Li Yunwei, Zhong Xiaoming, Cheng Guanchang, Zhao Cuihua, Zhang Lei, Hong Yan, Wan Qilin, He Ruili, Wang Zhizhong
Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China.
Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China.
Atherosclerosis. 2017 Apr;259:75-82. doi: 10.1016/j.atherosclerosis.2017.02.003. Epub 2017 Feb 9.
Inconsistent findings have been reported on the association between high-sensitivity C-reactive protein (hs-CRP) and mortality risk. The objective of this meta-analysis was to investigate the association of elevated baseline hs-CRP levels with all-cause, cardiovascular, and cancer mortality risk in the general population.
PubMed and Embase were systematically searched for studies published from inception to October 2016. Prospective observational studies were eligible if they reported the effects of elevated baseline hs-CRP levels on cancer-related, cardiovascular or all-cause mortality in the general population. The pooled adjusted risk ratio (RR) with 95% confidence interval (CI) comparing the highest to the lowest category of hs-CRP levels was used as association measures.
A total of 83,995 participants from 14 studies were identified. When comparing the highest to the lowest category of hs-CRP levels, the pooled RR was 1.25 (95% CI 1.13-1.38) for cancer-related mortality, 2.03 (95% CI 1.65-2.50) for cardiovascular mortality, and 1.75 (1.55-1.98) for all-cause mortality, respectively. Subgroup analysis showed that the effect of elevated hs-CRP levels on cancer-related mortality was observed in men (RR 1.26; 95% CI 1.11-1.43) but not in women (RR 1.03; 95% CI 0.83-1.27).
Elevated hs-CRP levels can independently predict risk of all-cause, cardiovascular mortality in the general population. However, the gender differences in the predictive role of hs-CRP on cancer mortality should to be further investigated.
关于高敏C反应蛋白(hs-CRP)与死亡风险之间的关联,已有研究结果不一致的报道。本荟萃分析的目的是研究基线hs-CRP水平升高与普通人群全因、心血管和癌症死亡风险之间的关联。
系统检索PubMed和Embase数据库中从建库至2016年10月发表的研究。纳入的前瞻性观察性研究需报告基线hs-CRP水平升高对普通人群癌症相关、心血管或全因死亡率的影响。采用合并调整风险比(RR)及95%置信区间(CI)作为关联指标,比较hs-CRP水平最高组与最低组。
共纳入14项研究的83,995名参与者。比较hs-CRP水平最高组与最低组时,癌症相关死亡率的合并RR为1.25(95%CI 1.13 - 1.38),心血管死亡率为2.03(95%CI 1.65 - 2.50),全因死亡率为1.75(1.55 - 1.98)。亚组分析显示,hs-CRP水平升高对癌症相关死亡率的影响在男性中观察到(RR 1.26;95%CI 1.11 - 1.43),而在女性中未观察到(RR 1.03;95%CI 0.83 - 1.27)。
hs-CRP水平升高可独立预测普通人群的全因、心血管死亡风险。然而,hs-CRP对癌症死亡率预测作用的性别差异仍需进一步研究。