? Hypertension 44(1):6–11 (Jul).

    Article  PubMed  CAS  Google Scholar 

  68. Verma, S., C. H. Wang, S. H. Li, A. S. Dumont, P. W. Fedak, M. V. Badiwala, B. Dhillon, R. D. Weisel, R. K. Li, D. A. Mickle, and D. J. Stewart. 2002. A self-fulfilling prophecy: C-reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation 106(8):913–919 (Aug).

    Article  PubMed  CAS  Google Scholar 

  69. Schmidt, R., C. Enzinger, S. Ropele, H. Schmidt, and F. Fazekas. 2006. Subcortical vascular cognitive impairment: Similarities and differences with multiple sclerosis. J. Neurol. Sci. 245(1–2):3–7 (Jun).

    Article  PubMed  Google Scholar 

  70. Gold, S. M., I. Dziobek, K. Rogers, A. Bayoumy, P. F. McHugh, and A. Convit. 2005. Hypertension and hypothalamo–pituitary–adrenal axis hyperactivity affect frontal lobe integrity. J. Clin. Endocrinol. Metab. 90(6):3262–3267 (Jun).

    Article  PubMed  CAS  Google Scholar 

  71. Raz, N., K. M. Rodrigue, and J. D. Acker. 2003. Hypertension and the brain: vulnerability of the prefrontal regions and executive functions. Behav. Neurosci. 117(6):1169–1180 (Dec).

    Article  PubMed  Google Scholar 

  72. van Dijk, E. J., N. D. Prins, S. E. Vermeer, H. A. Vrooman, A. Hofman, P. J. Koudstaal, and M. M. B. Breteler. 2005. C-reactive protein and cerebral small-vessel disease: the Rotterdam Scan Study. Circulation 112(6):900–905 (Aug).

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The study was supported by grants from the National Institutes of Health DK064087 and P30-AG-08051 and support from the NYU General Clinical Research Center (NCRR M01 RR00096).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Convit.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sweat, V., Starr, V., Bruehl, H. et al. C-Reactive Protein is Linked to Lower Cognitive Performance in Overweight and Obese Women. Inflammation 31, 198–207 (2008). https://doi.org/10.1007/s10753-008-9065-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10753-008-9065-3

Key words

Navigation