{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:38:41Z","timestamp":1768405121383,"version":"3.49.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Genet."],"abstract":"<jats:p>C-reactive protein (CRP) is a routinely measured blood biomarker for inflammation. Elevated levels of circulating CRP are associated with response to infection, risk for a number of complex common diseases, and psychosocial stress. The objective of this study was to compare the contributions of genetic ancestry, socioenvironmental factors, and inflammation-related health conditions to ethnic differences in C-reactive protein levels. We used multivariable regression to compare CRP blood serum levels between Black and White ethnic groups from the United Kingdom Biobank (UKBB) prospective cohort study. CRP serum levels are significantly associated with ethnicity in an age and sex adjusted model. Study participants who identify as Black have higher average CRP than those who identify as White, CRP increases with age, and females have higher average CRP than males. Ethnicity and sex show a significant interaction effect on CRP. Black females have higher average CRP levels than White females, whereas White males have higher average CRP than Black males. Significant associations between CRP, ethnicity, and genetic ancestry are almost completely attenuated in a fully adjusted model that includes socioenvironmental factors and inflammation-related health conditions. BMI, smoking, and socioeconomic deprivation all have high relative effects on CRP. These results indicate that socioenvironmental factors contribute more to CRP ethnic differences than genetics. Differences in CRP are associated with ethnic disparities for a number of chronic diseases, including type 2 diabetes, essential hypertension, sarcoidosis, and lupus erythematosus. Our results indicate that ethnic differences in CRP are linked to both socioenvironmental factors and numerous ethnic health disparities.<\/jats:p>","DOI":"10.3389\/fgene.2021.738485","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T12:29:34Z","timestamp":1634646574000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Comparing Genetic and Socioenvironmental Contributions to Ethnic Differences in C-Reactive Protein"],"prefix":"10.3389","volume":"12","author":[{"given":"Shashwat Deepali","family":"Nagar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew B.","family":"Conley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivam","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lavanya","family":"Rishishwar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. King","family":"Jordan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Mari\u00f1o-Ram\u00edrez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1161\/hy0202.104270","article-title":"Association between Pulse Pressure and C-Reactive Protein Among Apparently Healthy US Adults","volume":"39","author":"Abramson","year":"2002","journal-title":"Hypertension"},{"key":"B2","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.bbi.2005.10.003","article-title":"Socioeconomic Status and C-Reactive Protein Levels in the US Population: NHANES IV","volume":"20","author":"Alley","year":"2006","journal-title":"Brain Behav. Immun."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1534\/genetics.115.178616","article-title":"Characterizing Race\/Ethnicity and Genetic Ancestry for 100,000 Subjects in the Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort","volume":"200","author":"Banda","year":"2015","journal-title":"Genet. Aug."},{"key":"B4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.socscimed.2014.03.022","article-title":"Incorporating Intersectionality Theory into Population Health Research Methodology: Challenges and the Potential to advance Health Equity","volume":"110","author":"Bauer","year":"2014","journal-title":"Soc. Sci. Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1111\/josi.12061","article-title":"Everyday Discrimination Prospectively Predicts Inflammation across 7-Years in Racially Diverse Midlife Women: Study of Women's Health across the Nation","volume":"70","author":"Beatty Moody","year":"2014","journal-title":"J. Soc. Issues."