Response to Letter by Ramaraj
We thank Dr Ramaraj for his interesting comment. The author reported important additional clinical findings concerning differences in hsCRP and risk factors between men and women. In postmenopausal women body weight is correlated with hsCRP. Interestingly, hsCRP levels decrease with caloric restriction–induced weight loss.1 Moreover, the correlation between hsCRP and the development of metabolic syndrome is stronger in women compared to men.2 On the other hand, the metabolic syndrome is a risk factor for early carotid atherosclerosis in only women.3 According to these findings one might speculate that the correlation between hsCRP and IMT progression in women might be partly explained by a higher prevalence of metabolic factors and/or insulin resistance. Another interesting finding of our study was the steady increase of carotid IMT with increasing hsCRP quartiles. Therefore, we hypothesized that an elevated inflammatory response might be associated with enhanced atherosclerosis development only in women.4 Concerning the clinical importance of these gender differences and the role of hsCRP regarding the incidence of new vascular events we agree with Dr Ramaraj that more large prospective studies are necessary.
Tchernof A, Nolan A, Sites CK, Ades PA, Poehlman ET. Weight loss reduces C- reactive protein levels in obese postmenopausal women. Circulation. 2002; 105: 564–569.
Sander D, Winbeck K, Klingelhofer J, Etgen T, Conrad B. Progression of early carotid atherosclerosis is only temporarily reduced after antibiotic treatment of Chlamydia pneumoniae seropositivity. Circulation. 2004; 109: 1010–1015.