Serum C-reactive protein even at very low (<1.0 mg/l) concentration is associated with physical performance in a community-based elderly population aged 70 years and over

Background: Although several studies have reported that C-reactive protein (CRP) is associated with physical performance, few studies have evaluated the relationships between CRP and physical performance among subjects who had a very low range of CRP. Therefore, it is still unclear whether a lower CRP is favorably associated with physical performance even within a very low range. Objective: The aim of this study was to investigate the relationships between CRP and physical performance among a Japanese population with a low serum CRP concentration (CRP <1.0 mg/l). Methods: We designed a cross-sectional survey for 775 persons aged 70 years and older living in Japan. High-sensitivity CRP was measured using a nephelometric method. The subjects whose serum CRP concentrations were higher than 10.0 mg/l were excluded. Physical performance was assessed using a 10-meter maximum walk test, leg extension power, and a timed 'up and go' test. Results: The median value (interquartile range) of CRP was 0.55 (0.29-1.20) mg/l. After adjustment for potential confounding factors, an inverse relation of CRP with the 10-meter maximum walk test and leg power was observed in all subjects (p for trend = 0.10 and 0.04, respectively). For subjects who had a CRP <1.0 mg/l, these inverse relations were unchanged (p for trend = 0.03 and 0.02, respectively). Conclusions: Serum CRP concentration is favorably related to physical performance, even within a very low range in a community-based elderly population aged 70 years and over. The findings suggest that maintaining as low CRP levels as possible may potentially maintain better physical performance.