Wang Chi, Zheng Mengyi, Yun Cuijuan, Feng Zekun, Li Yanjie, Chen Shuohua, Wu Shouling, Xue Hao
Department of Cardiology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People's Republic of China.
Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China.
J Inflamm Res. 2025 Aug 27;18:11841-11852. doi: 10.2147/JIR.S527515. eCollection 2025.
We sought to investigate the joint association of systemic inflammation and atherogenic dyslipidemia with cardiometabolic disease (CMD) and whether the temporal relationship between them is associated with risk of CMD.
This prospective cohort study included 78,206 participants without history of cardiovascular disease and diabetes mellitus at study entry in 2006. Systemic inflammation and atherogenic dyslipidemia were evaluated by C-reactive protein (CRP) and atherogenic index of plasma (AIP), respectively. Participants were categorized into six groups according to their CRP level (<1, 1-3, or ≥3 mg/L) and AIP level (<0.1 or ≥0.1). We used Cox proportional hazard regression to calculate the hazard ratios and 95% confidence intervals (CI) for incident CMD. The temporal relationship between increased CRP and elevated AIP and the association of this temporal relationship with subsequent CMD risk were assessed by cross-lagged analysis and mediation analysis in the 53,713 participants who attended the resurvey in 2010.
Increased CRP and elevated AIP were additively associated with a higher risk of CMD, where participants with a CRP of ≥3 mg/L and an AIP of ≥0.1 had 64% higher risk compared with those with low CRP and AIP values (adjusted HR: 1.64, 95% CI, 1.55-1.74). In the cross-lagged analysis, the standard regression coefficient from baseline CRP to follow-up AIP was 0.069 (95% CI, 0.061-0.077), which was greater than that from baseline AIP to follow-up CRP 0.014 (95% CI, 0.005-0.023). Furthermore, in the mediation analysis, 21.52% (95% CI 17.71-25.34) of the total association between CRP and incident CMD was mediated through AIP.
Systemic inflammation and atherogenic dyslipidemia were jointly associated with increased risk of CMD. Systemic inflammation might precede atherogenic dyslipidemia, and atherogenic dyslipidemia partly mediated the association between systemic inflammation and incident CMD.
我们试图研究全身炎症和致动脉粥样硬化性血脂异常与心脏代谢疾病（CMD）的联合关联，以及它们之间的时间关系是否与CMD风险相关。
这项前瞻性队列研究纳入了2006年研究开始时无心血管疾病和糖尿病病史的78206名参与者。分别通过C反应蛋白（CRP）和血浆致动脉粥样硬化指数（AIP）评估全身炎症和致动脉粥样硬化性血脂异常。参与者根据其CRP水平（<1、1 - 3或≥3mg/L）和AIP水平（<0.1或≥0.1）分为六组。我们使用Cox比例风险回归来计算发生CMD的风险比和95%置信区间（CI）。在2010年参加重新调查的53713名参与者中，通过交叉滞后分析和中介分析评估CRP升高和AIP升高之间的时间关系以及这种时间关系与随后CMD风险的关联。
CRP升高和AIP升高与更高的CMD风险呈累加关联，其中CRP≥3mg/L且AIP≥0.1的参与者与CRP和AIP值低的参与者相比，风险高64%（调整后的HR：1.64，95%CI，1.55 - 1.74）。在交叉滞后分析中，从基线CRP到随访AIP的标准回归系数为0.069（95%CI，0.061 - 0.077），大于从基线AIP到随访CRP的0.014（95%CI，0.005 - 0.023）。此外，在中介分析中，CRP与发生CMD之间的总关联中有21.52%（95%CI 17.71 - 25.34）通过AIP介导。
全身炎症和致动脉粥样硬化性血脂异常与CMD风险增加联合相关。全身炎症可能先于致动脉粥样硬化性血脂异常出现，并且致动脉粥样硬化性血脂异常部分介导了全身炎症与发生CMD之间
