Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Am J Cardiol. 2010 Dec 1;106(11):1588-93. doi: 10.1016/j.amjcard.2010.07.044.
Plasma levels of high-sensitivity C-reactive protein (hsCRP) are an important predictor of cardiovascular disease, and achievement of lower targets of hsCRP with rosuvastatin treatment was associated with improved cardiovascular outcomes. The aim of this study was to examine whether hsCRP levels were related to genetic variants and traditional cardiovascular risk factors in Chinese patients treated with rosuvastatin 10 mg/day. The relations were analyzed between on-treatment plasma hsCRP concentrations and cardiovascular risk factors and 14 single-nucleotide polymorphisms in CRP and other candidate genes. In 281 patients with a median plasma hsCRP level of 0.81 mg/L (interquartile range 0.46 to 1.86), higher hsCRP levels were significantly associated with female gender, greater waist circumference (WC), having diabetes, higher triglycerides, and lower high-density lipoprotein (HDL) cholesterol. Three single-nucleotide polymorphisms (rs1205, 3872G>A and rs2808630, 5237A>G in CRP and rs1169288, I27L in HNF1A) were independently associated with hsCRP levels before and after adjustment for other variables. WC and the CRP rs1205 polymorphism showed the strongest relations with hsCRP, and in multiple regression analysis, gender, WC, diabetes, triglycerides, HDL cholesterol, and the 3 genetic variants explained 35.5% of the variance in hsCRP levels. The 2 CRP polymorphisms, female gender, higher WC, and lower HDL cholesterol were associated with risk for having CRP concentrations ≥ 1 mg/L. In conclusion, central obesity, low HDL cholesterol, and CRP polymorphisms are major determinants of higher hsCRP levels in Chinese patients receiving treatment with rosuvastatin.
血浆高敏 C 反应蛋白(hsCRP)水平是心血管疾病的重要预测指标,使用瑞舒伐他汀治疗达到较低的 hsCRP 目标与心血管结局改善相关。本研究旨在探讨中国接受瑞舒伐他汀 10mg/日治疗的患者中,hsCRP 水平与遗传变异和传统心血管危险因素的关系。分析了治疗后 hsCRP 浓度与心血管危险因素和 CRP 及其他候选基因的 14 个单核苷酸多态性之间的关系。在 281 例中位血浆 hsCRP 水平为 0.81mg/L(四分位间距 0.46 至 1.86)的患者中,较高的 hsCRP 水平与女性、更大的腰围(WC)、患有糖尿病、更高的甘油三酯和更低的高密度脂蛋白(HDL)胆固醇显著相关。三个单核苷酸多态性(CRP 中的 rs1205、3872G>A 和 rs2808630、5237A>G 以及 HNF1A 中的 rs1169288、I27L)在调整其他变量后与 hsCRP 水平独立相关。WC 和 CRP rs1205 多态性与 hsCRP 具有最强的相关性,在多元回归分析中,性别、WC、糖尿病、甘油三酯、HDL 胆固醇和 3 个遗传变异解释了 hsCRP 水平变异的 35.5%。2 个 CRP 多态性、女性、更高的 WC 和更低的 HDL 胆固醇与 CRP 浓度≥1mg/L 的风险相关。结论:在中国接受瑞舒伐他汀治疗的患者中,中心性肥胖、低 HDL 胆固醇和 CRP 多态性是 hsCRP 水平升高的主要决定因素。