Hamer Mark, Chida Yoichi
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
Atherosclerosis. 2009 Oct;206(2):599-603. doi: 10.1016/j.atherosclerosis.2009.02.032. Epub 2009 Mar 11.
Raised levels of C-reactive protein (CRP), a marker of low grade systemic inflammation, is common in ageing populations although the relevance of very highly elevated CRP (>10mg/L) remains unclear. We examined cross-sectional associations of very high CRP with psychosocial, behavioural, and cardiovascular risk factors.
Participants were 5307 men and women from the English Longitudinal Study of Ageing, a study of community dwelling older adults (46.0% men, aged 66.5+/-10.1 years). Psychosocial (social status, marital status, depressive symptoms), behavioural (smoking, physical activity, alcohol), and cardiovascular risk factors (blood pressure, cholesterol, glycated haemoglobin, body mass index, waist) were assessed in relation to CRP.
A very high CRP concentration was recorded in 7.5% of the sample. After adjustments for age, sex, acute infection and chronic inflammatory conditions, very high CRP was associated with lower social position, depressive symptoms, physical inactivity, smoking, and alcohol abstinence. There was a linear trend for increased prevalence of cardiovascular risk factors across CRP categories representing low (<1mg/L), medium (1 to <3mg/L), high (3-10mg/L), and very high (>10mg/L), although little differences in risk between high and very high groups were observed.
Very high levels of CRP in elderly participants might reflect chronic health and psychosocial adversity, independently of acute infection.
C反应蛋白（CRP）水平升高是低度全身炎症的一个标志物，在老年人群中很常见，不过CRP水平极高（>10mg/L）的相关性仍不明确。我们研究了CRP水平极高与心理社会、行为及心血管危险因素之间的横断面关联。
参与者来自英国老龄化纵向研究中的5307名男性和女性，该研究针对社区居住的老年人（男性占46.0%，年龄66.5±10.1岁）。评估了心理社会因素（社会地位、婚姻状况、抑郁症状）、行为因素（吸烟、体育活动、饮酒）以及心血管危险因素（血压、胆固醇、糖化血红蛋白、体重指数、腰围）与CRP的关系。
样本中7.5%的人CRP浓度极高。在对年龄、性别、急性感染和慢性炎症性疾病进行调整后，CRP水平极高与较低的社会地位、抑郁症状、缺乏体育活动、吸烟和戒酒相关。在代表低（<1mg/L）、中（1至<3mg/L）、高（3 - 10mg/L）和极高（>10mg/L）的CRP类别中，心血管危险因素的患病率呈线性上升趋势，尽管高组和极高组之间的风险差异不大。
老年参与者中CRP水平极高可能反映了慢性健康问题和心理社会逆境，与急性感染无关。
