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高敏 C 反应蛋白与胆囊疾病风险的关系:来自开滦队列研究的结果。

Relationship between high-sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study.

机构信息

Department of General Surgery, Aerospace Central Hospital, Beijing, China.

Department of General Surgery, Beijing Children's Hospital, National Center for Children's Health, Beijing, China.

出版信息

BMJ Open. 2020 Sep 22;10(9):e035880. doi: 10.1136/bmjopen-2019-035880.

Abstract

OBJECTIVES

Gallstone disease (GSD) can be caused by various health and clinical factors such as obesity, dyslipidaemia and an unhealthy diet, all of which are associated with higher high-sensitivity C reactive protein (hs-CRP) concentrations. Whether hs-CRP represents an independent risk factor for GSD is still unclear. We prospectively investigated hs-CRP in relation to the occurrence of GSD based on the Kailuan study.

STUDY DESIGN

Prospective cohort study.

SETTING

The Kailuan cohort study was conducted in Tangshan City in northern China.

PARTICIPANTS

95 319 participants who were free from GSD were recruited in this study. Epidemiological data, anthropometric parameters and biochemical data of participants were collected.

PRIMARY AND SECONDARY OUTCOME MEASURES

Cox proportional hazards regression models were used to evaluate the association between hs-CRP concentrations and the risk of GSD after adjustments for potential confounders.

RESULTS

During the mean 7.58 years of follow-up among 95 319 participants, 4205 participants were identified as newly diagnosed with GSD or having undergone cholecystectomy for cholelithiasis. Compared with the hs-CRP<1 mg/L group, elevated hs-CRP concentrations were significantly associated with higher risk of GSD with the corresponding HR of 1.11 (95% CI 1.03 to 1.19), 1.12 (95% CI 1.04 to 1.22) in the 1≤hs-CRP≤3 mg/L and hs-CRP>3 mg/L group, respectively. The multivariate model which included hs-CRP not only had a better line of fitness but also had better predictive values to help identify new cases of GSD during follow-up.

CONCLUSION

Elevated hs-CRP concentration is an independent risk factor for new-onset GSD among the Chinese population.

TRIAL REGISTRATION NUMBER

ChiCTR-TNC-11001489.

摘要

目的

胆石病(GSD)可由肥胖、血脂异常和不健康饮食等多种健康和临床因素引起,所有这些因素都与更高的高敏 C 反应蛋白(hs-CRP)浓度有关。hs-CRP 是否代表 GSD 的独立危险因素尚不清楚。我们基于开滦研究前瞻性调查了 hs-CRP 与 GSD 发生的关系。

研究设计

前瞻性队列研究。

地点

本研究在中国北方唐山市开展的开滦队列研究。

参与者

本研究共纳入 95319 名无 GSD 的参与者。收集了参与者的流行病学数据、人体测量参数和生化数据。

主要和次要结局测量

使用 Cox 比例风险回归模型,在校正潜在混杂因素后,评估 hs-CRP 浓度与 GSD 风险之间的关系。

结果

在 95319 名参与者平均 7.58 年的随访期间,4205 名参与者被诊断为新发 GSD 或因胆石症而行胆囊切除术。与 hs-CRP<1mg/L 组相比,hs-CRP 浓度升高与 GSD 风险显著相关,hs-CRP 浓度为 1≤hs-CRP≤3mg/L 和 hs-CRP>3mg/L 时,相应的 HR 分别为 1.11(95%CI 1.03 至 1.19)和 1.12(95%CI 1.04 至 1.22)。包含 hs-CRP 的多变量模型不仅拟合度更好,而且具有更好的预测值,有助于在随访期间识别新的 GSD 病例。

结论

在中国人群中,hs-CRP 浓度升高是新发 GSD 的独立危险因素。

临床试验注册

ChiCTR-TNC-11001489。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22d7/7509952/f6b72806ae0b/bmjopen-2019-035880f01.jpg

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