European Journal of Cardiovascular Medicine

Overweight and obesity continue to rise globally, influenced by reduced physical activity and calorie-dense dietary patterns. These conditions lead to excessive adipose accumulation and are closely linked with cardiometabolic disturbances that increase long-term cardiovascular morbidity and mortality. One of the key metabolic alterations seen in such individuals is dyslipidemia, characterized by elevated low-density lipoprotein cholesterol, lowered high-density lipoprotein cholesterol, and increased triglyceride concentrations, all of which contribute directly to atherosclerotic plaque formation and vascular injury [1,2].

Beyond lipid imbalance, obesity is now recognized as a chronic low-grade inflammatory state. Visceral adipose tissue behaves as an active endocrine organ, releasing pro-inflammatory cytokines that stimulate hepatic synthesis of C-reactive protein. High-sensitivity C-reactive protein (hs-CRP) therefore serves as a sensitive marker of this inflammatory load and has been associated with endothelial dysfunction and heightened cardiovascular risk even in the absence of overt clinical disease [3,4].

Understanding the interaction between dyslipidemia and inflammation is important for effective early risk assessment in overweight and obese adults. Measuring hs-CRP alongside lipid profile evaluation can offer a more comprehensive picture of metabolic health, enabling clinicians to identify individuals who may benefit from early intervention strategies aimed at lifestyle modification and targeted prevention [5].

The present study was designed to assess the pattern of dyslipidemia in overweight and obese adults and to determine its association with hs-CRP levels. By examining both lipid abnormalities and inflammatory status, this study aims to offer insight into the early metabolic risk profile of this population and highlight the importance of timely intervention.

This cross-sectional study was carried out at the Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, in collaboration with Vishnu Dental College, Bhimavaram. The study was conducted over a period of January 2024 to May 2024.

Study Population

Adults aged 18–60 years with BMI ≥25 kg/m² (overweight or obese) attending the outpatient departments of the participating institutions were considered for inclusion. Individuals with a known history of chronic inflammatory disease, acute infections, liver or renal failure, hypothyroidism, pregnancy, ongoing lipid-lowering therapy, or recent major illness were excluded to avoid confounding effects on lipid and inflammatory markers.

Sample Size

A total of 100 participants who fulfilled the inclusion criteria and provided informed consent were enrolled.

Data Collection

Demographic details such as age and gender were recorded. Anthropometric measurements included:

• Height (measured to the nearest 0.1 cm)
• Weight (measured to the nearest 0.1 kg)
• BMI calculated as weight (kg) / height (m²)
• Participants were classified as:
• Overweight: BMI 25–29.9 kg/m²
• Obese: BMI ≥30 kg/m²

Laboratory Investigations

Fasting blood samples (after an overnight fast of 10–12 hours) were collected to estimate:

• Total Cholesterol
• LDL-C
• HDL-C
• Triglycerides
• High-sensitivity C-reactive protein (hs-CRP)
• Lipid profile measurements were performed using an automated enzymatic method. hs-CRP levels were determined using a high-sensitivity immunoturbidimetric assay.

Definitions Used

Dyslipidemia was defined as per NCEP-ATP III criteria:

• LDL-C >130 mg/dL
• HDL-C <40 mg/dL (males) or <50 mg/dL (females)
• Triglycerides >150 mg/dL
• Mixed dyslipidemia: presence of two or more abnormalities.

Statistical Analysis

Data were entered into Microsoft Excel and analyzed using SPSS software (version 25.0). Continuous variables were expressed as mean ± standard deviation. Comparison of mean hs-CRP levels between overweight and obese groups was performed using the Student’s t-test. Associations between hs-CRP and lipid parameters were assessed using Pearson’s correlation coefficient. A p-value <0.05 was considered statistically significant.

Ethical Considerations

The study protocol was approved by the Institutional Ethics Committee, KIMS,Amalapuram. Informed written consent was obtained from all participants before inclusion in the study.

A total of 100 overweight and obese adults were included in the present study. The mean age of the participants was 42.6 ± 9.8 years. Females constituted a slightly higher proportion (58%) compared to males (42%). Based on BMI classification, 64% of individuals were categorized as overweight and 36% as obese. The baseline characteristics of the study population are presented in Table 1.

