Elevated C-reactive protein levels in patients with polypoidal choroidal vasculopathy and patients with neovascular age-related macular degeneration
Elevated C-reactive protein levels in patients with polypoidal choroidal vasculopathy and patients with neovascular age-related macular degeneration
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DOI：
10.1016/j.ophtha.2006.12.021
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发表时间：
2007-09-01
期刊：
影响因子：
13.7
通讯作者：
Terasaki, Hiroko
中科院分区：
文献类型：
--
作者：
Kikuchi, Masato;Nakamura, Makoto;Terasaki, Hiroko
目的：确定日本患者全身C反应蛋白（CRP）水平与息肉状脉络膜血管病（PCV）和晚期新生血管性年龄相关性黄斑变性（AMD）之间的关系。设计图：病例对照研究。参与者：97例PCV患者，176例晚期新生血管性AMD患者和262例无任何黄斑异常的对照者进行了研究。采用吲哚菁绿色血管造影和荧光素血管造影进行诊断。CRIP水平通过使用乳胶聚集免疫测定的高灵敏度测定来测量，并且使用Kruskal-Wallis检验将PCV和新生血管性AMD患者的水平与对照组中的水平进行比较。将研究人群分为四分位数后，采用Logistic回归分析，计算比值比（OR）和95%可信区间（Cls），比较CRP与PCV或新生血管性AMD的相关性。结果：PCV组（0.94 mg/l）或晚期新生血管性AMD组（0.95 mg/l）的CRIP中位数水平显著高于对照组（0.43 mg/l）（Kruskal-Wallis检验P < 0.001）。在校正基线特征如年龄、性别、吸烟状况、饮酒、体重指数、病史和抗抑郁药使用后，（OR，3.53; 95%CI，1.49-8.40）和新生血管性AMD（OR，4.08; 95%CI，1.94-8.56），以及CRP的第三四分位数对于新生血管性AMD（OR，2.29; 95%CI，1.07-4.91）。PCV（P = 0.001）和新生血管性AMD（P <0.001）的发病风险随CRP升高而增加的趋势具有统计学意义。结论：日本人血清CRP水平升高与PCV或新生血管性AMD之间的显著相关性强烈表明炎症过程参与PCV和新生血管性AMD的发病机制。Ophthalmology 2007，-114：1722-1727（c）2007，美国眼科学会。
Purpose: To determine the relationship between systemic C-reactive protein (CRP) levels and polypoidal choroidal vasculopathy (PCV) and advanced neovascular age-related macular degeneration (AMD) in Japanese patients. Design: Case-control study.Participants: Ninety-seven patients with PCV, 176 with advanced neovascular AMD, and 262 control subjects without any macular abnormality were studied.Methods: Color fundus photographs of the macular area were taken from both eyes in all subjects. Indocyanine green angiography and fluorescein angiography were performed for diagnosis. The CRIP level was measured by a high-sensitivity assay using a latex aggregation immunoassay, and the levels in patients with PCV and neovascular AMD were compared with that in the control group using the Kruskal-Wallis test. Associations between CRP and PCV or neovascular AMD were compared using logistic regression analysis by computing the odds ratios (ORs) and 95% confidence intervals (Cls) after the study populations were divided into quartiles.Main Outcome Measures: The CRP levels inpatients with PCV, patients with neovascular AMD, and control subjects. Standard univariate and multivariate analyses between groups.Results: Median CRIP levels were significantly higher in cases with PCV (0.94 mg/1) or with advanced neovascular AMD (0.95 mg/l) than in control subjects (0.43 mg/l) (P < 0.001 for Kruskal-Wallis test). After adjusting for baseline characteristics such as age, gender, smoking status, alcohol use, body mass index, history, and use of antiinflammatory drugs, the increase in risk was significant for the highest quartile of CRP for both PCV (OR, 3.53; 95% Cl, 1.49-8.40) and neovascular AMD (OR, 4.08; 95% Cl, 1.94-8.56), and for the third quartile of CRP for neovascular AMD (OR, 2.29; 95% Cl, 1.07-4.91). The trends for an increase in risk of disease with increase in CRP were statistically significant for both PCV (P = 0.001) and neovascular AMD (P < 0.001).Conclusions: The significant associations between elevated serum CRP levels and PCV or neovascular AMD in the Japanese strongly suggest that inflammatory processes are involved in the pathogenesis of PCV and neovascular AMD. Ophthalmology 2007,-114:1722-1727 (c) 2007 by the American Academy of Ophthalmology.