Hung Joseph, Knuiman Matthew W, Divitini Mark L, Davis Timothy, Beilby John P
School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, University of Western Australia, Perth, Western Australia.
Am J Cardiol. 2008 Jan 15;101(2):193-8. doi: 10.1016/j.amjcard.2007.07.061.
Measurement of the inflammatory biomarker C-reactive protein (CRP) is advocated for coronary heart disease risk assessment. The distribution and correlates of CRP in the general population should be known before it is used in clinical practice. CRP was measured in 1,761 men and 2,248 women aged 25 to 84 years who attended the 1994/1995 Busselton Health Survey. Prevalences of increased CRP >3 mg/L for age groups 25 to 39, 40 to 59, and 60 to 84 years were 15.7%, 20.6%, and 38.7%, respectively, in men and 21.2%, 22.1%, and 33.7%, respectively, in women not on hormone therapy. Logistic regression analysis identified independent predictors of increased CRP in men as obesity (odds ratio [OR] 3.5, 95% confidence interval [CI] 2.4 to 5.0), smoking (OR 3.1, 95% CI 2.1 to 4.5), hypertension (OR 1.6, 95% CI 1.1 to 2.3), and low high-density lipoprotein cholesterol (OR 1.4, 95% CI 1.0 to 1.8). In women, predictors were obesity (OR 7.8, 95% CI 5.8 to 10.6), hypertension (OR 1.4, 95% CI 1.0 to 1.9), high triglycerides (OR 1.6, 95% CI 1.1 to 2.4), vigorous exercise (OR 0.7, 95% CI 0.5 to 0.9), oral contraceptive use (OR 4.6, 95% CI 3.3 to 6.5), and hormone replacement therapy (OR 2.8, 95% CI 1.9 to 4.0). Overall, risks of increased CRP attributable to the presence of an abnormal or borderline coronary heart disease risk factor were 59% for men and 64% for women. In conclusion, despite gender-related differences in cardiovascular risk, increased CRP occurred commonly in men and women. Because increased CRP was largely attributable to conventional coronary heart disease risk factors, measurement of CRP may have limited utility for risk screening and primary prevention.
炎症生物标志物C反应蛋白（CRP）的检测被推荐用于冠心病风险评估。在将其应用于临床实践之前，应了解普通人群中CRP的分布及其相关因素。对参加1994/1995年巴瑟尔顿健康调查的1761名年龄在25至84岁的男性和2248名女性进行了CRP检测。在未接受激素治疗的男性中，25至39岁、40至59岁和60至84岁年龄组中CRP升高（>3mg/L）的患病率分别为15.7%、20.6%和38.7%；在女性中，相应患病率分别为21.2%、22.1%和33.7%。逻辑回归分析确定男性中CRP升高的独立预测因素为肥胖（比值比[OR]3.5，95%置信区间[CI]2.4至5.0）、吸烟（OR 3.1，95%CI 2.1至4.5）、高血压（OR 1.6，95%CI 1.1至2.3）和低高密度脂蛋白胆固醇（OR 1.4，95%CI 1.0至1.8）。在女性中，预测因素为肥胖（OR 7.8，95%CI 5.8至10.6）、高血压（OR 1.4，95%CI 1.0至1.9）、高甘油三酯（OR 1.6，95%CI 1.1至2.4）、剧烈运动（OR 0.7，95%CI 0.5至0.9）、口服避孕药使用（OR 4.6，95%CI 3.3至6.5）和激素替代疗法（OR 2.8，95%CI 1.9至4.0）。总体而言，因存在异常或临界冠心病风险因素导致CRP升高的风险在男性中为59%，在女性中为64%。总之，尽管心血管风险存在性别差异，但CRP升高在男性和女性中都很常见。由于CRP升高很大程度上归因于传统的冠心病风险因素，因此CRP检测在风险筛查和一级预防中的作用可能有限。
