van 't Klooster C C, van der Graaf Y, Ridker P M, Westerink J, Hjortnaes J, Sluijs I, Asselbergs F W, Bots M L, Kappelle L J, Visseren F L J
Department of Vascular Medicine, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), University Utrecht, Utrecht, Netherlands.
Atherosclerosis. 2020 May;301:37-43. doi: 10.1016/j.atherosclerosis.2020.03.022. Epub 2020 Apr 6.
Pharmacological lowering of inflammation has proven effective in reducing recurrent cardiovascular event rates. Aim of the current study is to evaluate lifestyle changes (smoking cessation, weight loss, physical activity level increase, alcohol moderation, and a summary lifestyle improvement score) in relation to change in plasma C-reactive protein (CRP) concentration in patients with established cardiovascular disease.
In total, 1794 patients from the UCC-SMART cohort with stable cardiovascular disease and CRP levels ≤10 mg/L, who returned for a follow-up study visit after median 9.9 years (IQR 5.4-10.8), were included. The relation between changes in smoking status, weight, physical activity, alcohol consumption, a summary lifestyle improvement score and change in plasma CRP concentration was evaluated with linear regression analyses.
Smoking cessation was related to a 0.40 mg/L decline in CRP concentration (β-coefficient -0.40; 95%CI -0.73,-0.07). Weight loss (per 1SD = 6.4 kg) and increase in physical activity (per 1 SD = 48 MET hours per week) were related to a decrease in CRP concentration (β-coefficients -0.25; 95%CI -0.33,-0.16 and -0.09; 95%CI -0.17,-0.01 per SD). Change in alcohol consumption was not related to CRP difference. Every point higher in the summary lifestyle improvement score was related to a decrease in CRP concentration of 0.17 mg/L (β-coefficient -0.17; 95%CI -0.26,-0.07).
Smoking cessation, increase in physical activity, and weight loss are related to a decrease in CRP concentration in patients with stable cardiovascular disease. Patients with the highest summary lifestyle improvement score have the most decrease in CRP concentration. These results may indicate that healthy lifestyle changes contribute to lowering systemic inflammation, potentially leading to a lower cardiovascular risk in patients with established cardiovascular disease.
药物性降低炎症已被证明可有效降低心血管事件复发率。本研究的目的是评估生活方式改变（戒烟、体重减轻、体力活动水平增加、适度饮酒以及综合生活方式改善评分）与已确诊心血管疾病患者血浆C反应蛋白（CRP）浓度变化之间的关系。
总共纳入了1794例来自UCC - SMART队列的患有稳定心血管疾病且CRP水平≤10mg/L的患者，这些患者在中位时间9.9年（四分位间距5.4 - 10.8）后返回进行随访研究。通过线性回归分析评估吸烟状态、体重、体力活动、饮酒量、综合生活方式改善评分的变化与血浆CRP浓度变化之间的关系。
戒烟与CRP浓度下降0.40mg/L相关（β系数 - 0.40；95%置信区间 - 0.73， - 0.07）。体重减轻（每1标准差 = 6.4kg）和体力活动增加（每1标准差 = 每周48代谢当量小时）与CRP浓度降低相关（β系数分别为 - 0.25；95%置信区间 - 0.33， - 0.16以及 - 0.09；95%置信区间 - 0.17， - 0.01每标准差）。饮酒量的变化与CRP差异无关。综合生活方式改善评分每提高1分与CRP浓度降低0.17mg/L相关（β系数 - 0.17；95%置信区间 - 0.26， - 0.07）。
戒烟、体力活动增加和体重减轻与稳定心血管疾病患者CRP浓度降低相关。综合生活方式改善评分最高的患者CRP浓度下降最多。这些结果可能表明健康的生活方式改变有助于降低全身炎症，潜在地降低已确诊心血管疾病患者的心血管风险。
