青年人血浆高敏C反应蛋白水平对远期动脉僵硬度的预测价值

Predictive value of plasma high-sensitivity C-reactive protein for long-term arterial stiffness in young adults

目的探讨青年人群血浆高敏C反应蛋白（hsCRP）水平与远期动脉僵硬度的关系。方法研究队列共包括231名青年个体,基线期（2005年）年龄中位数为28岁,2013年对其进行随访。基线期和随访期均进行了一般信息采集,血压、身高、心率等人体测量及空腹血糖、血脂、hsCRP等生化指标测定,并于2013年使用无创自动波形分析仪测量臂踝动脉脉搏波传导速度（baPWV）。结果人群基线期和随访期血浆hsCRP水平分别为0.36（0.18-0.72）和0.50（0.22-1.05）mg/L。2005年hsCRP和2013年hsCRP间的相关系数为0.290（P〈0.01）,校正混杂因素后,二者相关性未发生显著变化（r=0.186,P〈0.01）。

Objeetive To explore the relationship between long-term arterial stiffness and plasma high-sensitivity C reactive protein （hsCRP） in young adults. Methods This cohort comprised 231 young adults with the median age of 28 years at baseline in 2005, and they were followed up in 2013. Data at baseline and follow-up including general characteristics, blood pressure, height, heart rate, and biochemistry indexes such as fasting glucose, blood lipid, plasma hsCRP were collected Or measured. Brachial-ankle pulse wave velocity （baPWV） was recorded by noninvasire automatic waveform analyzer in 2013. Results Plasma hsCRP levels were 0.36 （ 0.18 - 0.72） and 0.50 （0.22-1.05） mg/L at baseline and follow-up, respectively. Correlation coefficient for plasma hsCRP was 0. 290 （P〈0.01） between 2005 and 2013, and did not exhibit material change after adjusting for confounders （r= 0. 186, P〈0.01 ）. Adults with hsCRP ≥75 % interquantile point at baseline experienced a significantly high risk of being in the top quartile at follow-up （RR = 3. 321, 95% CI 1. 681 - 6. 559, P〈0.01 ） as compared with those with hsCRP〈75% interquantile point. Spearman correlation analysis indicated that baPWV was positively correlated with hsCRP at baseline and follow-up （both P〈0.05）. After adjusting for age, sex, blood pressure and other confounders, plasma hsCRP was independently correlated with baPWV at follow-up （β= 0. 146, P= 0. 012） but not at baseline （β= -0. 028, P=0. 641） in stepwise multivariate regression analyses. After excluding adults who had hy- pertension or diabetes mellitus, plasma hsCRP was still an independent predicting factor for baPWV at follow-up （β=0. 157, P=0. 025） but not at baseline （β=0. 013, P=0. 853）. Conclusion Although plasma hsCRP is an independent risk factor for baPWV within the same period, it cannot independently predict the long-term baPWV at early stage in young adults.