Confounders in Identification and Analysis of Inflammatory Biomarkers in Cardiovascular Diseases

Biomolecules. 2021 Oct 5;11(10):1464. doi: 10.3390/biom11101464.

Abstract

Proinflammatory biomarkers have been increasingly used in epidemiologic and intervention studies over the past decades to evaluate and identify an association of systemic inflammation with cardiovascular diseases. Although there is a strong correlation between the elevated level of inflammatory biomarkers and the pathology of various cardiovascular diseases, the mechanisms of the underlying cause are unclear. Identification of pro-inflammatory biomarkers such as cytokines, chemokines, acute phase proteins, and other soluble immune factors can help in the early diagnosis of disease. The presence of certain confounding factors such as variations in age, sex, socio-economic status, body mass index, medication and other substance use, and medical illness, as well as inconsistencies in methodological practices such as sample collection, assaying, and data cleaning and transformation, may contribute to variations in results. The purpose of the review is to identify and summarize the effect of demographic factors, epidemiological factors, medication use, and analytical and pre-analytical factors with a panel of inflammatory biomarkers CRP, IL-1b, IL-6, TNFa, and the soluble TNF receptors on the concentration of these inflammatory biomarkers in serum.

Keywords: acute-phase proteins; chemokines; confounding factors; cytokines; demographic factors; epidemiological factors; inflammation; pre-analytical factors; pro-inflammatory biomarkers.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers / blood*
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / genetics
  • Humans
  • Immunologic Factors / blood*
  • Inflammation / blood*
  • Inflammation / diagnosis
  • Inflammation / genetics
  • Interleukin-1beta / blood
  • Interleukin-6 / blood
  • Receptors, Tumor Necrosis Factor / blood
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Biomarkers
  • IL1B protein, human
  • Immunologic Factors
  • Interleukin-1beta
  • Interleukin-6
  • Receptors, Tumor Necrosis Factor
  • TNF protein, human
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein