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Biomarkers

Inflammatory markers

Blood substances (hs-CRP, interleukins, ESR) that indicate chronic inflammation — a key mechanism of aging and most chronic diseases.

Inflammatory markers — a set of test tubes: CRP, ESR, IL-6, fibrinogen

Inflammatory markers are blood substances whose concentration changes with inflammation. They are called acute-phase proteins: the liver releases them in response to a signal from cytokines, above all interleukin-6.

In preventive medicine what matters is not vivid acute inflammation but chronic low-grade ("silent") inflammation — the very inflammaging that smolders for years, accelerates atherosclerosis and aging, and raises the risk of many diseases.

The main markers

C-reactive protein (CRP) is the fastest and most accurate; its sensitive version hs-CRP is used to assess cardiac risk. ESR is an old indirect indicator that reflects fibrinogen. Fibrinogen and ferritin also rise with inflammation. Among cytokines the key ones are IL-6 and TNF-α.

There are also "reverse" markers: with inflammation albumin and transferrin, on the contrary, fall.

Inflammation, aging and vessels

Chronic inflammation is a common denominator of aging. Persistently elevated CRP, IL-6 and TNF are associated with higher mortality: a simple index of IL-6 and the soluble TNF receptor predicts 10-year mortality in older adults. Inflammation is also built into the "aging clocks" — PhenoAge uses CRP as one of its components.

In the vessels, inflammation destabilizes plaques, so inflammatory markers complement the classic cardiovascular risk factors.

Reference ranges

Approximate reference values of the main inflammatory markers in adults:

CRPup to 5 mg/L
hs-CRP (cardiovascular risk)under 1 mg/L — low
ESR, men0 – 15 mm/h
ESR, women0 – 20 mm/h
Fibrinogen2 – 4 g/L
Important: Reference ranges depend on the laboratory, age and sex; a single elevation is nonspecific and requires context.

Calculate using this marker

Calculators where Inflammation markers is used directly:

PhenoAge (Levine) Nine blood markers — the formula from Morgan Levine et al., 2018 Open Metabolic Syndrome IDF/NCEP criteria — waist circumference, blood pressure, glucose, and lipids Open

Frequently asked questions

Which inflammatory marker is the best?

There is no universal one. For acute conditions CRP is more informative (it rises and falls quickly), for cardiac risk it is hs-CRP, and for monitoring rheumatic diseases ESR and CRP are often looked at together. The choice depends on the clinical question.

Elevated CRP without symptoms — what to do?

First rule out a recent infection or injury and retest after 2 weeks. If hs-CRP is persistently elevated in an otherwise healthy person, it is a marker of cardiovascular and metabolic risk — a reason to work on lifestyle and discuss further testing.

Related terms

C-reactive protein A marker of inflammation in the body hs-C-reactive protein High-sensitivity CRP — a marker of cardiovascular risk ASCVD (Atherosclerotic cardiovascular disease) Atherosclerotic Cardiovascular Disease — the group of conditions caused by atherosclerosis: heart attack, stroke, coronary heart disease. Atherosclerosis The buildup of cholesterol plaques in artery walls — the main cause of heart attacks and strokes. PhenoAge Phenotypic biological age from 9 blood markers Mortality risk ratio How many times higher the risk of death is than at a normal weight Oxidative stress An imbalance of free radicals and antioxidants — it damages neurons and accelerates aging CVD Cardiovascular disease Glycans Sugar molecules on the surface of proteins — a marker of inflammation and biological age

Sources

  1. StatPearls — Acute-Phase Reactants
  2. StatPearls — C-Reactive Protein
  3. Varadhan R, et al. Inflammatory index predicts 10-year mortality, J Gerontol A (2013)
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This content is educational and does not replace consultation with a physician. Reference ranges may vary depending on the laboratory and method — rely on the ranges stated on your own test report.
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