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C-Reactive Protein Mediates the Effect of Serum Progesterone on Obesity for Men and Postmenopausal Women in Henan Rural Cohort Study

Authors Nie L, Wei D, Liu P, Zhang L, Fan K, Song Y, Wang M, Wang L, Xu Q, Wang J, Liu X, Li L, Mao Z, Huang H, Wang C, Huo W

Received 25 November 2020

Accepted for publication 3 February 2021

Published 4 March 2021 Volume 2021:14 Pages 633—644

DOI https://doi.org/10.2147/JIR.S293882

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Ning Quan


Luting Nie,1,* Dandan Wei,2,* Pengling Liu,2 Li Zhang,2 Keliang Fan,2 Yu Song,1 Mian Wang,1 Lulu Wang,2 Qingqing Xu,2 Juan Wang,2 Xiaotian Liu,2 Linlin Li,2 Zhenxing Mao,2 Hui Huang,1 Chongjian Wang,2 Wenqian Huo1

1Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wenqian Huo
Department of Occupational and Environmental Health Sciences, 100 Kexue Avenue, Zhengzhou, Henan, 450001, People’s Republic of China
Tel +86 371 67781452
Fax +86 371 67781868
Email [email protected]

Purpose: Studies of progesterone with obesity have been lacking, and no prior studies have investigated progesterone and C-reactive protein in rural natural populations. This study aimed to investigate the association of serum progesterone with obesity based on anthropometric parameters in Henan Rural Cohort, then further to explore the potential role of C-reactive protein in this association.
Patients and Methods: A total of 4687 participants (2474 men and 2213 postmenopausal women) from the Henan Rural Cohort study were included. Logistic regression analysis, linear regression analysis, and restricted cubic splines were performed to estimate the relationships between progesterone, C-reactive protein, obesity, and obesity-related parameters. Mediation analysis was carried out to assess the intermediary role of C-reactive protein played in the association between progesterone and obesity.
Results: After controlling for confounders, the odds ratios of obesity no matter how obesity was defined was associated with progesterone (P trend < 0.05). Moreover, progesterone was related to obesity-related parameters. Also, C-reactive protein increased with the elevation of progesterone, and C-reactive protein was associated with obesity no matter how obesity was defined (P trend < 0.001). Mediation analysis indicated that hsCRP had the mediating effects on the obesity, and the proportion of the effects were 15.35% and full mediating effect (defined by body mass index), 15.46% and 12.24% (defined by waist circumference), 19.14% and 12.12% (defined by waist-to-hip ratio), 23.81% and 15.09% (defined by waist-to-height ratio) for men and postmenopausal women, relatively.
Conclusion: In the Chinese rural men and postmenopausal women population, progesterone and C-reactive protein are related to obesity. We firstly found C-reactive protein partly mediates the effect of progesterone on obesity, indicating that systemic inflammation played a critical role in the association.

Keywords: sex hormone, obesity, C-reactive protein, mediation effect

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