J Am Geriatr Soc. 2013 Aug 8. doi: 10.1111/jgs.12403.
Kositsawat J, Barry LC, Kuchel GA.
University of Connecticut Center on Aging, University of Connecticut Health Center, Farmington, Connecticut.
OBJECTIVES: To evaluate the independent and joint effects of C-reactive protein (CRP) and 25-OH vitamin D (25(OH)D) levels on mobility disability in older persons.
DESIGN: U.S. population-based cross-sectional study.
SETTING: National Health and Nutrition Examination Surveys (2001-2002).
PARTICIPANTS: Individuals aged 50 and older (N = 1,826).
MEASUREMENTS: C-reactive protein (mg/dL), with
- high CRP defined as ≥0.2 mg/dL, and
- 25(OH)D levels (ng/mL) operationalized as severe deficiency (<10 ng/mL), deficiency (10-19.9 ng/mL), insufficiency (20-29.9 ng/mL), and normal (≥30 ng/mL).
- Mobility disability was operationalized as gait speed of <0.8 m/s while completing a 20-foot walk (6.1 m).
RESULTS: High CRP and low 25(OH)D levels were associated with slow gait speed. Individuals with high CRP levels and severe vitamin D deficiency were more likely to have slow gait speed than were those with neither risk factor (odds ratio = 3.54, 95% confidence interval = 1.42-8.84, P = .007). A significant positive association between vitamin D level and gait speed was found only in those with high CRP in stratified analyses. Whites and blacks showed similar findings as the overall population.
CONCLUSION: These findings provide evidence of a potential joint effect of vitamin D and CRP on gait speed, suggesting that evaluation and correction of vitamin D levels may be especially important in individuals with high CRP levels.
The acute phase response develops in a wide range of acute and chronic inflammatory conditions like bacterial, viral, or fungal infections; rheumatic and other inflammatory diseases; malignancy; and tissue injury or necrosis.
Measuring CRP level is a screen for infectious and inflammatory diseases. Rapid, marked increases in CRP occur with inflammation, infection, trauma and tissue necrosis, malignancies, and autoimmune disorders.
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