C-reactive protein for risk assessment in the primary prevention of cardiovascular disease : association between effect of life style modification and C-reactive protein

本文对116例健康日本人(BMI：15.7~30.6 kg/m~2，15例BMI在25~29.9 kg/m~2，2例BMI等于或大于30 kg/m~2)与C反应蛋白(CRP)与内脏肥胖、胰岛素抵抗和颈动脉硬化的关系进行了研究。采用横断面设计，测量肥胖与内脏脂肪、C反应蛋白、白介素6、组织坏死因子α、颈动脉内中膜厚度等指标，并进行统计学分析。单因素分析中，C反应蛋白与肥胖指数显著相关，与腰围、腰臀比、内脏脂肪面积和调整年龄、性别、吸烟后的固有脂肪指数相关。IL-6、肿瘤坏死因子-α与C反应蛋白无相关性。血压、代谢指数、CCA-IMT也与C反应蛋白相关。在调整年龄、性别、吸烟、体重指数后，只有血压和高密度脂蛋白与C反应蛋白显著相关。在健康日本人中，C反应蛋白与内脏肥胖症和部分胰岛素抵抗指标有关，而与IL-6和肿瘤坏死因子-α无关。我们通过系统回顾普通人群中的现有研究，检验了超敏C反应蛋白与动脉硬化程度和生活方式改变的影响之间的关系。以下几点变得清晰起来。在健康的中年男性和女性中，CRP值独立预测动脉硬化性疾病的发病或死亡。然而，在一名80岁以上的老年人中，没有足够的证据。CRP值与膳食营养素呈正相关，体力活动降低CRP值，吸烟使CRP值升高。此外，CRP值与颈动脉实变(内-中膜增厚-IMT)有关，再次有证据表明饮用中等量饮酒会降低CRP值。

The association between C-reactive protein(CRP) and an index of internal organs obesity, insulin resistance, and arteriosclerosis of carotid arteries were investigated with 116 healthy Japanese(BMI:15.7〜30.6kg/m^2;15subjects' BMI were between 25〜29.9kg/m^2,2 subjects' BMI were equal or more than 30kg/m^2). Obesity and internal organs fat, CRP, interleukin-6(IL-6), tissue necrosis factor α(TNF-α), carotid artery supersonic intima-media thickness(IMT) were measured and analyzed in cross-sectional design. CRP was related to a fat index in univariate analysis significantly, and CRP was related by waist circumference, waist hips rate, a viscera adipose area and the built-in fat index that said after adjustment in age, sex, smoking. IL-6 and TNF-α were not related to CRP. Blood pressure, metabolic index, CCA-IMT were related with CRP, too. However, in the adjustment for age, sex, smoking, BMI, only blood pressure and HDL-cholesterol were significantly related with CRP.Among healthy Japanese, CRP was related to internal organs obesity and a part of indexes of insulin resistance, but was not related to IL-6 and TNF-α. We examined association between hyper-sensitive CRP, and degree of arterial sclerosis and effect of life-style modification by reviewing available studies in general population systematically. The following points became clear. CRP value foresees the arteriosclerotic disease onset or death independently among healthy middle-aged men and women. However, there was not enough evidence, among a senior citizen older than 80 years old. CRP value was in conjunction with dietary nutrient, and physical activity decreases CRP value, and smoking raises CRP value. In addition, CRP value was related with carotid artery consolidation(hyperplasia of Intima-medica thickness-IMT), and it became dear that there was level of evidence n about drinking of middle equivalence decreasing CRP value again.