},{"key":"B6","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1126\/science.aay5012","article-title":"Insights into Human Genetic Variation and Population History from 929 Diverse Genomes","volume":"367","author":"Bergstr\u00f6m","year":"2020","journal-title":"Science"},{"key":"B7","doi-asserted-by":"publisher","first-page":"48487","DOI":"10.1074\/jbc.R400025200","article-title":"C-reactive Protein","volume":"279","author":"Black","year":"2004","journal-title":"J. Biol. Chem."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.2105\/ajph.2012.300750","article-title":"The Problem with the PhraseWomen and Minorities:Intersectionality-An Important Theoretical Framework for Public Health","volume":"102","author":"Bowleg","year":"2012","journal-title":"Am. J. Public Health"},{"key":"B9","doi-asserted-by":"publisher","first-page":"180","DOI":"10.5406\/womgenfamcol.1.2.0180","article-title":"Multidimensional Approaches to Examining Gender and Racial\/ethnic Stratification in Health","volume":"1","author":"Brown","year":"2013","journal-title":"Women, Gend. Families Color."},{"key":"B10","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1038\/s41586-018-0579-z","article-title":"The UK Biobank Resource with Deep Phenotyping and Genomic Data","volume":"562","author":"Bycroft","year":"2018","journal-title":"Nature"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1093\/bioinformatics\/btu197","article-title":"R PheWAS: Data Analysis and Plotting Tools for Phenome-wide Association Studies in the R Environment","volume":"30","author":"Carroll","year":"2014","journal-title":"Bioinformatics"},{"key":"B12","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s13742-015-0047-8","article-title":"Second-generation PLINK: Rising to the challenge of Larger and Richer Datasets","volume":"4","author":"Chang","year":"2015","journal-title":"GigaSci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1513\/pats.200701-029aw","article-title":"Dissecting Complex Diseases in Complex Populations: Asthma in Latino Americans","volume":"4","author":"Choudhry","year":"2007","journal-title":"Proc. Am. Thorac. Soc."},{"key":"B14","doi-asserted-by":"publisher","first-page":"3435","DOI":"10.1534\/g3.117.1118","article-title":"A Comparative Analysis of Genetic Ancestry and Admixture in the Colombian Populations of Choc\u00f3 and Medell\u00edn","volume":"7","author":"Conley","year":"2017","journal-title":"G3 Genes|Genomes|Genetics"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1056\/NEJMoa032804","article-title":"C-reactive Protein and Other Circulating Markers of Inflammation in the Prediction of Coronary Heart Disease","volume":"350","author":"Danesh","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1097\/01.psy.0000041542.29808.01","article-title":"Association between Depression and Elevated C-Reactive Protein","volume":"65","author":"Danner","year":"2003","journal-title":"Psychosomatic Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.1016\/S0140-6736(05)67601-5","article-title":"Genetic Epidemiology and Public Health: hope, Hype, and Future Prospects","volume":"366","author":"Davey Smith","year":"2005","journal-title":"Lancet"},{"key":"B18","doi-asserted-by":"publisher","first-page":"872","DOI":"10.2337\/db06-0922","article-title":"Genetic Variation, C-Reactive Protein Levels, and Incidence of Diabetes","volume":"56","author":"Dehghan","year":"2007","journal-title":"Diabetes"},{"key":"B19","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1093\/ije\/dym276","article-title":"The UK Biobank Sample Handling and Storage Protocol for the Collection, Processing and Archiving of Human Blood and Urine","volume":"37","author":"Elliott","year":"2008","journal-title":"Int. J. Epidemiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1016\/j.ajhg.2019.08.012","article-title":"Harmonizing Genetic Ancestry and Self-Identified Race\/Ethnicity in Genome-wide Association Studies","volume":"105","author":"Fang","year":"2019","journal-title":"Am. J. Hum. Genet."},{"key":"B21","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1093\/geronb\/gbaa027","article-title":"Race, Gender, and Socioeconomic Variations in C-Reactive Protein Using the Health and Retirement Study","volume":"17","author":"Farmer","year":"2021","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci. Feb."},{"key":"B22","doi-asserted-by":"publisher","first-page":"279","DOI":"10.2307\/3350401","article-title":"The Relationship between Socioeconomic Status and Health: a Review of the Literature","volume":"71","author":"Feinstein","year":"1993","journal-title":"Milbank Q."