Preventive Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
BMJ Open. 2022 Jul 4;12(7):e052630. doi: 10.1136/bmjopen-2021-052630.
This study aimed to examine the association of high-sensitivity C reactive protein (CRP) with mortality risk and the attenuated effect of non-communicable disease history (NCD ) on the association.
Prospective cohort study.
Health Examinees cohort.
A total of 41 070 men and 81 011 women aged ≥40 years were involved (follow-up: 6.8 years).
Data and cause of death occurring until 31 December 2015 were confirmed by death statistics from the National Statistical Office. We conducted advanced analysis after stratification by NCD and sensitivity analysis after excluding death before 1 or 2 years from recruitment. Cox proportional hazard and restricted cubic spline models were used to assess the association.
The association between serum CRP and risk of all-cause mortality was observed with strong linearity in both genders and was not influenced by NCD . The association of serum CRP with risk of cancer mortality was not observed in women with NCD , but the association with risk of cardiovascular disease (CVD) mortality was predominantly observed in men with NCD .
This study suggests a dose-response association of CRP with mortality risk, including cancer and CVD mortality, in Koreans with low serum CRP, although the association with cancer and CVD mortality risk could be influenced by gender and NCD .
本研究旨在探讨高敏 C 反应蛋白(CRP)与死亡风险的相关性,以及非传染性疾病史(NCD)对这种相关性的减弱作用。
前瞻性队列研究。
健康体检者队列。
共有 41070 名男性和 81011 名年龄≥40 岁的女性参与(随访时间:6.8 年)。
截至 2015 年 12 月 31 日的数据和死亡原因通过国家统计局的死亡统计数据得到确认。我们在按 NCD 分层后进行了高级分析,并在排除招募前 1 年或 2 年的死亡后进行了敏感性分析。采用 Cox 比例风险和限制性立方样条模型评估相关性。
在男女两性中,血清 CRP 与全因死亡率之间的相关性呈强线性,不受 NCD 的影响。在患有 NCD 的女性中,血清 CRP 与癌症死亡率之间的相关性不明显,但在患有 NCD 的男性中,CRP 与心血管疾病(CVD)死亡率之间的相关性主要表现出来。
本研究表明,在 CRP 水平较低的韩国人群中,CRP 与死亡率风险(包括癌症和 CVD 死亡率)之间存在剂量反应关系,尽管 CRP 与癌症和 CVD 死亡率风险之间的相关性可能受到性别和 NCD 的影响。