(OR07-05-25) Central Obesity as a Strong Predictor of Elevated High-Sensitivity C-Reactive Protein Levels, Independent of BMI-Based Obesity: Insights From All of Us Data

Objectives: To determine differences in high sensitivity C-reactive protein (hs-CRP), a cardiovascular disease (CVD) risk marker, across body composition phenotypes.

Methods: We analyzed data from 4,502 U.S. adults aged 20-65 from the All of Us (AoU) research database, featuring BMI, waist circumference (WC), and hs-CRP measurements. Excluded were underweight individuals, pregnant women, those lacking smoking history data, and those with hs-CRP levels >10.5 mg/L. Overweight/obese was defined as BMI ≥25kg/m², with central obesity classified as WC ≥102cm for men and ≥88cm for women. The four phenotypes were: normal weight lean without central obesity (NWL), normal weight with central obesity (NWCO), overweight/obese without central obesity (OBL), and overweight/obese with central obesity (OBCO). Covariates included age, sex, race, ethnicity, and smoking status. Statistical analysis involved Kruskal-Wallis tests and multiple linear regression in RStudio with an alpha of 0.05 for significance.

Results: The mean age was 45.1 years (95% CI: 23.5 to 66.8); 66% were women, and 65% were Caucasian. OBCO had the highest hs-CRP (median=2.2, IQR: 0.8 to 4.8), followed by NWCO (median=2.1, IQR: 0.7 to 3.9). The lowest hs-CRP was in NWL (median=0.7, IQR: 0.3 to 1.8), with OBL having a median of 1.0 (IQR: 0.4 to 2.5). Controlling for covariates, hs-CRP levels in NWCO were comparable to OBCO (β = -.34, SE = .29, p > .05), while both NWL and OBL had significantly lower levels than OBCO (β = -1.54, SE = .10, p < .001, and β = -1.09, SE =.10, p < .001 , respectively). BMI-based overweight/obese (β = .44, SE = .11, p < .001) and central obesity (β = 1.10, SE = .10, p < .001) independently predicted elevated hs-CRP, with central obesity having a nearly threefold greater effect.

Conclusions: Central obesity is linked to elevated hs-CRP levels independent of BMI, suggesting it may pose a greater CVD risk. Assessing central obesity in normal-weight individuals may be crucial for identifying cardiometabolic health issues.

Funding Sources: We thank All of Us participants and the National Institutes of Health’s All of Us Research Program for the data used in this study, and the University of Mississippi Libraries for support in training and funding. This study uses data from the All of Us Research Program’s Registered Tier Dataset version 7, accessible to authorized users on the Researcher Workbench.