Shaaban Rafea, Kony Sabine, Driss Fathi, Leynaert Bénédicte, Soussan David, Pin Isabelle, Neukirch Françoise, Zureik Mahmoud
National Institute of Health and Medical Research (INSERM), Unit 700, Epidémiologie des Maladies Respiratoires, Faculté Xavier Bichat, BP 416, 16 rue Henri Huchard, 75018 Paris, France.
Respir Med. 2006 Dec;100(12):2112-20. doi: 10.1016/j.rmed.2006.03.027. Epub 2006 May 2.
Reduced pulmonary function is an important predictor of cardiovascular morbidity and mortality. The mechanisms underlying this association are unknown but may involve systemic inflammation. We assessed the cross-sectional and longitudinal relationships between C-reactive protein (CRP) levels and forced expiratory volume in 1s (FEV1) and its decline in the general population, over a period of 8.5 years. The analyzes were based on 531 subjects (mean age at baseline: 37+/-7 years, 50% women and 42% non-smokers), recruited at two French centers participating in the European Community Respiratory Health Survey. Lung function was expressed as a percentage of predicted FEV1. CRP was measured centrally, by means of a highly sensitive assay. In cross-sectional analysis, FEV1 as a % of predicted values was negatively associated with serum CRP concentration (P=0.002). Multivariate adjustment did not alter these results (P=0.002). In longitudinal analysis, annual FEV1 decline tended to increase from the lower to the upper tertile for baseline CRP concentration but the association was borderline significant (P=0.14). Mean values of annual FEV1 decline were 26+/-32, 31+/-32, and 34+/-32 ml/year for the lower, middle and upper tertiles of baseline CRP concentration, respectively, after adjusting for potential confounders (P=0.09). Changes in CRP levels during follow-up were associated with annual FEV1 decline. The mean annual FEV1 declines in subjects with increasing CRP, in those with stable CRP and in those with decreasing CRP were 36+/-31, 30+/-31 and 24+/-31 ml/year, respectively (P<0.001). These findings were not affected by adjustment for potential confounders (P=0.002). In conclusion, increases in CRP levels over time were associated with a steeper FEV1 decline.
肺功能降低是心血管疾病发病率和死亡率的重要预测指标。这种关联背后的机制尚不清楚，但可能涉及全身炎症。我们评估了在8.5年期间，C反应蛋白（CRP）水平与一般人群中1秒用力呼气量（FEV1）及其下降之间的横断面和纵向关系。分析基于在参与欧洲共同体呼吸健康调查的两个法国中心招募的531名受试者（基线平均年龄：37±7岁，50%为女性，42%为非吸烟者）。肺功能以预测FEV1 的百分比表示。CRP通过高灵敏度检测法在中心实验室进行测量。在横断面分析中，FEV1占预测值的百分比与血清CRP浓度呈负相关（P = 0.002）。多变量调整并未改变这些结果（P = 0.002）。在纵向分析中，基线CRP浓度从低三分位数到高三分位数，年度FEV1下降趋势呈上升，但该关联接近显著（P = 0.14）。在调整潜在混杂因素后，基线CRP浓度低、中、高三分位数的年度FEV1平均下降值分别为26±32、31±32和34±32 ml/年（P = 0.09）。随访期间CRP水平的变化与年度FEV1下降相关。CRP升高、稳定和降低的受试者的年度FEV1平均下降值分别为36±31、30±31和24±31 ml/年（P<0.001）。这些发现不受潜在混杂因素调整的影响（P = 0.002）。总之，随着时间推移CRP水平升高与FEV1下降更快有关。
