高敏C反应蛋白升高与腹主动脉瘤风险：基于挪威HUNT研究的前瞻性人群研究
Elevated High Sensitivity C Reactive Protein and Risk of Abdominal Aortic Aneurysm: A Prospective Population Based Study in The Norwegian HUNT Study.
作者信息
Håland Aslak Bryne, Mattsson Erney, Videm Vibeke, Albrektsen Grethe, Nyrønning Linn Åldstedt
机构信息
Department of Vascular Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
出版信息
Eur J Vasc Endovasc Surg. 2025 May;69(5):733-741. doi: 10.1016/j.ejvs.2024.12.036. Epub 2025 Jan 9.
OBJECTIVE
Inflammation seems to be crucial in the pathogenesis of abdominal aortic aneurysm (AAA). Previous research links inflammatory biomarkers, such as high sensitivity C reactive protein (hs-CRP), to AAA. Few studies, however, have used a prospective design. The aim of this study was to examine whether individuals with elevated hs-CRP have increased risk of AAA, using a prospective and population based design.
METHODS
This prospective, population based, cohort study included 46 322 participants in the Trøndelag Health Study (HUNT) in Norway (53.7% female). During a median follow up of 12.6 years (range 0 - 26 years), 407 individuals were diagnosed with AAA (22.4% female). Cox proportional hazards regression was applied to examine associations between hs-CRP and risk of AAA. hs-CRP was treated either as a continuous or a categorical variable (dichotomised at 2 mg/L, 1 mg/L, or median [1.2 mg/L], or as quartiles).
RESULTS
The hazard ratio (HR) of developing AAA per 1 mg/L increase in hs-CRP (continuous hs-CRP) was 1.02 (95% confidence interval [CI] 1.01 - 1.03) in the analysis adjusted for smoking, coronary heart disease, hypertension, diabetes, body mass index, and total cholesterol. Individuals with hs-CRP ≥ 2 mg/L had almost twice the risk of AAA compared with individuals with hs-CRP < 2 mg/L (adjusted HR 1.84, 95% CI 1.51 - 2.25). Dichotomising hs-CRP at a clinical cutoff point of 1 mg/L (adjusted HR 2.13, 95% CI 1.64 -2.76) or at the median of 1.2 mg/L (adjusted HR 2.12, 95% CI 1.62 - 2.76) slightly strengthened the HR. The adjusted HR gradually increased through the ordered hs-CRP quartiles, and was almost four times higher (HR 3.87, 95% CI 2.54 - 5.92) in the highest hs-CRP quartile (hs-CRP > 2.7 mg/L) compared with the lowest quartile (hs-CRP ≤ 0.6 mg/L).
CONCLUSION
Individuals with elevated hs-CRP had significantly increased risk of developing AAA.
目的
炎症似乎在腹主动脉瘤（AAA）的发病机制中起关键作用。先前的研究将炎症生物标志物，如高敏C反应蛋白（hs-CRP），与AAA联系起来。然而，很少有研究采用前瞻性设计。本研究的目的是使用前瞻性和基于人群的设计，检验hs-CRP升高的个体患AAA的风险是否增加。
方法
这项前瞻性、基于人群的队列研究纳入了挪威特隆赫姆健康研究（HUNT）中的46322名参与者（53.7%为女性）。在中位随访12.6年（范围0 - 26年）期间，407人被诊断为AAA（22.4%为女性）。采用Cox比例风险回归分析来检验hs-CRP与AAA风险之间的关联。hs-CRP被视为连续变量或分类变量（在2mg/L、1mg/L或中位数[1.2mg/L]处二分，或作为四分位数）。
结果
在对吸烟、冠心病、高血压、糖尿病、体重指数和总胆固醇进行调整后的分析中，hs-CRP每升高1mg/L（连续hs-CRP）发生AAA的风险比（HR）为1.02（95%置信区间[CI]1.01 - 1.03）。hs-CRP≥2mg/L的个体患AAA的风险几乎是hs-CRP<2mg/L个体的两倍（调整后HR 1.84，95%CI 1.51 - 2.25）。将hs-CRP在临床切点1mg/L（调整后HR 2.13，95%CI 1.64 - 2.76）或中位数1.2mg/L（调整后HR 2.12，95%CI 1.62 - 2.76）处二分，略微增强了HR。调整后的HR通过有序的hs-CRP四分位数逐渐增加，与最低四分位数（hs-CRP≤0.6mg/L）相比，最高hs-CRP四分位数（hs-CRP>2.7mg/L）的调整后HR几乎高出四倍（HR 3.87，95%CI 2.54 - 5.92）。
结论
hs-CRP升高的个体患AAA的风险显著增加。
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