**Author details**

a population of 2484 individuals, researchers concluded that CRP was an important predictive value for cardiovascular mortality, especially in association with other risk factors such as obesity. Other recent studies have shown a direct association between elevated plasma levels of hs-CRP and the occurrence of cardiovascular accidents, both in individuals without cardiovascular disease [36, 37], and in individuals with previous cardiovascular disease [38]. In this sense, hs-CRP has demonstrated to be a sensitive and specific marker for early identification of individuals with cardiovascular risk, especially among obese subjects [39]. On the other hand, prospective studies show that CRP levels in the general population and especially in obese subjects is a strong predictor of future coronary events, stroke, peripheral artery disease, congestive heart failure, and cardiovascular mortality in general [40], with a continuous gradient of cardiovascular risk over the whole of their serum levels. In addition, serum levels of CRP may be an indicator of subclinical atherosclerosis, correlating its concentration with intima-media thickness [41] and with the calcification degree of the coronary arteries [42]. Pande et al. [43], in their study with a population of 3000 patients, described higher levels of CRP in patients with peripheral arterial disease. Ridker et al. [44], from a population greater than 13,000 subjects and assessing different inflammatory markers, including CRP, also found a statistically significant correlation between CRP levels and the risk of peripheral arterial disease. In addition, in a five-year follow-up in a small cohort of 150 patients, the authors conclude that those subjects who developed peripheral artery disease had higher average CRP values during the monitoring period. In this sense, Vainas et al. [45], in a sample greater than 300 patients with peripheral arterial disease, they conclude that the severity of

In the recent study, Gaillard et al. [46] were studied 1116 pregnant women with obesity. The study was developed during the second trimester of pregnancy and evaluated the serum levels of CRP in the mothers and fetus's fat mass. The authors concluded that higher second-trimester maternal CRP level was associated with higher mid-childhood overall and central adiposity.

Other studies have shown that the obesity is a negative prognostic factor after diagnosis of breast cancer [47]. There are evidences that propose a greater amount of adipose tissue will increase the susceptibility of the patients to metastasis development [48]. Several mechanisms have been proposed to explain the adverse effect of obesity on survival among women with breast cancer, including alteration in cytokines profiles such as CRP [49]. In this sense, alteration in acute phase proteins such us CRP in obese patients may exaggerate the inflammation status [47]. Owing to the fact that the inflammation has the potential to prone the patients toward later distant metastasis, it is necessary to regulate and control the levels of CRP among other cytokines. Nevertheless, the exact mechanisms in which obesity and CRP levels may influence breast cancer are not well known and need more research for its clarifying [47].

In conclusion, the available scientific evidence justifies the need to include determining the values of hs-CRP among clinical screening tests on obese subjects to evaluate the cardiovas-

peripheral arterial disease was correlated with serum CRP levels.

76 Adiposity - Omics and Molecular Understanding

**4. Conclusions**

Emilio González-Jiménez\*

Address all correspondence to: emigoji@ugr.es

Department of Nursing, Faculty of Health Science, University of Granada, Spain
