Cummings Doyle M, King Dana E, Mainous Arch G
Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA.
Ann Pharmacother. 2003 Nov;37(11):1593-7. doi: 10.1345/aph.1D029.
C-reactive protein (CRP) is an important biological marker of inflammation that has been linked to cardiovascular disease. The extent to which the inflammatory processes associated with elevated CRP concentrations impair physical functioning and quality of life, and whether this is modulated by hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) and aspirin, which have been shown to lower CRP concentrations, is unclear.
To determine whether an association exists between CRP concentrations and health-related quality of life among patients with diabetes, and to determine whether the association is affected by use of statins and nonsteroidal antiinflammatory drugs (NSAIDs).
A trained interviewer collected self-reported information regarding demographics, health-related quality of life (SF-12), and medication use, and a nurse collected a blood sample from 86 adult subjects with type 2 diabetes mellitus who were part of a larger population-based survey. The serum was analyzed for CRP using a highly sensitive assay.
In simple bivariate analysis, there was a significant inverse relationship between CRP and the physical health component score of health-related quality of life (Spearman correlation coefficient [r] = -0.26; p = 0.025). For subjects on statins (r = -0.44; p = 0.02; n = 27), this relationship persisted, while for patients on NSAIDs or aspirin (r = -0.21; p = 0.17; n = 44), no relationship was observed. Similar findings were observed with self-rated health alone as an outcome variable. However, stepwise linear regression revealed no consistent relationship between CRP and health-related quality of life (i.e., standardized SF-12 physical component score) when demographic variables, disease duration, glucose control, serum creatinine, smoking, and medication use were controlled for.
In multivariate regression modeling, the initial inverse relationship between CRP and health-related quality of life was lost, suggesting that other covariates are responsible for this association. While statins and NSAIDs may impact CRP or health-related quality of life independently, they do not appear to modulate a relationship between these factors.
C反应蛋白（CRP）是一种重要的炎症生物标志物，与心血管疾病有关。与CRP浓度升高相关的炎症过程在多大程度上损害身体功能和生活质量，以及这是否受到已被证明可降低CRP浓度的羟甲基戊二酰辅酶A还原酶抑制剂（他汀类药物）和阿司匹林的调节，目前尚不清楚。
确定糖尿病患者中CRP浓度与健康相关生活质量之间是否存在关联，并确定这种关联是否受他汀类药物和非甾体抗炎药（NSAIDs）使用的影响。
一名经过培训的访员收集了有关人口统计学、健康相关生活质量（SF - 12）和药物使用的自我报告信息，一名护士从86名2型糖尿病成年受试者中采集了血样，这些受试者是一项更大规模的基于人群的调查的一部分。使用高灵敏度检测方法分析血清中的CRP。
在简单的双变量分析中，CRP与健康相关生活质量的身体健康成分得分之间存在显著的负相关关系（斯皮尔曼相关系数[r] = -0.26；p = 0.025）。对于服用他汀类药物的受试者（r = -0.44；p = 0.02；n = 27），这种关系持续存在，而对于服用NSAIDs或阿司匹林的患者（r = -0.21；p = 0.17；n = 44），未观察到相关性。以自评健康作为唯一结果变量时也观察到了类似的结果。然而，当控制人口统计学变量、病程、血糖控制、血清肌酐、吸烟和药物使用时，逐步线性回归显示CRP与健康相关生活质量（即标准化的SF - 12身体成分得分）之间没有一致的关系。
在多变量回归模型中，CRP与健康相关生活质量之间最初的负相关关系消失了，这表明其他协变量导致了这种关联。虽然他汀类药物和NSAIDs可能独立影响CRP或健康相关生活质量，但它们似乎并未调节这些因素之间的关系。
