文章摘要
董莹,王增武,王馨,田野,张林峰,陈祚,曹慧青.中国中年人群超敏C反应蛋白与心血管事件、总死亡事件的关联研究[J].中华流行病学杂志,2018,39(4):428-432
中国中年人群超敏C反应蛋白与心血管事件、总死亡事件的关联研究
Association between high-sensitivity C-reactive protein and both cardiovascular, total mortality events in middle-aged Chinese adults
收稿日期:2017-09-25  出版日期:2018-04-18
DOI:10.3760/cma.j.issn.0254-6450.2018.04.008
中文关键词: 超敏C反应蛋白;心血管事件;全因死亡事件;中年人群
英文关键词: High-sensitivity C-reactive protein;Cardiovascular events;All-cause mortality events;Middle aged population
基金项目:国家自然科学基金(81373070)
作者单位E-mail
董莹 102308 北京, 中国医学科学院阜外医院 国家心血管病中心社区防治部  
王增武 102308 北京, 中国医学科学院阜外医院 国家心血管病中心社区防治部 wangzengwu@foxmail.com 
王馨 102308 北京, 中国医学科学院阜外医院 国家心血管病中心社区防治部  
田野 102308 北京, 中国医学科学院阜外医院 国家心血管病中心社区防治部  
张林峰 102308 北京, 中国医学科学院阜外医院 国家心血管病中心社区防治部  
陈祚 102308 北京, 中国医学科学院阜外医院 国家心血管病中心社区防治部  
曹慧青 100871 北京大学分子医学研究所  
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中文摘要:
      目的 了解超敏C反应蛋白(hs-CRP)与心血管事件、全因死亡事件是否独立相关。方法 2009-2010年在我国12个研究地区各抽取35~64岁调查对象1 000人,实际入选11 623人。收集清晨空腹血标本检测hs-CRP,同时调查心血管病危险因素。2016-2017年对12个地区中的7个地区进行随访,中位随访时间为6.21年(36 075人年),并记录心血管和死亡事件。总共随访6 177例,排除基线感染者、未进行hs-CRP检测和体格测量的研究对象后,5 984例纳入最终分析。根据hs-CRP值(mg/L)将人群分为3组(<1、1~和>3)。使用Cox比例风险模型,在调整各混杂因素后,探讨hs-CRP与心血管事件及总死亡事件的关联。结果 随访对象平均年龄50.2岁。hs-CRP<1、1~和>3 mg/L 3组人群心血管事件的发生率分别为3.6/1 000人年、7.1/1 000人年和10.4/1 000人年;全因死亡事件发生率分别为3.0/1 000人年、5.7/1 000人年和9.1/1 000人年。调整混杂因素后,与hs-CRP<1 mg/L组相比,hs-CRP 1~和>3 mg/L明显增加心血管事件的发生风险,HR值(95% CI)分别为1.33(0.95~1.84)和1.76(1.20~2.60),呈明显上升趋势(趋势检验P=0.003);发生全因死亡风险也明显增加,HR值(95% CI)分别为1.76(1.23~2.54)和2.64(1.74~4.01),呈明显上升趋势(趋势检验P<0.001)。结论 hs-CRP增高与心血管事件及全因死亡事件呈独立相关。
英文摘要:
      Objective To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events. Methods During 2009-2010, out of the 11 623 individuals, 1 000 participants aged 35-64 years, were recruited and divided into 12 age-groups, to have received a study on CVD risk factors. Information on the risk factors of cardiovascular diseases was also collected. Fasting blood sample was gathered for all the participants, with hs-CRP tested. Participants in 7 out of the 12 sites were followed, with 6.21 years (36 075 person-years) as the median follow-up period. Cardiovascular and all-cause mortality events were collected. A total of 6 177 participants had been followed after excluding participants who had baseline infections, or did not take hs-CRP test/physical examination at the baseline. Finally, 5 984 participants were included for analysis. Participants were categorized into three groups based on the hs-CRP (mg/L) values:<1, 1-3 and >3, respectively. Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events, after adjusting for confounding factors. Results Mean age of the participants was 50.2 years. The incidence rates of cardiovascular disease events were 3.6/1 000 person-years, 7.1/1 000 person-years, and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years, 5.7/1 000 person-years, 9.1/1 000 person-years for all-cause mortality events, respectively. After adjusting for confounding factors, the hazard risks (HR) for cardiovascular events were 1.33 (95% CI:0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95% CI:1.20-2.60) in the hs-CRP>3 mg/L group when comparing with the hs-CRP<1 mg/L group (trend test P=0.003). The HRs for all-cause mortality events were 1.76 (95% CI:1.23-2.54) and 2.64 (95% CI:1.74-4.01) (trend test P<0.001), respectively. Conclusion Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.
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