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C反应蛋白在中国关节炎患者全因死亡率预测中的作用:对公共卫生教育与推广的启示

The role of C-reactive protein in predicting all-cause mortality among Chinese arthritis patients: implications for public health education and promotion.

作者信息

Ye Shuchao, Ye Damei, Lin Changyi, Lu Dongming, You Xuelan, Xu Chaoyan, Wu Yongyang

机构信息

Department of Urology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, China.

Department of Rheumatology Immunology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, China.

出版信息

Front Public Health. 2025 Feb 6;13:1511860. doi: 10.3389/fpubh.2025.1511860. eCollection 2025.

Abstract

OBJECTIVE

Arthritis poses a significant public health challenge, contributing to increased healthcare resource utilization and reduced quality of life. C-reactive protein (CRP), a key inflammatory biomarker, plays a critical role in monitoring disease progression and guiding health promotion strategies. This study aims to investigate the association between CRP levels and all-cause mortality in Chinese arthritis patients, highlighting its implications for public health education and intervention programs.

METHODS

A prospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. Individuals diagnosed with arthritis in 2011 were included, with CRP levels as the primary exposure variable and mortality as the outcome of interest. Kaplan-Meier survival curves and Cox proportional hazards regression models were employed to assess the relationship between CRP levels and mortality risk, emphasizing the potential for targeted health education and promotion interventions.

RESULTS

A total of 3,413 participants were analyzed, with 87 deaths recorded during the 10-year follow-up period. Deceased individuals were older and exhibited higher levels of CRP, creatinine, and uric acid, alongside lower BMI, MET, eGFR, and HGB. Across three Cox regression models, elevated CRP levels (≥3 mg/L) were significantly associated with increased mortality risk [hazard ratio (HR) = 3.73 (2.23-6.23), HR = 3.00 (1.79-5.01), HR = 4.94 (1.77-13.78), respectively]. Kaplan-Meier survival curves further confirmed that arthritis patients with CRP levels ≥3 mg/L faced a markedly higher mortality risk.

CONCLUSION

Elevated CRP levels are strongly associated with increased all-cause mortality in arthritis patients, underscoring the importance of integrating CRP monitoring into public health education and promotion strategies. Efforts to control inflammation and promote health literacy regarding arthritis management may improve survival outcomes and reduce the public health burden associated with arthritis.

摘要

目的

关节炎对公共卫生构成重大挑战,导致医疗资源利用增加和生活质量下降。C反应蛋白(CRP)作为一种关键的炎症生物标志物,在监测疾病进展和指导健康促进策略方面发挥着关键作用。本研究旨在探讨中国关节炎患者CRP水平与全因死亡率之间的关联,强调其对公共卫生教育和干预项目的意义。

方法

利用中国健康与养老追踪调查(CHARLS)2011年至2020年的数据进行前瞻性队列研究。纳入2011年诊断为关节炎的个体,以CRP水平作为主要暴露变量,死亡率作为感兴趣的结局。采用Kaplan-Meier生存曲线和Cox比例风险回归模型评估CRP水平与死亡风险之间的关系,强调针对性健康教育和促进干预的潜力。

结果

共分析了3413名参与者,在10年随访期间记录到87例死亡。死亡个体年龄较大,CRP、肌酐和尿酸水平较高,同时BMI、MET、eGFR和HGB较低。在三个Cox回归模型中,CRP水平升高(≥3mg/L)与死亡风险增加显著相关[风险比(HR)分别为3.73(2.23-6.23)、3.00(1.79-5.01)、4.94(1.77-13.78)]。Kaplan-Meier生存曲线进一步证实,CRP水平≥3mg/L的关节炎患者面临明显更高的死亡风险。

结论

CRP水平升高与关节炎患者全因死亡率增加密切相关,强调将CRP监测纳入公共卫生教育和促进策略的重要性。控制炎症和提高关节炎管理健康素养的努力可能改善生存结局,减轻与关节炎相关的公共卫生负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d74a/11839721/6c08ebd10b98/fpubh-13-1511860-g001.jpg

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