Kuo Hsu-Ko, Yen Chung-Jen, Chen Jen-Hau, Yu Yau-Hua, Bean Jonathan F
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Int J Cardiol. 2007 Jan 2;114(1):28-33. doi: 10.1016/j.ijcard.2005.11.110. Epub 2006 May 5.
Elevated C-reactive protein (CRP) is a risk factor for atherosclerosis. Cardiorespiratory fitness, the ability of active skeletal muscle to utilize oxygen during aerobic exercise, can be impaired by atherosclerotic changes peripherally affecting the vasculature or centrally perturbing the heart and coronary arteries. However, the association between cardiorespiratory fitness and CRP has not been adequately examined.
We examined 1438 adults aged 20-49 years with reliable measures of fitness and non-missing values in CRP from Health and Nutrition Examination Survey 1999-2002. Subjects with major cardiovascular and respiratory conditions were excluded from fitness test which measured the estimated maximal oxygen uptake (VO2max), by a submaximal exercise test. Levels of CRP were quantified by utilizing latex-enhanced nephelometry.
In both genders, we observed inverse associations between estimated VO2max and levels of CRP after controlling for age, race, body mass index category, hypertension, diabetes, smoking status, alcohol consumption, and use of medications including aspirin, non-steroidal anti-inflammatory drugs, steroid, lipid-lowering agents, antimicrobials, or estrogen/progesterone (in women). Men in the 2nd, 3rd, and 4th quartiles of CRP concentrations had lower estimated VO2max compared to the first quartile (regression coefficients for quartile 2, -1.54 ml/kg/min, p=0.105; quartile 3, -1.46 ml/kg/min, p=0.130; quartile 4, -2.64 ml/kg/min, p=0.009; p for trend 0.013). Women in the highest quartile of CRP had a significantly lower estimated VO2max (2.40 ml/kg/min, p=0.023) compared to the lowest (p for trend 0.025).
CRP levels, inversely related to cardiorespiratory fitness, are important indicators of exercise tolerance and may be useful in targeting individuals requiring endurance intervention to prevent loss of cardiovascular fitness and function.
C反应蛋白（CRP）升高是动脉粥样硬化的一个危险因素。心肺适能，即活跃骨骼肌在有氧运动期间利用氧气的能力，可能会因外周影响血管系统的动脉粥样硬化改变或中枢干扰心脏和冠状动脉而受损。然而，心肺适能与CRP之间的关联尚未得到充分研究。
我们对1438名年龄在20 - 49岁的成年人进行了研究，这些数据来自1999 - 2002年健康与营养检查调查，具备可靠的适能测量值且CRP无缺失值。患有主要心血管和呼吸系统疾病的受试者被排除在通过次极量运动试验测量估计最大摄氧量（VO2max）的适能测试之外。CRP水平通过乳胶增强比浊法进行定量。
在控制了年龄、种族、体重指数类别、高血压、糖尿病、吸烟状况、饮酒量以及使用包括阿司匹林、非甾体抗炎药、类固醇、降脂药、抗菌药或雌激素/孕激素（女性）在内的药物后，我们在男性和女性中均观察到估计的VO2max与CRP水平之间呈负相关。与第一四分位数相比，CRP浓度处于第二、第三和第四四分位数的男性估计VO2max较低（四分位数2的回归系数为 - 1.54 ml/kg/min，p = 0.105；四分位数3为 - 1.46 ml/kg/min，p = 0.130；四分位数4为 - 2.64 ml/kg/min，p = 0.009；趋势p值为0.013）。与最低四分位数相比，CRP处于最高四分位数的女性估计VO2max显著更低（2.40 ml/kg/min，p = 0.023）（趋势p值为0.025）。
CRP水平与心肺适能呈负相关，是运动耐力的重要指标，可能有助于确定需要进行耐力干预以预防心血管适能和功能丧失的个体。
