New analysis links excess body fat to doubled hs-CRP levels

High-sensitivity C-reactive protein (hs-CRP) levels nearly doubled in individuals classified at stage 1 of cardiovascular-kidney-metabolic (CKM) syndrome, according to a new analysis of US national health data. The study, conducted by researchers from the University of Eastern Finland and Rutgers Robert Wood Johnson Medical School, identifies this earliest phase—defined by excess or unhealthy body fat—as having the most significant inflammatory increase compared to those with no metabolic risk factors.

Inflammation spikes at first stage

The American Heart Association introduced CKM syndrome in 2023 to describe the link between heart disease, kidney disease, obesity, and type 2 diabetes. The condition progresses from stage 0 (no risk factors) through stage 1 (excess or unhealthy body fat), stage 2 (conditions such as high blood pressure, diabetes, or kidney disease), to stages 3 and 4 (early and established heart disease). While hs-CRP rises across all stages, the largest jump occurs between stage 0 and stage 1.

Data drawn from 4,315 adults in the 2015 to 2018 National Health and Nutrition Examination Survey (NHANES) showed that average hs-CRP crossed the 2 mg/L threshold commonly used to signal increased cardiovascular risk during this initial transition. From stage 1 onward, average levels remained above this mark, rising only modestly at stage 2 before leveling off. Participants had an average age of 48 years, and half were women.

Early warning signs identified

"What stood out to us is that inflammation was already elevated at the very first stage, before people had developed diabetes, kidney disease or heart disease, which is where we may have the most room to change the course," said lead author Douglas R. Corsi, MD, a physician at Rutgers Robert Wood Johnson Medical School and a PhD student at the University of Eastern Finland.

The findings suggest that inflammation is present at the onset of CKM syndrome. However, because the study analyzed data from a single point in time, it demonstrates an association rather than proving that inflammation drives the syndrome forward. Longitudinal studies and trials testing early prevention are now required to establish causality.

Prevention strategies proposed

Senior author Andrew Agbaje, MD, MPH, PhD, Associate Professor (Docent) of Clinical Epidemiology and Child Health at the University of Eastern Finland, noted that hs-CRP serves best as an easy-to-measure warning sign of underlying inflammation rather than a direct treatment target. He argued that the data supports early prevention efforts, either by treating inflammation directly or by reducing excess body fat through lifestyle and dietary changes while tracking risk with inexpensive blood tests like hs-CRP.

The research was published open access in the European Journal of Preventive Cardiology and presented at the European Society of Cardiology Congress 2026. The journal reference is Corsi, D. R., et al. (2026). High-sensitivity C-reactive protein across the cardiovascular–kidney–metabolic syndrome spectrum: a nationally representative, survey-weighted analysis of US adults. European Journal of Preventive Cardiology. DOI: 10.1093/eurjpc/zwag476.