C-reactive protein: associations with haematological variables, cardiovascular risk factors and prevalent cardiovascular disease
C-reactive protein: associations with haematological variables, cardiovascular risk factors and prevalent cardiovascular disease
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DOI：
10.1046/j.1365-2141.2003.04387.x
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发表时间：
2003-07-01
影响因子：
6.5
通讯作者：
Tunstall-Pedoe, H
中科院分区：
文献类型：
--
作者：
Woodward, M;Rumley, A;Tunstall-Pedoe, H
C-反应蛋白（CRP）已被认为是心血管疾病的危险因素;然而，这种关联被与经典和血液学心血管危险因素的相互关系所混淆。因此，我们在格拉斯哥北部的MONICA（心血管疾病的监测趋势）调查中，用高灵敏度测定法测定了414名男性和515名女性的储存血浆样本中的CRP，以研究其与血液学变量、经典危险因素和流行心血管疾病的相关性。CRP与年龄、口服避孕药使用、绝经和大多数经典心血管危险因素（血压除外）相关。CRP还与促炎细胞因子白细胞介素6、红细胞压积、粘度、红细胞聚集、白色细胞计数、凝血因子[纤维蛋白原、女性中的因子（F）VII、FVIII、FIX]和抑制剂（女性中的抗凝血酶和蛋白C;蛋白S）的血浆水平相关，但与凝血活化标志物无关。CRP与男性（P = 0.03）和女性（P = 0.009）的心血管疾病患病率显著相关，然而，在调整了首先是经典危险因素，然后是纤维蛋白原后，这种关联变得不显著。我们的结论是经典的和血液学的危险因素的相关性占CRP与流行性心血管疾病的关联的一个重要组成部分，但有证据表明，在妇女中的残留，独立的影响。
C-reactive protein (CRP) has been proposed as a risk factor for cardiovascular disease; however, this association is confounded by mutual relationships with both classical and haematological cardiovascular risk factors. We, therefore, measured CRP with a high-sensitivity assay in stored plasma samples from 414 men and 515 women in the north Glasgow MONICA (MONItoring trends in CArdiovascular diseases) survey, to study its correlation with haematological variables, classical risk factors and prevalent cardiovascular disease. CRP correlated with age, oral contraceptive use, menopause and most classical cardiovascular risk factors (except blood pressure). CRP also correlated with plasma levels of the pro-inflammatory cytokine interleukin 6, and haematocrit, viscosity, red cell aggregation, white cell count, and coagulation factors [fibrinogen, factor (F) VII in women, FVIII, FIX] and inhibitors (antithrombin and protein C in women; protein S) but not coagulation activation markers. CRP was significantly associated with prevalent cardiovascular disease in both men (P = 0.03) and women (P = 0.009), however, the association became non-significant after adjustment for firstly classical risk factors, then fibrinogen. We conclude that correlations with classical and haematological risk factors account for a substantial component of the association of CRP with prevalent cardiovascular disease, but there is evidence of a residual, independent effect among women.