Food (salt) Safety Research Center, Semnan University of Medical Sciences, Semnan, Iran.
George Institute for Global Health, University of Oxford, Oxford, UK.
Heart. 2019 May;105(9):686-692. doi: 10.1136/heartjnl-2018-314216. Epub 2019 Jan 30.
To systematically assess the association of circulating inflammation markers with the future risk of hypertension.
We did a systematic literature search of PubMed and Scopus, from database inception to July 10, 2018. Prospective and retrospective cohort studies evaluating the association of circulating C reactive protein (CRP), high-sensitive CRP (hs-CRP), interleukin 6 (IL-6) and IL-1β to the risk of developing hypertension in the general population were included. The relative risks (RRs) for the top versus bottom tertiles of circulating biomarkers were calculated using a fixed-effects/random-effects model. A potential non-linear dose-response association was tested.
Fourteen prospective cohort studies, two retrospective cohort studies and five nested case-control studies involving 142 640 participants and 20 676 cases were identified. The RR for the third versus first tertiles of circulating CRP was 1.23 (95% CI 1.11 to 1.35; I=59%, n=12). The association remained unchanged after adjustment for body mass index. The RRs for other biomarkers were as follows: hs-CRP (RR 1.20, 95% CI 1.02 to 1.37; I=74%, n=7), IL-6 (RR 1.51, 95% CI 1.30 to 1.71; I=0%, n=5), and IL-1β (RR 1.22, 95% CI 0.92 to 1.51; I=0%, n=3). A non-linear dose-response meta-analysis demonstrated that the risk of hypertension increased linearly with increasing circulating inflammation markers, even within the low-risk and intermediate-risk categories.
Higher levels of circulating CRP, hs-CRP and IL-6, but not IL-1β, were associated with the risk of developing hypertension. The association persisted in subgroups of studies defined by major sources of heterogeneity.
系统评估循环炎症标志物与未来高血压风险的关联。
我们对 PubMed 和 Scopus 数据库进行了系统文献检索，检索时间从数据库建立至 2018 年 7 月 10 日。纳入了评估循环 C 反应蛋白（CRP）、高敏 CRP（hs-CRP）、白细胞介素 6（IL-6）和 IL-1β与普通人群高血压发病风险相关性的前瞻性和回顾性队列研究。使用固定效应/随机效应模型计算循环生物标志物最高与最低三分位数的相对风险（RR）。检测潜在的非线性剂量-反应关联。
共纳入 14 项前瞻性队列研究、2 项回顾性队列研究和 5 项巢式病例对照研究，涉及 142640 名参与者和 20676 例病例。循环 CRP 第三与第一三分位相比，RR 为 1.23（95%CI 1.11 至 1.35；I=59%，n=12）。经体重指数调整后，该关联保持不变。其他生物标志物的 RR 如下：hs-CRP（RR 1.20，95%CI 1.02 至 1.37；I=74%，n=7）、IL-6（RR 1.51，95%CI 1.30 至 1.71；I=0%，n=5）和 IL-1β（RR 1.22，95%CI 0.92 至 1.51；I=0%，n=3）。非线性剂量-反应荟萃分析表明，即使在低风险和中风险类别中，高血压风险也随循环炎症标志物的升高呈线性增加。
较高水平的循环 CRP、hs-CRP 和 IL-6，但不是 IL-1β，与高血压发病风险相关。在由主要异质性来源定义的研究亚组中，该关联仍然存在。
