Department of Emergency, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443000, China.
Intensive Care Unit, Hospital of Traditional Chinese Medicine of Jingzhou City, Jingzhou, 434000, China.
Sci Rep. 2024 Sep 4;14(1):20573. doi: 10.1038/s41598-024-71754-z.
Asthma is a prevalent chronic disease characterized by airflow obstruction, causing breathing difficulties and wheezing. This study investigates the association between the C-reactive protein to albumin ratio (CAR) and asthma prevalence, as well as all-cause and respiratory mortality among asthma patients, using data from the 2001-2018 National Health and Nutrition Examination Survey. We included participants aged 20 years and older with complete CAR data, excluding those who were pregnant or lost to follow-up. The analysis employed weighted logistic regression and Cox proportional hazards models with stepwise adjustment, restricted cubic spline analysis for nonlinear relationships, and time-dependent ROC curves for predictive accuracy. Results showed that the highest CAR quartile significantly increased the risk of asthma (OR 1.56, 95% CI 1.38-1.78), all-cause mortality (HR 2.20, 95% CI 1.67-2.89), and respiratory mortality (HR 2.56, 95% CI 1.30-5.38). The impact of CAR on all-cause mortality was particularly significant in hypertensive patients. These findings highlight CAR's potential as a valuable biomarker for predicting asthma prevalence and mortality, underscoring its role in asthma management and prognostication.
哮喘是一种常见的慢性疾病，其特征是气流阻塞，导致呼吸困难和喘息。本研究利用 2001-2018 年全国健康和营养调查的数据，调查了 C 反应蛋白与白蛋白比值（CAR）与哮喘患病率以及哮喘患者全因和呼吸死亡率之间的关系。我们纳入了年龄在 20 岁及以上且具有完整 CAR 数据的参与者，排除了怀孕或失访的患者。分析采用了加权 logistic 回归和 Cox 比例风险模型进行逐步调整，非线性关系采用限制性立方样条分析，预测准确性采用时间依赖性 ROC 曲线。结果表明，CAR 最高四分位组显著增加了哮喘（OR 1.56，95%CI 1.38-1.78）、全因死亡率（HR 2.20，95%CI 1.67-2.89）和呼吸死亡率（HR 2.56，95%CI 1.30-5.38）的风险。CAR 对全因死亡率的影响在高血压患者中尤为显著。这些发现强调了 CAR 作为预测哮喘患病率和死亡率的有价值生物标志物的潜力，突出了其在哮喘管理和预后中的作用。
