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Chlamydial LPS and high-sensitivity CRP levels in serum are associated with an elevated body mass index in patients with cardiovascular disease

Respiratory Infection Unit, National Public Health Institute, Oulu, Finland, taina.lajunen{at}ktl.fi, Department of Medical Microbiology, University of Oulu, Oulu, Finland

Pirkka Vikatmaa

Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland

Aini Bloigu

Respiratory Infection Unit, National Public Health Institute, Oulu, Finland

Tuija Ikonen

Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland, Department of Surgery, Turku University Central Hospital, Turku, Finland

Mauri Lepäntalo

Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland

Pirkko J. Pussinen

Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki

Pekka Saikku

Department of Medical Microbiology, University of Oulu, Oulu, Finland

Maija Leinonen

Respiratory Infection Unit, National Public Health Institute, Oulu, Finland

Objective: Seropositivity for Chlamydia pneumoniae has been associated with an elevated body mass index (BMI). Our aim was to study if serum chlamydial lipopolysaccharide (cLPS), C. pneumoniae antibodies and high-sensitivity C-reactive protein (hsCRP) levels are associated with BMI

Patients and Methods : The study population consisted of 174 patients with symptomatic carotid stenosis, abdominal aortic aneurysm or occlusive aortic disease. Information on BMI, diabetes, smoking, hypercholesterolemia, and statin medication was available. Serum C. pneumoniae IgG and IgA antibodies, cLPS, hsCRP and total endotoxin activity (totLPS) were measured.

Results: BMI correlated with cLPS (r = 0.197; P < 0.01) and with hsCRP ( = 0.195; P < 0.01); in addition, there was a positive correlation between cLPS and hsCRP ( = 0.499; P < 0.01). A trend of an increasing proportion of C. pneumoniae IgG positivity (titre 64; P = 0.018) and higher serum cLPS (P = 0.01) and hsCRP (P = 0.01) concentrations was observed across the BMI groups (BMI 24.9 kg/m², BMI = 25.0—29.9 kg/m², and BMI 30.0 kg/m²). Among the three BMI groups, 24.6%, 38.8%, and 48.3% were C. pneumoniae IgG-positive and the median (IQR) cLPS concentrations (ng/ml) of the groups were: 92.6 (50.8—167.0), 128.9 (76.4—163.9), and 146.4 (105.8—175.8), respectively. The median (IQR) hsCRP (mg/l) concentrations of the groups were: 1.70 (0.70—3.05) 1.70 (0.80—5.20), and 3.40 (1.45—8.55), respectively. These associations remained statistically significant in a multivariate analysis.

Conclusions: Elevated serum cLPS levels were associated with an elevated BMI. This is a novel finding and it strengthens the link between chlamydial infection and obesity. A lack of association between totLPS and BMI suggests that the association between infection and an elevated BMI may be specific to certain pathogens.

Key Words: Atherosclerosis • body mass index • Chlamydia pneumoniae • chlamydial LPS • hsCRP • obesity

Innate Immunity, Vol. 14, No. 6, 375-382 (2008)
DOI: 10.1177/1753425908099172


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