Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, and Institute of Community Medicine, University of Tsukuba, Tsukuba 305-8575, Japan.
Atherosclerosis. 2011 Jul;217(1):187-93. doi: 10.1016/j.atherosclerosis.2011.03.001. Epub 2011 Mar 10.
Epidemiological studies have shown high-sensitive C-reactive protein (hs-CRP) to predict cardiovascular disease. However, there are only limited studies on the effects of hs-CRP levels on risk of stroke especially stroke subtypes. We examined associations of hs-CRP levels with risks of total stroke and its subtypes.
A prospective nested case-control study of Japanese 40-85 years of age was conducted using frozen serum samples collected from 13,521 men and women who participated in cardiovascular risk surveys from 1984 to 2001 for one community and 1989 to 1998 for the other two communities under the Circulatory Risk in Communities Study (CIRCS). Three control subjects per case were matched by sex, age, community, year of serum storage, and fasting status.
By the end of 2005, we identified 261 incident strokes (165 ischemic strokes and 96 hemorrhagic strokes). There was a positive association between hs-CRP and incidence of incidence of total stroke, ischemic stroke and lacunar infarction. After further adjustment for known cardiovascular risk factors, these relationships remained statistically significant. The multivariable conditional odds ratios associated with 1-SD increment of log-transformed hs-CRP were 1.17(1.01-1.35) for total stroke, 1.27(1.06-1.52) for ischemic stroke, and 1.24(1.00-1.55) for lacunar infarction. The association between hs-CRP levels and incidence of ischemic stroke did not vary by sex, age, body mass index and smoking. No associations were found between hs-CRP levels and risk of hemorrhagic stroke.
hs-CRP predicts the incidence of total and ischemic strokes among middle-aged Japanese men and women.
流行病学研究表明，高敏 C 反应蛋白（hs-CRP）可预测心血管疾病。然而，关于 hs-CRP 水平对中风风险（尤其是中风亚型风险）的影响，仅有有限的研究。我们研究了 hs-CRP 水平与总中风及其亚型风险的关系。
采用前瞻性嵌套病例对照研究设计，以参加心血管风险调查的日本 40-85 岁男性和女性的冷冻血清样本为研究对象，这些研究对象来自一个社区（1984-2001 年）和两个其他社区（1989-1998 年）的社区心血管风险研究（Circulatory Risk in Communities Study，CIRCS）。每个病例匹配 3 名性别、年龄、社区、血清储存年份和空腹状态相匹配的对照。
截止到 2005 年底，共发现 261 例中风（165 例缺血性中风和 96 例出血性中风）。hs-CRP 与总中风、缺血性中风和腔隙性梗死的发生率呈正相关。进一步调整已知心血管危险因素后，这些相关性仍具有统计学意义。与 log 转化后 hs-CRP 每增加 1-SD 相关的多变量条件比值比分别为总中风 1.17（1.01-1.35）、缺血性中风 1.27（1.06-1.52）和腔隙性梗死 1.24（1.00-1.55）。hs-CRP 水平与缺血性中风发生率之间的关系不因性别、年龄、体重指数和吸烟状况而变化。hs-CRP 水平与出血性中风风险之间没有关联。
hs-CRP 可预测日本中年男性和女性总中风和缺血性中风的发病风险。
