Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita-shi, Osaka 565-0871, Japan.
Atherosclerosis. 2009 Nov;207(1):291-7. doi: 10.1016/j.atherosclerosis.2009.04.020. Epub 2009 Apr 24.
Limited evidence of association between C-reactive protein levels and cardiovascular disease has been produced for Japanese whose median protein levels are low by western standards.
We conducted a nested case-control study as part of the Japan Collaborative Cohort Study for evaluation of cancer risk (JACC Study). A total of 39,242 subjects 40-79 years of age provided serum samples at baseline between 1988 and 1990. During the 13-year follow-up, there were 525 deaths from total strokes (ICD10: I60-I69), 209 coronary heart diseases (I20-I25) and 939 total cardiovascular diseases (I00-I99). The control subjects were matched for sex, age, area of residence and year of serum storage, and analyses were conducted after further adjustment for cardiovascular risk factors. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured with ultra-sensitive latex-enhanced immunoassay.
Median hs-CRP levels for controls were 0.40 mg/L for men and 0.41 mg/L for women. Hs-CRP levels were positively associated with risks of mortality from stroke, coronary heart disease, and total cardiovascular disease for men. The respective multivariable odds ratios (OR 95% CI) for the highest (>or=0.85 mg/L) vs. lowest (<0.19 mg/L) quartiles of hs-CRP for men were 1.60 (0.90-2.85), 3.68 (1.02-13.3), and 2.31 (1.49-3.59). For women, positive associations with hs-CRP levels were weaker, reaching statistical significance only for total cardiovascular disease: OR=1.69 (1.06-2.68). The positive association with total cardiovascular disease did not vary according to sex, age, smoking status, or body mass index.
Higher serum hs-CRP levels were associated with higher mortality from cardiovascular disease in Japanese.
对于那些按照西方标准蛋白质水平较低的日本人，目前有关 C 反应蛋白水平与心血管疾病之间关联的证据有限。
我们进行了一项嵌套病例对照研究，作为日本癌症风险评估合作队列研究（JACC 研究）的一部分。共有 39242 名 40-79 岁的受试者于 1988 年至 1990 年期间在基线时提供血清样本。在 13 年的随访期间，共有 525 人死于全因卒中（ICD10：I60-I69）、209 人死于冠心病（I20-I25）和 939 人死于心血管疾病（I00-I99）。对照组按性别、年龄、居住区域和血清储存年份进行匹配，并在进一步调整心血管危险因素后进行分析。采用超敏乳胶增强免疫测定法测量血清高敏 C 反应蛋白（hs-CRP）水平。
男性对照组的 hs-CRP 中位数为 0.40mg/L，女性为 0.41mg/L。hs-CRP 水平与男性卒中、冠心病和心血管疾病总死亡率的风险呈正相关。男性 hs-CRP 最高（>或=0.85mg/L）与最低（<0.19mg/L）四分位距的多变量比值比（OR 95%CI）分别为 1.60（0.90-2.85）、3.68（1.02-13.3）和 2.31（1.49-3.59）。对于女性，hs-CRP 水平与疾病之间的关联较弱，仅对心血管疾病总死亡率有统计学意义：OR=1.69（1.06-2.68）。hs-CRP 水平与心血管疾病总死亡率之间的正相关关系不因性别、年龄、吸烟状况或体重指数而异。
在日本人中，较高的血清 hs-CRP 水平与心血管疾病死亡率的升高相关。
