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Letter to the Editor
High-sensitivity C-reactive protein in obese children: Too complex a marker to use?
Proteína C reativa de alta sensibilidade em crianças obesas: um marcador demasiado complexo para utilizar?
Ayşe Tuğba Kartala, Ömer Kartalb,
Autor para correspondência
dr.omerkartal@hotmail.com

Corresponding author.
a Marmaris State Hospital, Department of Pediatry, 48750 Mugla, Turkey
b Aksaz Military Hospital, Department of Pediatry, 48750 Mugla, Turkey
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        "titulo" => "Prote&#237;na C reativa de alta sensibilidade em crian&#231;as obesas&#58; um marcador demasiado complexo para utilizar&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read with great interest the recent article by Pires et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In this excellent study&#44; the authors investigated the relationship between markers of adiposity&#44; inflammation and adipokines in a Portuguese obese pediatric population&#46; They concluded that leptin&#44; adiponectin and high-sensitivity C-reactive protein &#40;hs-CRP&#41; may be used for cardiovascular risk stratification in obese children&#44; as well as in the assessment of weight control programs&#46; We thank and congratulate the authors for having addressed such an important issue&#46; However&#44; we have some concerns regarding this report&#44; which we would like to share with you&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Firstly&#44; high-sensitivity C-reactive protein is a sensitive reflector of low-grade inflammation and is not specific&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Low-grade inflammation is seen in many conditions such as periodontitis&#44; cigarette smoking&#44; diabetes mellitus&#44; uremia&#44; hypertension&#44; low levels of physical activity&#44; oral hormone replacement therapy&#44; sleep disturbance&#44; chronic fatigue&#44; low alcohol consumption&#44; depression and aging&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> However&#44; the authors did not mention these confounders&#44; which may affect their conclusions&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Secondly&#44; some medications may easily alter hs-CRP levels&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Therefore&#44; it would have been useful if the patients included in the study had been described in greater detail in terms of medication with&#44; for example&#44; nonsteroidal anti-inflammatory drugs &#40;aspirin&#44; ibuprofen&#44; and naproxen&#41;&#44; statins and antibiotics&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> This may lead to bias in patient selection&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Thirdly&#44; there was a large numerical difference between the study group&#44; which included 120 obese children and the control group&#44; which included 41 healthy individuals&#59; the difference was four-fold in some parameters&#46; This may decrease the credibility of the study&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; we are of the opinion that hs-CRP levels should be evaluated with other independent variables as mentioned above&#46; Thus the credibility of the study can be increased&#46;</p></span>"
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                      "titulo" => "Pro-inflammatory triggers in childhood obesity&#58; correlation between leptin&#44; adiponectin and high-sensitivity C-reactive protein in a group of obese Portuguese children"
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                      "titulo" => "High-sensitive C-reactive protein&#58; universal prognostic and causative biomarker in heart disease&#63;"
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                          "etal" => false
                          "autores" => array:2 [
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                      "doi" => "10.2217/bmm.11.108"
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                      "titulo" => "High levels of high-sensitivity C-reactive protein and uric acid can predict disease severity in patients with mitral regurgitation"
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                      "titulo" => "A unifying biologic explanation for &#8220;high-sensitivity&#8221; C-reactive protein and &#8220;low-grade&#8221; inflammation"
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                        "tituloSerie" => "Arthritis Care Res &#40;Hoboken&#41;"
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Informação do artigo
ISSN: 08702551
Idioma original: Inglês
DOI:10.1016/j.repc.2015.03.019
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