Evidence map›Paper›PMID 30735532›Full record

Trial reportPloS one2019

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.

Henriette Steppuhn, Detlef Laußmann, Jens Baumert, Lars Kroll, Thomas Lampert, Dietrich Plaß, Christa Scheidt-Nave, Christin Heidemann

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Henriette SteppuhnDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.ORCID 0000-0002-8652-3368
Detlef LaußmannDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Jens BaumertDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Lars KrollDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Thomas LampertDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Dietrich PlaßDepartment of Environmental Hygiene, German Environment Agency, Berlin, Germany.
Christa Scheidt-NaveDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Christin HeidemannDepartment of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh-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.

methodsData 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.

resultsNo 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.

conclusionsArea-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.

Indexed as

Databases, FactualHeart DiseasesMetabolic DiseasesModels, BiologicalAdolescentAdultAgedC-Reactive ProteinCross-Sectional StudiesEnvironmental ExposureFemaleGermanyHumansLongitudinal StudiesMaleMiddle AgedC-Reactive ProteinParticulate Matter

Identifiers

PMID30735532
PMCPMC6368296

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.