基线高敏C反应蛋白水平对臂踝脉搏波传导速度的影响

The Impact of the Different Baseline Level of High-sensitivity C-reactive Protein on the Brachial-ankle Pulse Wave Velocity

目的探讨不同基线高敏c反应蛋白（hs—CRP）水平对臂踝脉搏波传导速度（baPWV）的影响。方法采用前瞻性队列研究，在2006～2007年参加健康体检的101510例开滦集团职工中随机分层抽取5852例作为研究对象，进行统一问卷调查及血液生物化学检查，符合入选标准的为5440例。于2010～2011年度进行第3次健康体检并测量baPWV，最终纳入统计分析的有效数据为4651例。依据2006～2007年健康体检时hs-CRP浓度将研究人群分为3组，对影响baPWV的相关危险因素进行多因素线性回归分析及多因素Logistic回归分析。结果（1）hs—CRP〈1mg／L（n=2682）、1mg／L≤hs—CRP〈3mg／L（n=1307）、hs—CRP〉3mg／L（n=662）各组平均baPWV分别为1505．82cm／s、1612．48cm／s、1671．04cm／s（P〈0．001）；baPWV≥1400cm／s各组检出率分别为55．1％、64．8％、72．1％（P〈0．001）；（2）在校正其他危险因素后的多元线性回归分析中，基线lg—CRP每增加一个单位，baPWV增加6．448cm／s（P=0．034）；（3）影响baPWV的多因素Logistic回归分析显示：与hs-CRP〈1mg／L组相比，hs．CRP〉3mg／L组为baPWV增加的危险因素，其RR值为1．34（95％CI1．04～1．72）。结论随着基线hs—CRP浓度的升高，baPWV逐渐增加；血清hs．CRP〉3mg／L是总人群baPWV增加的独立危险因素，在男性人群中更加显著。

Aim To explore the impact of the different baseline level of high-sensitivity C-reactive protein （ hs- CRP） on the brachial-ankle pulse wave velocity （baPWV）. Methods Prospective cohort study method was used in our study. 101 510 workers who had participated in the 2006-2007 Kailuan health examination were stratified randomly, and 5 440 participants with sufficient information for questionnaires and blood biochemical tests were recruited. In the 2010-2011 Kailuan health examination the baPWV was tested, and 4 651 were included for the final analysis. According to the concentration of hs-CRP in 2006-2007 Kailuan health examination, the participants were divided into three groups, and multivariate linear regression analysis and multivariate Logistic regression analysis were used to calculate the rate ratios for baPWV. Results （1）The average baPWV in hs-CRP〈I mg/L group （n =2 682）, 1 mg/L〈hs-CRP〈3 mg/L group （n = 1 307） and hs-CRP 〉3 mg/L group （n =662） were respectively 1 505.82 cm/s, 1 612.48 cm/s, 1671.04cm/s （P 〈 0. 001 ） ; （2）After adjustment for other risk factors, with the every one unit increasing of baseline lg_hs-CRP, baPWV increased 6. 448 cm/s in the multiple linear regression analysis （P = 0. 034） ; （3）Compared with participants whose hs-CRP 〈 1 mg/L, the RR for those with hs-CRP 〉3 mg/L was 1.34 （95%CI 1.04-1.72） in multivariate Logistic regression analysis. Conclusions The baPWV gradually increased with the increasing of baseline hs-CRP concentration. Serum hs-CRP 〉 3 mg/L was an independent risk factor for increased baPWV in the general population, especially in men.