Early life, life course and gender influences on levels of C-reactive protein among migrant Bangladeshis in the UK

Khurshida Begum; Gillian D Cooper; Nasima Akhter; Papreen Nahar; Adetayo Kasim; Gillian R Bentley

doi:10.1093/emph/eoab041

Early life, life course and gender influences on levels of C-reactive protein among migrant Bangladeshis in the UK

Evol Med Public Health. 2021 Nov 27;10(1):21-35. doi: 10.1093/emph/eoab041. eCollection 2022.

Authors

Khurshida Begum¹, Gillian D Cooper¹, Nasima Akhter¹, Papreen Nahar^{1

2}, Adetayo Kasim^{1

3

4}, Gillian R Bentley¹

Affiliations

¹ Department of Anthropology, Durham University, Dawson Building, South Road, Durham DH1 3LE, UK.
² Department of Global Health and Infection, University of Sussex, BSMS Teaching Building, Brighton BN1 9PX, East Sussex, UK.
³ Durham Research Methods Centre, Faculty of Social Sciences & Health, Durham University, Arthur Holmes Building, Durham DH1 3LE, UK.
⁴ UCB Pharmaceuticals, 216 Bath Road, Slough SL1 3WE, UK.

Abstract

Background and objectives: Humans co-evolved with pathogens, especially helminths, that educate the immune system during development and lower inflammatory responses. The absence of such stimuli in industrialized countries is associated with higher baseline levels of C-reactive protein (CRP) among adults who appear at greater risk for inflammatory disorders. This cross-sectional study examined effects of early life development on salivary CRP levels in 452 British-Bangladeshis who spent varying periods growing up in Bangladesh or UK. We also analyzed how gender and central obesity modulate effects on CRP. We hypothesized that: (i) first-generation Bangladeshis with higher childhood exposure to pathogens would have chronically lower CRP levels than second-generation British-Bangladeshis; (ii) effects would be greater with early childhoods in Bangladesh; (iii) effects by gender would differ; and (iv) increasing obesity would mitigate early life effects.

Methodology: Saliva samples were assayed for CRP using ELISAs, and anthropometric data collected. Participants completed questionnaires about demographic, socioeconomic, lifestyle and health histories. Data were analyzed using multiple linear regression.

Results: First-generation migrants who spent early childhoods in mostly rural, unhygienic areas, and moved to UK after age 8, had lower salivary CRP compared to the second-generation. Effects differed by gender, while waist circumference predicted higher CRP levels. CRP increased with years in UK, alongside growing obesity.

Conclusions and implications: Our study supports the hypothesis that pathogen exposure in early life lowers inflammatory responses in adults. However, protective effects differed by gender and can be eroded by growing obesity across the life course which elevates risks for other inflammatory disorders. Lay Summary: Migrants to the UK who spent early childhoods in less hygienic environments in Bangladesh that help to educate their immune systems had lower levels of the inflammatory marker, C-reactive protein (CRP) compared to migrants who grew up in UK. Both gender and increasing obesity were associated with increased levels of CRP.

Keywords: Bangladeshi migrants; C-reactive protein; early life development; gender; inflammation; obesity.