Race and gender differences in C-reactive protein levels
Race and gender differences in C-reactive protein levels
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DOI：
10.1016/j.jacc.2005.04.051
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发表时间：
2005-08-02
影响因子：
24
通讯作者：
de Lemos, JA
中科院分区：
文献类型：
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作者：
Khera, A;McGuire, DK;de Lemos, JA
本研究试图确定是否有种族和性别差异的C-反应蛋白（CRP）levels.Background分布的CRP分布在不同的种族和性别组比较的数据很少。最近临床实践推荐CRP检测用于心血管风险评估，建议使用统一的阈值来定义高相对风险方法：我们测量了2,749名年龄在30到65岁之间的白色和黑人受试者的CRP，这些受试者参加了达拉斯心脏研究，这是一项多种族的、基于人群的概率样本，结果黑人CRP水平高于白色人群，而白人CRP水平高于黑人女性的CRP水平高于男性（中位数，3.3 vs. 1.8 mg/l; p < 0.001）。在白色男性、黑人男性、白色女性和黑人女性中，CR-P水平> 3 mg/l的受试者的样本重量校正比例分别为31%、40%、51%和58%（每组与白色男性相比p < 0.05）。在校正传统的心血管危险因素、雌激素和他汀类药物的使用以及体重指数后，CRP水平> 3 mg/l在白色女性中仍然更常见（比值比[OR] 1.6; 95%置信区间[CI] 1.1至2.5）和黑人女性（OR 1.7; 95% CI 1.2 ~ 2.6），但黑人男性与白色男性相比无显著性差异（OR 1.3; 95% CI 0.8 ~ 1.9）。需要进一步研究以确定CRP水平的种族和性别差异是否有助于心血管结局的差异，以及心血管风险评估的阈值是否应针对不同种族和性别组进行调整。
OBJECTIVES This study sought to determine whether there are race and gender differences in the distribution of C-reactive protein (CRP) levels.BACKGROUND Few data are available comparing CRP distributions in different race and gender groups. Recent clinical practice recommendations for CRP testing for cardiovascular risk assessment suggest a uniform threshold to define high relative risk (> 3 mg/l).METHODS We measured CRP in 2,749 white and black subjects ages 30 to 65 participating in the Dallas Heart Study, a multiethnic, population-based, probability sample, and compared levels of CRP between different race and gender groups.RESULTS Black subjects had higher CRP levels than white subjects (median, 3.0 vs. 2.3 mg/l; p < 0.001) and women had higher CRP levels than men (median, 3.3 vs. 1.8 mg/l; p < 0.001). The sample-weight adjusted proportion of subjects with CR-P levels > 3 mg/l was 31%, 40%, 51%, and 58% in white men, black men, white women, and black women, respectively (p < 0.05 for each group vs. white men). After adjustment for traditional cardiovascular risk factors, estrogen and statin use, and body mass index, a CRP level > 3 mg/l remained more common in white women (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.1 to 2.5) and black women (OR 1.7; 95% CI 1.2 to 2.6) but not in black men (OR, 1.3; 95% CI, 0.8 to 1.9) when compared with white men.CONCLUSIONS Significant race and gender differences exist in the population distribution of CRP. Further research is needed to determine whether race and gender diffierences in CRP levels contribute to diffierences in cardiovascular outcomes, and whether thresholds for cardiovascular risk assessment should be adjusted for different race and gender groups.