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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:1640.)
© 2003 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Strikingly Low Circulating CRP Concentrations in Ultramarathon Runners Independent of Markers of Adiposity

How Low Can You Go?

Maciej Tomaszewski; Fadi J. Charchar; Malgorzata Przybycin; Lynne Crawford; A. Michael Wallace; Katarzyna Gosek; Gordon D. Lowe; Ewa Zukowska-Szczechowska; Wladyslaw Grzeszczak; Naveed Sattar; Anna F. Dominiczak

From the British Heart Foundation Glasgow Cardiovascular Research Centre (M.T., F.J.C., A.F.D.), Division of Cardiovascular and Medical Sciences, University of Glasgow, UK; Department of Internal Medicine (M.T., M.P., K.G., E.Z.-S., W.G.), Diabetology and Nephrology, Medical University of Silesia, Zabrze, Poland; and Department of Pathological Biochemistry (L.C., A.M.W., G.D.L., N.S.), University of Glasgow, UK.

Correspondence to Dr Maciej Tomaszewski, BHF Glasgow Cardiovascular Research Centre, Division of Cardiovascular and Medical Sciences, University of Glasgow, Western Infirmary, G11 6NT, Glasgow, UK. E-mail mt65{at}clinmed.gla.ac.uk

Objective— This study was undertaken to evaluate to what extent C-reactive protein (CRP) can be reduced by exercise by examining its circulating concentrations in male ultramarathon runners and to determine if low leptin as a robust circulating marker of fat mass could account for low CRP in such men.

Methods and Results— Sixty-seven male ultramarathon runners and 63 sedentary male controls of similar age and body mass index were recruited. CRP and leptin were measured by ELISA and radioimmunoassay, respectively. Median CRP concentration in lean (body mass index <25 kg/m²) marathon runners was less than half control median (0.4 [0.2 to 0.9] mg/L versus 0.9 [0.5 to 2.7] mg/L, P=0.0013) and, more strikingly, in nonlean runners was approximately 26% of control median (0.4 [0.3 to 0.8] mg/L versus 1.5 [0.9 to 2.5] mg/L, P=0.0002). Circulating leptin levels were also substantially lower in lean (45% less) and nonlean (63% less, both P<0.0001) ultramarathon runners. However, interleukin-6 levels were not different. Furthermore, leptin adjustment only minimally attenuated the case-control difference in CRP, suggesting that mechanisms other than fat mass reduction contribute to low concentrations of CRP in marathon runners.

Conclusions— This study suggests that circulating CRP concentrations can be markedly suppressed, independently of total adiposity or indeed fat mass, by intense regular physical exercise.

Key Words: exercise • inflammation • leptin • C-reactive protein • cardiovascular risk

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