Wakugawa Yoshiyuki, Kiyohara Yutaka, Tanizaki Yumihiro, Kubo Michiaki, Ninomiya Toshiharu, Hata Jun, Doi Yasufumi, Okubo Ken, Oishi Yoshinori, Shikata Kentaro, Yonemoto Koji, Maebuchi Daisuke, Ibayashi Setsuro, Iida Mitsuo
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City 812-8582, Japan.
Stroke. 2006 Jan;37(1):27-32. doi: 10.1161/01.STR.0000194958.88216.87. Epub 2005 Nov 23.
The role of high-sensitivity C-reactive protein (hsCRP) in the development of stroke is not clearly understood. We investigated the relationship between serum hsCRP levels and stroke occurrence in a general Japanese population.
We followed 2692 subjects > or =40 years of age for 12 years. The relative risks and 95% CIs for ischemic and hemorrhagic stroke occurrence were calculated according to the hsCRP quintiles.
During the follow-up, 129 first-ever ischemic and 59 hemorrhagic strokes occurred. In men, the age-adjusted incidence of ischemic stroke significantly increased with elevated serum hsCRP levels; the difference between the first and fifth quintiles was statistically significant (1.4 versus 6.6 per 1000 person-years; P=0.02). This association remained significant even after adjustment for other confounding factors, such as age, systolic blood pressure, ECG abnormalities, diabetes, body mass index, total cholesterol, high-density lipoprotein cholesterol, smoking habits, alcohol intake, and regular exercise (adjusted relative risks, 3.11; 95% CI, 1.04 to 9.32; P=0.04). However, such associations were not observed for ischemic stroke in women or in hemorrhagic stroke in either sex. Among male subjects who were both in the fifth hsCRP level and had hypertension, diabetes, obesity, hypercholesterolemia, or a smoking habit, the risk of ischemic stroke was extremely increased, even after adjustment for other risk factors.
Our findings suggest that elevated serum hsCRP levels are an independent risk factor for future ischemic stroke in Japanese men and that the coexistence of a high hsCRP level with another risk factor extremely increases the risk of ischemic stroke.
高敏C反应蛋白（hsCRP）在中风发生过程中的作用尚未完全明确。我们调查了日本普通人群血清hsCRP水平与中风发生之间的关系。
我们对2692名年龄≥40岁的受试者进行了12年的随访。根据hsCRP五分位数计算缺血性和出血性中风发生的相对风险及95%可信区间。
随访期间，发生了129例首次缺血性中风和59例出血性中风。在男性中，随着血清hsCRP水平升高，年龄调整后的缺血性中风发病率显著增加；第一和第五五分位数之间的差异具有统计学意义（每1000人年分别为1.4例和6.6例；P=0.02）。即使在调整了其他混杂因素后，这种关联仍然显著，这些因素包括年龄、收缩压、心电图异常、糖尿病、体重指数、总胆固醇、高密度脂蛋白胆固醇、吸烟习惯、饮酒量和规律运动（调整后的相对风险为3.11；95%可信区间为1.04至9.32；P=）。然而，在女性缺血性中风或任何性别出血性中风中均未观察到这种关联。在hsCRP水平处于第五分位数且患有高血压、糖尿病、肥胖症、高胆固醇血症或有吸烟习惯的男性受试者中，即使调整了其他风险因素，缺血性中风的风险仍极度增加。
我们的研究结果表明，血清hsCRP水平升高是日本男性未来发生缺血性中风的独立危险因素，且hsCRP水平升高与另一个危险因素并存会极度增加缺血性中风的风险。
