van Durme Yannick M T A, Verhamme Katia M C, Aarnoudse Albert-Jan L H J, Van Pottelberge Geert R, Hofman Albert, Witteman Jacqueline C M, Joos Guy F, Brusselle Guy G, Stricker Bruno H C
Department of Respiratory Medicine, Ghent University and Ghent University Hospital, Ghent, Belgium.
Am J Respir Crit Care Med. 2009 Mar 1;179(5):375-82. doi: 10.1164/rccm.200810-1540OC. Epub 2008 Dec 18.
Chronic obstructive pulmonary disease (COPD) is characterized by substantial chronic inflammation in the pulmonary compartment as well as in the systemic circulation.
To investigate potentially causal association, we examined whether serum levels of high-sensitivity C-reactive protein (hsCRP) and variations in the CRP gene are associated with the risk of developing COPD.
This study is part of the Rotterdam Study, a prospective population-based cohort study among subjects aged 55 years or older. At baseline, 6,836 subjects without COPD had a blood sample available for assessment of hsCRP serum levels and haplotypes of the CRP gene. We analyzed the association between hsCRP levels, CRP gene haplotypes, and incident COPD with Cox proportional hazard models, adjusted for age, sex, and other confounders.
High levels of hsCRP (>3 mg/L) were associated with a significantly increased risk of incident COPD (hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.16-2.49) compared with persons with low levels (<1 mg/L). The risk remained increased after adjusting for potential confounders and introducing a latency period of 3 years. The risk was most pronounced in former smokers (HR, 2.2; 95% CI, 1.12-3.74). hsCRP was not a risk factor in never smokers. No CRP single nucleotide polymorphism or haplotype was associated with a significantly increased or decreased COPD risk.
Increased hsCRP levels are predictive for the occurrence of COPD in smokers. However, haplotypes of the CRP gene, which influence hsCRP levels, are not associated with an altered risk of developing COPD.
慢性阻塞性肺疾病（COPD）的特征是肺部以及体循环中存在大量慢性炎症。
为了研究潜在的因果关系，我们检测了高敏C反应蛋白（hsCRP）的血清水平和CRP基因变异是否与患COPD的风险相关。
本研究是鹿特丹研究的一部分，这是一项针对55岁及以上人群的基于人群的前瞻性队列研究。在基线时，6836名无COPD的受试者提供了血样，用于评估hsCRP血清水平和CRP基因单倍型。我们使用Cox比例风险模型分析了hsCRP水平、CRP基因单倍型与COPD发病之间的关联，并对年龄、性别和其他混杂因素进行了调整。
与hsCRP水平低（<1mg/L）的人相比，hsCRP水平高（>3mg/L）与COPD发病风险显著增加相关（风险比[HR]，1.7；95%置信区间[CI]，1.16-2.49）。在调整潜在混杂因素并引入3年的潜伏期后，风险仍然增加。这种风险在既往吸烟者中最为明显（HR，2.2；95%CI，1.12-3.74）。hsCRP在从不吸烟者中不是风险因素。没有CRP单核苷酸多态性或单倍型与COPD风险显著增加或降低相关。
hsCRP水平升高可预测吸烟者中COPD的发生。然而，影响hsCRP水平的CRP基因单倍型与患COPD风险的改变无关。
