Sjaarda Lindsey A, Radin Rose G, Swanson Chandra, Kuhr Daniel L, Mumford Sunni L, Galai Noya, Silver Robert M, Wactawski-Wende Jean, Perkins Neil J, Schisterman Enrique F
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Department of Statistics, University of Haifa, Haifa, Israel.
Paediatr Perinat Epidemiol. 2018 Jan;32(1):55-67. doi: 10.1111/ppe.12409. Epub 2017 Sep 15.
Inflammation, measured by high-sensitivity C-reactive protein (hsCRP), is linked to adverse reproductive outcomes. However, prevalence and predictors of low-grade inflammation are poorly understood among reproductive age women. Therefore, the current aim was to characterize: (i) the prevalence of elevated hsCRP and (ii) whether the association of various demographic, anthropometric, life style, and metabolic characteristics with higher hsCRP varies across populations of reproductive age women with varying risk profiles for adverse reproductive outcomes.
Bivariate analysis of characteristics among women ages 18-40 having hsCRP <2.0 vs. ≥2.0 mg/L in the BioCycle Study (N = 259), the Effects of Aspirin in Gestation and Reproduction Trial (EAGeR) (N = 1228), and the National Health and Nutrition Examination Survey (NHANES; N = 2173) were conducted. Multivariable regression analysis estimated the association of all characteristics to hsCRP within each cohort.
Prevalence of hsCRP≥2 mg/L ranged from 20 to 40%. Age, BMI, waist circumference, blood pressure, lipids, glucose, and insulin were frequently higher in women with hsCRP ≥2 mg/L. In multivariable models, however, only adiposity (BMI, waist circumference) was independently associated with hsCRP within all three cohorts. Some variables showed cohort-specific associations with higher hsCRP: white race (EAGeR), higher fasting glucose (BioCycle), and lesser education and employment (NHANES). The total characteristics explained 28-46% of the variation in hsCRP across the three cohorts.
Low-grade inflammation was common, including among predominantly non-obese women, affecting from 20 to 40% of reproductive age women. Given the potential to reduce inflammation through inexpensive, widely available therapies, examination of the impact of chronic inflammation on reproductive and pregnancy outcomes, as well as preventive interventions, are now needed.
通过高敏C反应蛋白（hsCRP）测定的炎症与不良生殖结局相关。然而，育龄女性中低度炎症的患病率及预测因素尚不清楚。因此，当前的目的是明确：（i）hsCRP升高的患病率；（ii）不同人口统计学、人体测量学、生活方式及代谢特征与较高hsCRP之间的关联在具有不同不良生殖结局风险特征的育龄女性群体中是否存在差异。
对生物周期研究（N = 259）、阿司匹林对妊娠和生殖影响试验（EAGeR）（N = 1228）以及国家健康与营养检查调查（NHANES；N = 2173）中18 - 40岁hsCRP <2.0与≥2.0 mg/L的女性的特征进行双变量分析。多变量回归分析估计了每个队列中所有特征与hsCRP的关联。
hsCRP≥2 mg/L的患病率在20%至40%之间。hsCRP≥2 mg/L的女性年龄、体重指数（BMI）、腰围、血压、血脂、血糖和胰岛素水平通常更高。然而，在多变量模型中，仅肥胖（BMI、腰围）在所有三个队列中均与hsCRP独立相关。一些变量显示出与较高hsCRP的队列特异性关联：白人种族（EAGeR）、较高的空腹血糖（生物周期研究）以及较低的教育程度和就业率（NHANES）。在三个队列中，所有特征共解释了hsCRP变异的28%至46%。
低度炎症很常见，包括在以非肥胖女性为主的人群中，影响20%至40%的育龄女性。鉴于通过廉价且广泛可得的治疗方法有可能减轻炎症，现在需要研究慢性炎症对生殖和妊娠结局的影响以及预防性干预措施。
