Nakhai-Pour H R, Grobbee D E, Bots M L, Muller M, van der Schouw Y T
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
J Hum Hypertens. 2007 Dec;21(12):949-55. doi: 10.1038/sj.jhh.1002255. Epub 2007 Jun 28.
High plasma C-reactive protein (hs-CRP) levels and arterial stiffness are risk factors for cardiovascular diseases. Pulse wave velocity (PWV) and augmentation index (AIx) have been found to be elevated in patients with vascular inflammation, diabetes mellitus, hypertension, hypercholesterolemia and in smokers. We investigated the relation of high-sensitivity CRP (hs-CRP) with aortic stiffness in 362 men. The levels of hs-CRP were measured using a nephelometric method. Aortic PWV and AIx were assessed from carotid-femoral segment and radial artery waveforms with the use of the SphygmoCor device. In the crude model, aortic PWV increased significantly with increasing serum hs-CRP levels; PWV increased by 2.48 m/s (95% CI 1.58; 3.38) in the fifth compared to the first quintile of hs-CRP. In the adjusted model, the PWV increased by 0.84 m/s (95% CI 0.13; 1.55) in the fifth quintile compared to the first quintile (P-value was 0.02). In the crude model, AIx increased significantly with increasing serum hs-CRP levels; AIx increased by 7.17% (95% CI 3.72; 10.62) in the fifth versus the first quintile. Adjusted for confounders, AIx remained 4.57% (95% CI 1.32; 7.82) higher in the fifth compared to the first quintile (P-value for trend was <0.01). More adjustment for subclinical atherosclerosis attenuated the beta-coefficient for PWV (difference 0.71 m/s (95% CI 0.01; 1.41), but not for AIx (4.60% (95% CI 1.34; 7.85)). In summary, low-grade inflammation seems to be independently related to increase of aortic artery stiffness over and above traditional risk factors and atherosclerosis.
高血浆C反应蛋白（hs-CRP）水平和动脉僵硬度是心血管疾病的危险因素。已发现血管炎症、糖尿病、高血压、高胆固醇血症患者以及吸烟者的脉搏波速度（PWV）和增强指数（AIx）升高。我们在362名男性中研究了高敏CRP（hs-CRP）与主动脉僵硬度的关系。hs-CRP水平采用比浊法测量。使用SphygmoCor设备从颈动脉-股动脉段和桡动脉波形评估主动脉PWV和AIx。在粗模型中，主动脉PWV随血清hs-CRP水平升高而显著增加；与hs-CRP第一五分位数相比，第五五分位数的PWV增加了2.48 m/s（95%CI 1.58；3.38）。在调整模型中，与第一五分位数相比，第五五分位数的PWV增加了0.84 m/s（95%CI 0.13；1.55）（P值为0.02）。在粗模型中，AIx随血清hs-CRP水平升高而显著增加；与第一五分位数相比，第五五分位数的AIx增加了7.17%（95%CI 3.72；10.62）。在对混杂因素进行调整后，与第一五分位数相比，第五五分位数的AIx仍高出4.57%（95%CI 1.32；7.82）（趋势P值<0.01）。对亚临床动脉粥样硬化进行更多调整后，PWV的β系数减弱（差异0.71 m/s（95%CI 0.01；1.41）），但AIx未减弱（4.60%（95%CI 为1.34；7.85））。总之，低度炎症似乎独立于传统危险因素和动脉粥样硬化，与主动脉僵硬度增加有关。
