Juonala Markus, Viikari Jorma S A, Rönnemaa Tapani, Taittonen Leena, Marniemi Jukka, Raitakari Olli T
The Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.
Arterioscler Thromb Vasc Biol. 2006 Aug;26(8):1883-8. doi: 10.1161/01.ATV.0000228818.11968.7a. Epub 2006 May 25.
Atherosclerosis begins in childhood, and inflammation may contribute to its pathophysiology. The value of measuring inflammatory markers in the pediatric risk assessment, however, is uncertain. We examined whether childhood C-reactive protein (CRP) levels predict CRP and carotid intima-media thickness (IMT) in adulthood.
Study cohort included 1617 subjects, aged 3 to 18 years at baseline in 1980. These subjects were reexamined in 2001 at ages 24 to 39 years. In 2001, CRP was measured from fresh samples, and the subjects underwent carotid IMT study to evaluate subclinical atherosclerosis. Baseline (1980) CRP concentrations were measured from frozen samples in 2005. A significant tracking was observed between childhood and adult CRP levels. The age- and sex-specific correlations were the highest in the age group of 18 years at baseline (r=0.47 in females, r=0.32 in males, P<0.0001). The association between childhood and adult CRP levels was independent of serum lipids, blood pressure, smoking, obesity indices, and insulin. In multivariate analysis, childhood risk factors that independently associated with increased adult IMT included elevated systolic blood pressure (P<0.0001), high low-density lipoprotein-cholesterol (P=0.01) and smoking (P=0.049), but not CRP (P=0.95).
Childhood CRP values predict weakly but significantly adult CRP, and this association is independent of other metabolic risk factors. Unlike conventional risk factors, however, childhood CRP does not predict adult IMT.
动脉粥样硬化始于儿童期,炎症可能在其病理生理过程中起作用。然而,在儿童风险评估中测量炎症标志物的价值尚不确定。我们研究了儿童期C反应蛋白(CRP)水平是否能预测成年期的CRP和颈动脉内膜中层厚度(IMT)。
研究队列包括1617名受试者,1980年基线时年龄为3至18岁。这些受试者于2001年进行复查,年龄在24至39岁之间。2001年,从新鲜样本中测量CRP,并对受试者进行颈动脉IMT研究以评估亚临床动脉粥样硬化。2005年从冷冻样本中测量基线(1980年)CRP浓度。观察到儿童期和成年期CRP水平之间存在显著的追踪关系。在基线年龄为18岁的年龄组中,年龄和性别特异性相关性最高(女性r = 0.47,男性r = 0.32,P < 0.0001)。儿童期和成年期CRP水平之间的关联独立于血脂、血压、吸烟、肥胖指数和胰岛素。在多变量分析中,与成年期IMT增加独立相关的儿童期风险因素包括收缩压升高(P < 0.0001)、高低密度脂蛋白胆固醇(P = 0.01)和吸烟(P = 0.049),但不包括CRP(P = 0.95)。
儿童期CRP值对成年期CRP有较弱但显著的预测作用,且这种关联独立于其他代谢风险因素。然而,与传统风险因素不同,儿童期CRP不能预测成年期IMT。