Huang Jiaofeng, Wang Mingfang, Wu Yinlian, Kumar Rahul, Lin Su
Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, Fujian, China.
Front Physiol. 2022 Oct 20;13:1012887. doi: 10.3389/fphys.2022.1012887. eCollection 2022.
High-sensitive C-reactive protein (hs-CRP) is one of the diagnostic components for metabolic (-dysfunction) associated fatty liver disease (MAFLD). This study aimed to explore the relationship between hs-CRP level and 25-year mortality in patients with MAFLD. The study data were from the Third National Health and Nutrition Examination Survey 1988-1994. All participants were followed up until December 2015 and the outcome of each participant was ascertained from National Death Index records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence interval (CI) of all-cause mortality, cardiovascular-related mortality, and malignancy-related mortality. A total of 4,145 participants with MAFLD were included in final analysis. The median follow-up period was 22.3 years (interquartile range 16.9-24.2). There were 1,610 (38.8%) all-cause deaths. The leading cause of death was malignant neoplasms (365/1,610, 22.7%), followed by cardiovascular diseases (342/1,610, 21.2%). Of the 4,145 patients with MAFLD, 1,293 (31.2%) had an hs-CRP level greater than 0.5 mg/dl. Those with hs-CRP > 0.5 mg/dl were older, more likely to be female and had greater derangements of metabolic profiles than those with lower hs-CRP. The results of Cox regression analysis showed that hs-CRP ≥ 0.5 mg/dl was an independent risk factor for all-cause mortality (HR = 1.394, 95% CI 1.253-1.551), cardiovascular mortality (HR = 1.497, 95% CI 1.190-1.885) and malignant neoplasms related mortality (HR = 1.290, 95% CI 1.030-1.615) after adjusting for risk factors. This study confirms that hs-CRP is an independent predictive factor of poor prognosis in patients with MAFLD.
高敏C反应蛋白（hs-CRP）是代谢（功能障碍）相关脂肪性肝病（MAFLD）的诊断指标之一。本研究旨在探讨MAFLD患者hs-CRP水平与25年死亡率之间的关系。研究数据来自1988 - 1994年第三次全国健康与营养检查调查。所有参与者均随访至2015年12月，每位参与者的结局通过国家死亡指数记录确定。采用Cox比例风险模型估计全因死亡率、心血管相关死亡率和恶性肿瘤相关死亡率的风险比（HRs）及95%置信区间（CI）。最终分析纳入了4145例MAFLD参与者。中位随访期为22.3年（四分位间距16.9 - 24.2）。共有1610例（38.8%）全因死亡。主要死因是恶性肿瘤（365/1610，22.7%），其次是心血管疾病（342/1610，21.2%）。在4145例MAFLD患者中，1293例（31.2%）hs-CRP水平高于0.5mg/dl。hs-CRP>0.5mg/dl的患者年龄更大，更可能为女性，且代谢指标紊乱程度高于hs-CRP水平较低者。Cox回归分析结果显示，在校正风险因素后，hs-CRP≥0.5mg/dl是全因死亡率（HR = 1.394，95%CI 1.253 - 1.551）、心血管死亡率（HR = 1.497，95%CI 1.190 - 1.885）和恶性肿瘤相关死亡率（HR = 1.290，95%CI 1.030 - 1.615）的独立危险因素。本研究证实hs-CRP是MAFLD患者预后不良的独立预测因素。
