A
Inflammatory Biomarkers and Cardiovascular Risk
Ridker PM • J Am Coll Cardiol • 2007
hsCRP independently predicts myocardial infarction, stroke, diabetes, and all-cause mortality
cardiovascular diseaseInflammationmortality
Scientific References
The research behind Metabolicum's evidence-based approach
How We Evaluate Evidence
Not all research is equal. We assign confidence grades to each source based on study design, sample size, replication status, and methodology. This helps you understand how confident you can be in each finding.
Grade A
High Confidence
Replicated findings across multiple well-designed studies
Grade B
Good Confidence
Well-designed single studies with strong methodology
Grade C
Moderate Confidence
Observational data with consistent patterns
Grade D
Emerging Evidence
Mechanistic or theoretical - interpret cautiously
Grade E
Clinical Consensus
Practitioner experience without formal trials
Understanding the Reproducibility Crisis
Why are we so careful about evidence grading? Because a significant portion of published research fails to replicate.
| Study | Finding | Grade |
|---|---|---|
| Begley & Ellis, 2012 | Only 21% of landmark cancer studies could be replicated | A |
| Open Science Collaboration, 2015 | Only 36% of psychology studies replicated | A |
| Ioannidis, 2005 | Theoretical framework explaining why most findings are false | A |
This doesn't mean you should distrust all research. It means:
- •Single studies warrant caution — Replication matters
- •Peer review is necessary but not sufficient — Many peer-reviewed findings are later overturned
- •Effect size matters more than p-values — Statistical significance ≠ practical importance
- •Longer studies are generally more reliable — Short-term biomarker changes may not reflect long-term outcomes
We grade evidence honestly so you can calibrate your confidence appropriately.
Research Library
In-depth analysis of foundational studies with translated summaries
Showing studies cited on: hsCRP Guide
Showing 10 studies
Meta-Analysis
A
JUPITER Trial: Statin Therapy for Elevated CRP
Ridker PM, Danielson E, Fonseca FA, et al. • N Engl J Med • 2008
Statin therapy reduces cardiovascular events by 44% in people with elevated CRP and normal LDL
cardiovascular diseaseInflammationstatins
A
AHA/CDC Scientific Statement on Inflammatory Markers
Pearson TA, Mensah GA, Alexander RW, et al. • Circulation • 2003
AHA/CDC endorses hsCRP for cardiovascular risk stratification in intermediate-risk patients
cardiovascular diseaseInflammationguidelines
A
C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis
Emerging Risk Factors Collaboration • Lancet • 2010
Per 3-fold higher CRP: CHD HR 1.37 (1.27-1.48), ischaemic stroke HR 1.27 (1.15-1.40), vascular mortality HR 1.55 (1.37-1.76) after adjustment
hscrpCardiovascularInflammation
E
Omega-3 Fatty Acids and Inflammatory Processes
Calder PC • Nutrients • 2010
Effective anti-inflammatory effects require >2g EPA+DHA daily; EPA-derived eicosanoids 10-100 fold less potent as inflammatory mediators; new steady-state reached within ~4 weeks
hscrpomega 3Inflammation
A
Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation
Irwin MR, et al • Biological Psychiatry • 2016
Sleep disturbance associated with elevated CRP (effect size 0.12) and IL-6 (effect size 0.20); long sleep duration associated with higher CRP (effect size 0.17)
hscrpInflammationsleep
A
Mediterranean Diet and Vascular Inflammation
Esposito K, Marfella R, Ciotola M, et al. • JAMA • 2004
Mediterranean diet significantly reduces hsCRP and other inflammatory markers
dietInflammationcardiovascular disease
B
Low-Carb vs Low-Fat Diets and Inflammation
Forsythe CE, Phinney SD, Fernandez ML, et al. • Lipids • 2008
Low-carbohydrate diets may reduce inflammatory markers more effectively than low-fat diets
dietlow carbInflammation
A
Weight Loss and CRP: Systematic Review
Selvin E, Paynter NP, Erlinger TP • Arch Intern Med • 2007
Weight loss reduces CRP levels proportionally to the degree of weight lost
weight lossInflammationObesity
E
Low-grade inflammation, diet composition and health: current research evidence and its translation
Minihane AM, et al • British Journal of Nutrition • 2015
An unresolved inflammatory response is likely involved from early stages of disease development; current fasting inflammatory markers represent an insensitive and highly variable index of tissue inflammation
hscrpInflammationdiet+1 more
How We Use References
In Calculators
Primary thresholds come from Grade A sources. When Grade A evidence suggests a range rather than a single value, we present the range with context.
In Educational Content
We draw on Grades A-C for educational claims, clearly labeling evidence quality. Grade D and E content is marked as theoretical or practitioner-derived.
In Paradigm Frameworks
- Standard Medical: Grade A (established guidelines)
- Research Consensus: Grade A-B (outcome research)
- Metabolic Optimization: Grade B-E (intervention research + clinical consensus)
Related Pages
Evidence Grades
Grade A: High ConfidenceReplicated findings across multiple studiesGrade B: Good ConfidenceWell-designed single studiesGrade C: Moderate ConfidenceObservational data with consistent patternsGrade D: Emerging EvidenceMechanistic or theoreticalGrade E: Clinical ConsensusPractitioner consensus
Other Pages
This bibliography contains the research supporting Metabolicum's evidence-based approach.
Last comprehensive review: December 2025