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Interactive effect of increased high sensitive C-reactive protein and dyslipidemia on cardiovascular diseases: a
Solim Essomandan Clémence Bafei1, Xianghai Zhao2, Changying Chen1
1Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
Insights
This study found that abnormal blood lipid levels and high-sensitivity C-reactive protein (hs-CRP) have negative interactions on cardiovascular disease (CVD) risk. These findings suggest a complex relationship between inflammation and dyslipidemia in CVD development.
Area of Science:
- Cardiology
- Biochemistry
- Epidemiology
Background:
- Cardiovascular diseases (CVD) are significantly influenced by dyslipidemia and inflammation.
- Research on the interaction between dyslipidemia and inflammation in CVD risk is limited.
Purpose of the Study:
- To investigate the interaction between dyslipidemia and high-sensitivity C-reactive protein (hs-CRP) on the risk of developing CVD.
Main Methods:
- A prospective cohort study of 4,128 adults followed for 13 years.
- Cox-proportional hazard regression analysis was used to assess associations and interactions.
- Additive and multiplicative interaction analyses were performed using RERI and HRs.
Main Results:
- Increased hs-CRP was associated with higher CVD risk (HR: 1.42) in individuals with normal lipid levels.
- Specific lipid abnormalities (e.g., high LDL-C, non-HDL-C) were linked to CVD risk in those with normal hs-CRP.
- Negative multiplicative and additive interactions were observed between increased hs-CRP and elevated LDL-C or non-HDL-C on CVD risk.
Conclusions:
- Dyslipidemia and hs-CRP exhibit negative interactions concerning CVD risk.
- Further large-scale studies are needed to confirm these findings and elucidate the underlying biological mechanisms.
Background:
Dyslipidemia and inflammation are significant factors for the onset of cardiovascular diseases (CVD); however, studies regarding their interactions on the risk of CVD are scarce. This study aimed to assess the interaction of dyslipidemia and high-sensitivity C-reactive protein (hs-CRP) on CVD.
Methods:
This prospective cohort enrolled 4,128 adults at baseline in 2009 and followed them up until May 2022 for collecting CVD events. Cox-proportional hazard regression analysis estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of the associations of increased hs-CRP (≥ 1 mg/L) and dyslipidemia with CVD. The additive interactions were explored using the relative excess risk of interaction (RERI) and the multiplicative interactions were assessed with HRs (95% CI) while the multiplicative interactions were assessed by the HRs (95% CI) of interaction terms.
Results:
The HRs of the association between increased hs-CRP and CVD were 1.42 (95% CI: 1.14-1.79) and 1.17 (95% CI: 0.89-1.53) among subjects with normal lipid levels and subjects with dyslipidemia, respectively. Stratified analyses by hs-CRP levels showed that among participants with normal hs-CRP (< 1 mg/L), TC ≥ 240 mg/dL, LDL-C ≥ 160 mg/dL, non-HDL-C ≥ 190 mg/dL, ApoB < 0.7 g/L, and LDL/HDL-C ≥ 2.02 were associated with CVD [HRs (95%CIs): 1.75 (1.21-2.54), 2.16 (1.37-3.41), 1.95 (1.29-2.97), 1.37 (1.01-1.67), and 1.30 (1.00-1.69), all P < 0.05, respectively]. While in the population with increased hs-CRP, only ApoAI > 2.10 g/L had a significant association with CVD [HR (95% CI): 1.69 (1.14-2.51)]. Interaction analyses showed that increased hs-CRP had multiplicative and additive interactions with LDL-C ≥ 160 mg/dL and non-HDL-C ≥ 190 mg/dL on the risk of CVD [HRs (95%CIs): 0.309 (0.153-0.621), and 0.505 (0.295-0.866); RERIs (95%CIs): -1.704 (-3.430-0.021 and - 0.694 (-1.476-0.089), respectively, all P < 0.05].
Conclusion:
Overall our findings indicate negative interactions between abnormal blood lipid levels and hs-CRP on the risk of CVD. Further large-scale cohort studies with trajectories measurement of lipids and hs-CRP might verify our results as well explore the biological mechanism behind that interaction.
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