Hong Guo-Bao, Gao Pei-Chun, Chen Yun-Yin, Xia Yue, Ke Xiao-Su, Shao Xiao-Fei, Xiong Chong-Xiang, Chen Hai-Shan, Xiao Hua, Ning Jing, Zou He-Qun
Department of Nephrology, Institute of Nephrology and Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510630, People's Republic of China.
Department of Nephrology, The Affiliated Nanhai Hospital of Southern Medical University, Foshan 528200, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Feb 28;13:581-590. doi: 10.2147/DMSO.S241774. eCollection 2020.
Metabolic syndrome (MetS), characterized by a constellation of insulin resistance, central obesity, hypertension, and hyperlipidemia, is a global health threat. High-sensitivity C-reactive protein (hs-CRP) has been shown to be associated with type 2 diabetes and cardiovascular disease; however, its association with incident MetS is less known. Therefore, the aim of this study was to examine the prospective association between hs-CRP and MetS among a Chinese population in a 5-year follow-up study.
The levels of hs-CRP were measured using serum samples collected at baseline recruitment in 2012 from 886 participants without MetS. Follow-up interviews were conducted in 2018, and MetS was diagnosed by 2017 criteria from the Chinese Diabetes Society. Multivariate logistic regression models were used to assess the overall and sex-specific associations between hs-CRP and incident MetS. The odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were computed with adjustment for demographic, socioeconomic, clinical, and lifestyle factors.
After a mean follow-up duration of 5.40 ± 0.56 years, 116 (13.3%) participants developed MetS. In the total study population, increased hs-CRP levels were associated with a higher risk of MetS (OR comparing extreme quartiles of hs-CRP: 4.06 [95% CI: 1.91-8.65]) in the fully-adjusted model. When stratified by sex, the positive association was only observed in women (OR: 4.82 [1.89-12.3]) but not in men (OR: 3.15 [0.82-12.1]; -interaction = 0.039).
In this study of a Chinese population, a positive association between hs-CRP and incident MetS was found only in women and not in men. Sex-specific prediction and intervention of MetS using hs-CRP as a target should be further evaluated.
代谢综合征（MetS）以胰岛素抵抗、中心性肥胖、高血压和高脂血症为特征，是一种全球性的健康威胁。高敏C反应蛋白（hs-CRP）已被证明与2型糖尿病和心血管疾病有关；然而，其与新发MetS的关联尚鲜为人知。因此，本研究的目的是在一项为期5年的随访研究中，探讨中国人群中hs-CRP与MetS之间的前瞻性关联。
使用2012年基线招募时从886名无MetS的参与者中采集的血清样本测量hs-CRP水平。2018年进行随访访谈，并根据中国糖尿病学会2017年标准诊断MetS。采用多变量逻辑回归模型评估hs-CRP与新发MetS之间的总体关联和性别特异性关联。计算比值比（OR）和相应的95%置信区间（CI），并对人口统计学、社会经济、临床和生活方式因素进行调整。
在平均随访5.40±0.56年后，116名（13.3%）参与者发生了MetS。在整个研究人群中，在完全调整模型中，hs-CRP水平升高与MetS风险较高相关（比较hs-CRP极端四分位数的OR：4.06 [95%CI：1.91 - 8.65]）。按性别分层时，仅在女性中观察到正相关（OR：4.82 [1.89 - 12.3]），而在男性中未观察到（OR：3.15 [0.82 - 12.1]；交互作用P = 0.039）。
在这项针对中国人群的研究中，仅在女性而非男性中发现hs-CRP与新发MetS之间存在正相关。应进一步评估以hs-CRP为靶点对MetS进行性别特异性预测和干预。
