高敏C反应蛋白与视网膜动脉阻塞及缺血性中风风险：一项跨队列研究。

High-sensitivity C-reactive protein and risk of retinal artery occlusion and ischaemic stroke: a cross-cohort study.

作者信息

Wang Yaxin, Zhang Xiayin, Liang Anyi, Niu Yongyi, Chen Daiyu, Du Zijing, Wu Wei, Zhang Feng, Wu Guanrong, Fang Ying, Shang Xianwen, Zhu Zhuoting, Hu Yijun, Chen Xiangjun, Yu Honghua, Hu Lidan

机构信息

Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

Department of Ophthalmology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.

出版信息

Br J Ophthalmol. 2025 Aug 20;109(9):1081-1087. doi: 10.1136/bjo-2023-325044.

DOI:10.1136/bjo-2023-325044

PMID:39904581

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12418542/

Abstract

AIMS

Previous studies have suggested an association between retinal artery occlusion (RAO) and ischaemic stroke (IS), both associated with elevated inflammatory factors. However, the role of high-sensitivity C-reactive protein (hs-CRP) in the sequential onset of these two diseases is still unclear. Based on this evidence, we evaluated the association of hs-CRP with RAO and IS.

METHODS

We examined hs-CRP from both the large multicentre cohort study UK Biobank and Chinese Retinal Artery Occlusion study. Cox proportional hazard models were used to study the association of hs-CRP with incident RAO and IS during the long-term follow-up in the UK Biobank. Logistic regression analysis was employed to assess the cross-sectional relationship between hs-CRP with RAO and IS in the Chinese cohort. A restricted cubic spline (RCS) approach was employed to evaluate potential non-linear associations of hs-CRP with IS.

RESULTS

After exclusions, the analysis included 459 188 participants from the UK and 338 participants from China. Over a median follow-up of 12.2 years, 136 cases of incident RAO and 3206 cases of incident IS events were recorded in the UK Biobank. After multivariable adjustment, higher hs-CRP (per 10 mg/L) level was associated with increased risks of RAO (HR: 1.34, 95% CI: 1.01 to 1.76) and IS (HR: 1.24, 95% CI: 1.17 to 1.33). RCS analysis revealed a significant non-linear relationship between hs-CRP levels and incident IS (P<0.001). Furthermore, RAO patients with higher hs-CRP levels were more likely to be combined with IS (2.81 mg/L vs 10.14 mg/L, p<0.001). In the Chinese cohort, the association between hs-CRP with RAO and IS was further confirmed. Higher hs-CRP (per 1 mg/L) level was associated with increased risks of RAO (OR: 1.43, 95% CI: 1.15 to 1.78) and IS (OR: 1.13, 95% CI: 1.03 to 1.24).

CONCLUSIONS

Our findings underscore hs-CRP as a robust risk factor for both RAO and IS. Controlling hs-CRP levels might reduce the incidence of RAO and secondary stroke.

摘要

目的

以往研究表明视网膜动脉阻塞（RAO）与缺血性卒中（IS）之间存在关联，二者均与炎症因子升高有关。然而，高敏C反应蛋白（hs-CRP）在这两种疾病相继发病中的作用仍不明确。基于此证据，我们评估了hs-CRP与RAO和IS的关联。

方法

我们检查了来自大型多中心队列研究英国生物银行和中国视网膜动脉阻塞研究中的hs-CRP。在英国生物银行的长期随访中，采用Cox比例风险模型研究hs-CRP与新发RAO和IS的关联。在中国队列中，采用逻辑回归分析评估hs-CRP与RAO和IS之间的横断面关系。采用受限立方样条（RCS）方法评估hs-CRP与IS之间潜在的非线性关联。

结果

排除后，分析纳入了来自英国的459188名参与者和来自中国的338名参与者。在英国生物银行中，中位随访12.2年期间，记录了136例新发RAO病例和3206例新发IS事件。多变量调整后，较高的hs-CRP（每10mg/L）水平与RAO（风险比：1.34，95%置信区间：1.01至1.76）和IS（风险比：1.24，95%置信区间：1.17至1.33）风险增加相关。RCS分析显示hs-CRP水平与新发IS之间存在显著的非线性关系（P<0.001）。此外，hs-CRP水平较高的RAO患者更易合并IS（2.81mg/L对10.14mg/L，p<0.001）。在中国队列中，进一步证实了hs-CRP与RAO和IS之间的关联。较高的hs-CRP（每1mg/L）水平与RAO（比值比：1.43，95%置信区间：1.15至1.78）和IS（比值比：1.13，95%置信区间：1.03至1.24）风险增加相关。