},{"key":"B23","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1097\/00001648-200209000-00012","article-title":"Does Exercise Reduce Inflammation? Physical Activity and C-Reactive Protein Among U.S. Adults","volume":"13","author":"Ford","year":"2002","journal-title":"Epidemiology"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e576","DOI":"10.1016\/s2468-2667(18)30200-7","article-title":"The Effect of Socioeconomic Deprivation on the Association between an Extended Measurement of Unhealthy Lifestyle Factors and Health Outcomes: a Prospective Analysis of the UK Biobank Cohort","volume":"3","author":"Foster","year":"2018","journal-title":"The Lancet Public Health"},{"key":"B25","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.ajhg.2015.12.022","article-title":"Fast Principal-Component Analysis Reveals Convergent Evolution of ADH1B in Europe and East Asia","volume":"98","author":"Galinsky","year":"2016","journal-title":"Am. J. Hum. Genet."},{"key":"B26","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1038\/nature15393","article-title":"A Global Reference for Human Genetic Variation","volume":"526","author":"Genomes Project","year":"2015","journal-title":"Nature"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.2105\/ajph.2007.132852","article-title":"Socioeconomic Status and Improvements in Lifestyle, Coronary Risk Factors, and Quality of Life: the Multisite Cardiac Lifestyle Intervention Program","volume":"99","author":"Govil","year":"2009","journal-title":"Am. J. Public Health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/j.appet.2005.05.003","article-title":"Why Do Women of Low Socioeconomic Status Have Poorer Dietary Behaviours Than Women of Higher Socioeconomic Status? A Qualitative Exploration","volume":"45","author":"Inglis","year":"2005","journal-title":"Appetite"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e1008225","DOI":"10.1371\/journal.pgen.1008225","article-title":"Native American Admixture Recapitulates Population-specific Migration and Settlement of the continental United States","volume":"15","author":"Jordan","year":"2019","journal-title":"Plos Genet."},{"key":"B30","article-title":"Forestmodel: forest Plots from Regression Models","author":"Kennedy","year":"2020"},{"key":"B31","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.jacc.2005.04.051","article-title":"Race and Gender Differences in C-Reactive Protein Levels","volume":"46","author":"Khera","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.ahj.2006.02.015","article-title":"Gender and C-Reactive Protein: Data from the Multiethnic Study of Atherosclerosis (MESA) Cohort","volume":"152","author":"Lakoski","year":"2006","journal-title":"Am. Heart J."},{"key":"B33","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/j.bbi.2009.11.011","article-title":"Self-reported Experiences of Everyday Discrimination Are Associated with Elevated C-Reactive Protein Levels in Older African-American Adults","volume":"24","author":"Lewis","year":"2010","journal-title":"Brain Behav. Immun."},{"key":"B34","doi-asserted-by":"publisher","first-page":"e1008624","DOI":"10.1371\/journal.pgen.1008624","article-title":"What Is Ancestry","volume":"16","author":"Mathieson","year":"2020","journal-title":"Plos Genet."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1016\/j.ahj.2004.08.027","article-title":"Ethnic Differences in Cardiovascular Risk Factor burden Among Middle-Aged Women: Study of Women's Health across the Nation (SWAN)","volume":"149","author":"Matthews","year":"2005","journal-title":"Am. Heart J."},{"key":"B36","doi-asserted-by":"publisher","first-page":"100960","DOI":"10.1016\/j.eclinm.2021.100960","article-title":"Socioeconomic Deprivation and Genetic Ancestry Interact to Modify Type 2 Diabetes Ethnic Disparities in the United Kingdom","volume":"37","author":"Nagar","year":"2021","journal-title":"EClinicalMedicine"},{"key":"B37","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1186\/1471-2458-7-212","article-title":"Socioeconomic and Racial\/ethnic Differentials of C-Reactive Protein Levels: a Systematic Review of Population-Based Studies","volume":"7","author":"Nazmi","year":"2007","journal-title":"BMC Public Health"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1805","DOI":"10.1172\/jci200318921","article-title":"C-reactive Protein: a Critical Update","volume":"111","author":"Pepys","year":"2003","journal-title":"J. Clin. Invest."