Table 1: Baseline Demographic Characteristics of the Study Participants (n = 100)

Dyslipidemia was common in the study group, with an overall prevalence of 72%. Elevated LDL-C levels were observed in 61% of participants, while low HDL-C levels were present in 48%. Hypertriglyceridemia was noted in 38% of the individuals. Mixed dyslipidemia, defined by the presence of two or more lipid abnormalities, was found in 29% of participants. The distribution of dyslipidemia patterns is shown in Table 2.

Table 2: Pattern of Dyslipidemia Among Participants (n = 100)

Figure 1.Pattern of Dyslipidemia Among Participants

The mean hs-CRP values showed a rising trend with increasing BMI. Obese individuals demonstrated significantly higher hs-CRP levels (5.6 ± 2.3 mg/L) compared to the overweight group (4.1 ± 1.8 mg/L), and this difference was statistically significant (p < 0.05). These findings are summarized in Table 3.

Table 3: Comparison of Mean hs-CRP Levels Based on BMI Category

Correlation analysis indicated that hs-CRP had a positive relationship with LDL-C (r = 0.42, p < 0.01) and triglycerides (r = 0.39, p < 0.01), suggesting that individuals with higher lipid derangements tended to have higher inflammatory status. In contrast, hs-CRP showed a negative correlation with HDL-C (r = –0.36, p < 0.01). These correlations are detailed in Table 4.

Table 4: Correlation Between hs-CRP and Lipid Profile Parameters

The present study demonstrated that a large proportion of overweight and obese adults exhibited dyslipidemia, and hs-CRP levels increased progressively with rising BMI. This pattern reflects the deeper metabolic and inflammatory disturbances linked with excess adiposity. Elevated LDL-C and reduced HDL-C were common in our participants, which is consistent with the dyslipidemic profile typically associated with obesity and its contribution to atherogenesis [6]. Low HDL-C in particular weakens reverse cholesterol transport and impairs vascular protection.

The significantly higher hs-CRP levels observed in obese individuals reinforce the view that adipose tissue functions as an active endocrine organ releasing pro-inflammatory cytokines, especially from visceral fat stores [7]. These cytokines promote hepatic production of CRP, making hs-CRP a sensitive marker of chronic, low-grade inflammation linked to obesity. Such inflammatory activation has been implicated in endothelial dysfunction, insulin resistance, and accelerated atherosclerosis [8].

The positive correlations between hs-CRP and LDL-C as well as triglycerides in our study further illustrate the interdependence of lipid derangements and inflammation. In contrast, the inverse relationship between hs-CRP and HDL-C aligns with the established anti-inflammatory and antioxidant roles of HDL particles [9]. These findings support the concept that inflammation and lipid metabolism are interconnected biological processes rather than isolated pathways.

Mixed dyslipidemia, present in nearly one-third of participants, was associated with the highest hs-CRP levels, suggesting an additive inflammatory burden when multiple lipid abnormalities coexist. Patients with such profiles may have substantially greater long-term cardiovascular risk and may require early and sustained intervention strategies. Lifestyle changes, including structured physical activity and dietary modification, remain the foundation of treatment. However, individuals who do not achieve adequate improvement may benefit from targeted pharmacological therapies that address both lipid imbalance and inflammatory activation [10-12].

Limitations

This study was limited by its cross-sectional design, which restricts causal inference. The sample size was modest and drawn from a single geographic region, limiting generalizability. Dietary habits, physical activity levels, and body fat distribution were not assessed, which may have influenced lipid profile and inflammatory marker variations.

This study found a high prevalence of dyslipidemia among overweight and obese adults, with elevated LDL-C and reduced HDL-C being the most frequent abnormalities. hs-CRP levels were significantly higher in obese individuals, and a clear association was noted between rising inflammatory marker levels and worsening lipid profile. These findings suggest that lipid imbalance and systemic inflammation progress together in individuals with excess body weight. Assessing hs-CRP along with routine lipid evaluation may help in early identification of those at greater cardiometabolic risk. Strengthening lifestyle modification, weight management, dietary restructuring, and timely clinical intervention is essential to reduce long-term cardiovascular complications in this population.

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