Assessing salivary C-reactive protein: Longitudinal associations with systemic inflammation and cardiovascular disease risk in women exposed to intimate partner violence

doi:10.1016/j.bbi.2012.01.019

Brain, Behavior, and Immunity

Volume 26, Issue 4, May 2012, Pages 543-551

https://doi.org/10.1016/j.bbi.2012.01.019 Get rights and content

Abstract

This study evaluated individual differences in levels of C-reactive protein (CRP) measured in saliva, cross-sectionally and prospectively, in relation to systemic inflammation and risk for cardiovascular disease (CVD). Plasma and saliva samples, later assayed for CRP, were collected multiple times from an ethnically diverse group of women seeking help from domestic violence crisis shelters-agencies (N = 107; mean age at study start = 34 years). Plasma and saliva CRP levels were moderately associated cross-sectionally and across two years. There were indications that saliva CRP levels were, on average, higher in the morning than evening. Higher levels of saliva and plasma CRP were associated with a higher body mass index, but did not differ between women who did and did not smoke. Salivary CRP reliably discriminated between high and low levels of plasma CRP, using a clinically relevant cutoff point of 3 mg/L, recommended by the American Heart Association. Results build upon an emerging literature suggesting that under specific conditions levels of CRP in saliva may reflect low-grade inflammation and have the potential to serve as a screen for CVD risk status.

Highlight

► This study provides support for the validity of salivary CRP as a minimally invasive marker of systemic inflammation and points to its potential use as a screening tool.

Section snippets

Sample

Data for the current study come from a convenience sample of women seeking help from three domestic violence crisis shelters and community agencies in a Midwestern State. These women were recruited for participation in a larger 2-year longitudinal study involving seven waves of data collection. Women 18 years of age or older, currently in an intimate abusive relationship, and residing in either a shelter or help-seeking in the community were eligible for the study. Women were excluded from

Diurnal variation in salivary CRP

Descriptive statistics for plasma and salivary levels of CRP are displayed in Table 1. Morning levels of salivary CRP could not be assessed for the majority of the sample at wave 7 due to insufficient specimen volume (samples were first tested for two other analytes). A log transformation was applied to correct for the skewed distribution, and outlying values were winsorized (i.e., replaced with the next highest value of the remaining distribution; Tabachnick and Fidell, 2001). Differences in

Discussion

In a prospective longitudinal study of high risk women, we observed moderate associations between CRP measured in saliva and plasma and significant associations of both saliva and plasma CRP with BMI (but not smoking) within each wave of assessment. Salivary CRP reliably distinguished between individuals with high and low plasma levels of CRP, even after controlling for general and oral health. ROC analyses showed that the classification accuracy was adequate, especially for lower levels of

Conflict of interest

In the interest of full disclosure, D.A.G. is founder and Chief Strategy and Scientific Advisor at Salimetrics LLC (State College, PA). D.A.G.’s relationship with Salimetrics LLC is managed by the policies of the Conflict of Interest Committee at the Johns Hopkins University School of Medicine. Salimetrics donated a portion of the salivary CRP kits used in this study.

Acknowledgements

This research was supported by NINR/NICHHD (R01 009286) and an Ohio Board of Regents Grant to S.W. D.O. was supported by a Rubicon award (446-10-026) from the Netherlands Organization for Scientific Research.

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Citation Excerpt :
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^☆: Please see Brief Commentary by Chamindie Punyadeera found on page 541 of this issue.

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Assessing salivary C-reactive protein: Longitudinal associations with systemic inflammation and cardiovascular disease risk in women exposed to intimate partner violence☆

Abstract

Highlight

Section snippets

Sample

Diurnal variation in salivary CRP

Discussion

Conflict of interest

Acknowledgements

J. Biol. Chem.

Ann. Epidemiol.

Am. J. Med.

Lancet

Am. J. Prev. Med.

Brain Behav. Immun.

Physiol. Behav.

J. Immunol. Methods

Life Sci.

J. Midwifery Womens Health

C-reactive protein is a mediator of cardiovascular disease

Eur. Heart J.

Intimate partner violence and physical health consequences

Arch. Intern. Med.

The hypothalamic–pituitary–adrenal axis and immune-mediated inflammation

N. Engl. J. Med.

Childhood maltreatment predicts adult inflammation in a life-course study

Proc. Natl. Acad. Sci. USA

Detection of homocysteine and C-reactive protein in the saliva of healthy adults. Comparison with blood levels

Biomarker Insights

Use of saliva-based nano-biochip tests for acute myocardial infarction at the point of care. A feasibility study

Clin. Chem.

Stress-induced immune dysfunction. Implications for health

Nat. Rev. Immunol.

Intimate partner violence as a risk factor for mental disorders. A meta-analysis

J. Fam. Violence

Immunology and developmental psychopathology

Applied Logistic Regression

Post-traumatic stress disorder (PTSD) in victims of domestic violence. A review of the research

Trauma Violence Abuse

Variation in high-sensitivity C-reactive protein levels over 24 hours in patients with stable coronary artery disease

Tex. Heart Inst. J.