Department of Epidemiology, University of Washington, Seattle, WA, USA.
Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya.
Int J Gynaecol Obstet. 2020 Dec;151(3):443-449. doi: 10.1002/ijgo.13352. Epub 2020 Sep 16.
To evaluate the association between metabolic syndrome (MetS) and high-sensitivity C-reactive protein (hsCRP), a biomarker of chronic inflammation and an independent predictor for cardiovascular disease overall and in subgroups of women with/without pre-eclampsia and gestational hypertension (GHT).
A prospective cohort study was conducted in Nairobi, Kenya. Women with pre-eclampsia or GHT and normotensive women within 12 weeks postpartum underwent physical, anthropometric, fasting lipid profile, plasma glucose, and hsCRP measurements at 6 months postpartum. A generalized linear regression model with Poisson distribution adjusted for body mass index and age was used to estimate the association between elevated hsCRP and MetS overall and stratified by pre-eclampsia or GHT.
In the 171 women included in the study, risk of elevated hsCRP (>3 mg/L) was greater among women with compared to those without MetS (adjusted relative risk [ARR] 1.70, 95% confidence interval [CI] 1.05-2.73, P=0.03) and was statistically significantly higher in the hypertensive (ARR 2.16 95% CI 1.01-4.62, P=0.04) but not in the normotensive (ARR 1.46, 95% CI 0.93-2.28) group.
Increased risk of elevated hsCRP postpartum can guide longitudinal mechanistic and intervention studies to reduce postpartum cardiovascular morbidity in women with MetS, especially after pre-eclampsia or GHT.
评估代谢综合征（MetS）与高敏 C 反应蛋白（hsCRP）之间的关联，hsCRP 是一种慢性炎症的生物标志物，也是心血管疾病的整体和亚组（包括患有先兆子痫和妊娠期高血压的女性以及血压正常的女性）的独立预测因子。
在肯尼亚内罗毕进行了一项前瞻性队列研究。患有先兆子痫或妊娠期高血压的女性和产后 12 周内血压正常的女性，在产后 6 个月时进行了体格检查、人体测量、空腹血脂谱、血浆葡萄糖和 hsCRP 测量。使用具有泊松分布的广义线性回归模型，根据体重指数和年龄进行调整，以估计 hsCRP 升高与 MetS 之间的总体关联，并按先兆子痫或妊娠期高血压进行分层。
在纳入研究的 171 名女性中，与没有 MetS 的女性相比，患有 MetS 的女性发生 hsCRP 升高（>3mg/L）的风险更高（调整后的相对风险 [ARR] 1.70，95%置信区间 [CI] 1.05-2.73，P=0.03），并且在高血压女性中（ARR 2.16，95%CI 1.01-4.62，P=0.04），而在血压正常女性中（ARR 1.46，95%CI 0.93-2.28），这一差异无统计学意义。
产后 hsCRP 升高的风险增加可以指导纵向机制和干预研究，以降低 MetS 女性，尤其是先兆子痫或妊娠期高血压后女性的产后心血管发病率。
