University of Melbourne, Department of Medicine, St Vincent's Hospital, Melbourne, Australia.
BMC Public Health. 2010 Nov 15;10:700. doi: 10.1186/1471-2458-10-700.
Previous studies reported high C-reactive protein (CRP) levels in Indigenous Australians, which may contribute to their high risk of cardiovascular disease. We compared CRP levels in Indigenous Australians and the general population, accounting for obesity and other risk factors.
Cross-sectional study of CRP and risk factors (weight, height, waist and hip circumferences, blood pressure, lipids, blood glucose, and smoking status) in population-based samples from the Diabetes and Related conditions in Urban Indigenous people in the Darwin region (DRUID) study, and the Australian Diabetes, Obesity and Lifestyle study (AusDiab) follow-up.
CRP concentrations were higher in women than men and in DRUID than AusDiab. After multivariate adjustment, including waist circumference, the odds of high CRP (>3.0 mg/L) in DRUID relative to AusDiab were no longer statistically significant, but elevated CRP was still more likely in women than men. After adjusting for BMI (instead of waist circumference) the odds for elevated CRP in DRUID participants were still higher relative to AusDiab participants among women, but not men. Lower HDL cholesterol, impaired glucose tolerance (IGT), and higher diastolic blood pressure were associated with having a high CRP in both men and women, while current smoking was associated with high CRP in men but not women.
High concentrations of CRP in Indigenous participants were largely explained by other risk factors, in particular abdominal obesity. Irrespective of its independence as a risk factor, or its aetiological association with coronary heart disease (CHD), the high CRP levels in urban Indigenous women are likely to reflect increased vascular and metabolic risk. The significance of elevated CRP in Indigenous Australians should be investigated in future longitudinal studies.
先前的研究报告称，澳大利亚原住民的 C 反应蛋白（CRP）水平较高，这可能导致他们患心血管疾病的风险较高。我们比较了澳大利亚原住民和一般人群的 CRP 水平，同时考虑了肥胖和其他风险因素。
对来自达尔文地区城市原住民中的糖尿病和相关情况研究（DRUID 研究）和澳大利亚糖尿病、肥胖和生活方式研究（AusDiab）随访的基于人群样本中的 CRP 和风险因素（体重、身高、腰围和臀围、血压、血脂、血糖和吸烟状况）进行了横断面研究。
女性的 CRP 浓度高于男性，DRUID 的 CRP 浓度高于 AusDiab。经过包括腰围在内的多变量调整后，DRUID 发生 CRP 升高（>3.0mg/L）的几率与 AusDiab 相比不再具有统计学意义，但女性发生 CRP 升高的可能性仍高于男性。在调整 BMI（而不是腰围）后，DRUID 参与者的 CRP 升高几率仍高于 AusDiab 参与者，尤其是女性，但男性则不然。低 HDL 胆固醇、葡萄糖耐量受损（IGT）和舒张压升高与男性和女性的 CRP 升高有关，而男性吸烟与 CRP 升高有关，但女性则不然。
原住民参与者 CRP 浓度升高主要是由其他风险因素引起的，特别是腹部肥胖。无论 CRP 是否作为一个独立的风险因素，或者与冠心病（CHD）的病因学相关，城市原住民女性 CRP 水平升高很可能反映出血管和代谢风险增加。在未来的纵向研究中，应该进一步研究 CRP 升高在澳大利亚原住民中的意义。