},{"key":"B39","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1038\/s41576-018-0020-3","article-title":"Using Genetic Data to Strengthen Causal Inference in Observational Research","volume":"19","author":"Pingault","year":"2018","journal-title":"Nat. Rev. Genet."},{"key":"B40","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.ssmph.2016.04.011","article-title":"(En)gendering Racial Disparities in Health Trajectories: A Life Course and Intersectional Analysis","volume":"2","author":"Richardson","year":"2016","journal-title":"SSM - Popul. Health."},{"key":"B41","doi-asserted-by":"publisher","first-page":"S176","DOI":"10.1542\/peds.2009-1100E","article-title":"Social Inequality and Racial Discrimination: Risk Factors for Health Disparities in Children of Color","volume":"124","author":"Sanders-Phillips","year":"2009","journal-title":"Pediatrics"},{"key":"B42","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1086\/427888","article-title":"Genetic Structure, Self-Identified Race\/ethnicity, and Confounding in Case-Control Association Studies","volume":"76","author":"Tang","year":"2005","journal-title":"Am. J. Hum. Genet."},{"key":"B43","volume-title":"R: A Language and Environment for Statistical Computing","year":"2013"},{"key":"B44","volume-title":"Health and Deprivation: Inequality and the","author":"Townsend","year":"1988"},{"key":"B45","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s12864-016-3391-x","article-title":"Comparison of DNA Quantification Methodology Used in the DNA Extraction Protocol for the UK Biobank Cohort","volume":"18","author":"Welsh","year":"2017","journal-title":"BMC Genomics"},{"key":"B46","first-page":"10","article-title":"Elegant Graphics for Data Analysis","volume":"35","author":"Wickham","year":"2009","journal-title":"Media"},{"key":"B47","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s10865-008-9185-0","article-title":"Discrimination and Racial Disparities in Health: Evidence and Needed Research","volume":"32","author":"Williams","year":"2009","journal-title":"J. Behav. Med."},{"key":"B48","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1001\/2013.jamapsychiatry.102","article-title":"Elevated C-Reactive Protein Levels, Psychological Distress, and Depression in 73 131 Individuals","volume":"70","author":"Wium-Andersen","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"B49","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1111\/j.1520-037x.2001.00570.x","article-title":"Distribution of C-Reactive Protein and its Relation to Risk Factors and Coronary Heart Disease Risk Estimation in the National Health and Nutrition Examination Survey (NHANES) III","volume":"4","author":"Wong","year":"2001","journal-title":"Prev. Cardiol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1177\/1049732310361892","article-title":"Superwoman Schema: African American Women's Views on Stress, Strength, and Health","volume":"20","author":"Woods-Giscomb\u00e9","year":"2010","journal-title":"Qual. Health Res."},{"key":"B51","doi-asserted-by":"publisher","first-page":"e14325","DOI":"10.2196\/14325","article-title":"Mapping ICD-10 and ICD-10-CM Codes to Phecodes: Workflow Development and Initial Evaluation","volume":"7","author":"Wu","year":"2019","journal-title":"JMIR Med. Inform."},{"key":"B52","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1126\/science.aac4951","article-title":"Taking Race Out of Human Genetics","volume":"351","author":"Yudell","year":"2016","journal-title":"Science"},{"key":"B53","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1093\/eurheartj\/ehq103","article-title":"C-reactive Protein and All-Cause Mortality-Tthe Copenhagen City Heart Study","volume":"31","author":"Zacho","year":"2010","journal-title":"Eur. Heart J."}],"container-title":["Frontiers in Genetics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgene.2021.738485\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T12:30:18Z","timestamp":1634646618000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgene.2021.738485\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,18]]},"references-count":53,"alternative-id":["10.3389\/fgene.2021.738485"],"URL":"https:\/\/doi.org\/10.3389\/fgene.2021.738485","relation":{},"ISSN":["1664-8021"],"issn-type":[{"value":"1664-8021","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,18]]},"article-number":"738485"}}