C-反应蛋白和潜在的心脏代谢风险:缺血性中风和全因死亡的观察性和门德尔式随机化研究
Monica G Rolver1,2, Frida Emanuelsson1,2, Børge G Nordestgaard2,3,4
1Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Cardiovascular diabetology
|December 11, 2025
概括
在观察性研究中,高C反应蛋白 (CRP) 预测缺血性中风和死亡的风险更高. 然而,基因分析发现CRP与这些结果之间没有因果关系,这表明炎症是标记物,而不是原因.
科学领域:
- 心血管流行病学心血管流行病学
- 炎症生物标志物 炎症生物标志物
- 遗传流行病学遗传流行病学
背景情况:
- 升高的C-反应蛋白 (CRP) 与全身炎症和心脏代谢疾病有关.
- 在一般人群中,对于缺血性中风和全因死亡率的CRP的预测值需要进一步研究.
- 了解CRP在这些结果中的因果作用对于临床风险评估至关重要.
研究的目的:
- 为了确定血CRP度是否预测缺血性中风和全因死亡风险.
- 研究血CRP升高对缺血性中风和全因死亡的潜在因果作用.
主要方法:
- 综合观察和门德尔随机化 (MR) 分析.
- 利用了大量的人口队列:哥本哈根城市心脏研究和哥本哈根总人口研究 (n=113,491).
- 在多个联盟 (CHARGE CIWG,UKBB,FinnGen,MEGASTROKE) 的多达575,531名个人中使用了两种样本MR.
主要成果:
- 通过观察,较高的CRP度与缺血性中风 (HR 1.51) 和全因死亡 (HR 1.69) 的风险显著增加有关.
- 患有CRP≥2 mg/L的个体在80岁时,缺血性中风的累积发病率高出57%,全因死亡率高出62%.
- 一个和两个样本的MR分析没有支持CRP对缺血性中风或全因死亡的因果关系 (ORs ≈1.01).
结论:
- 较高的CRP度超过人口中位数 (1.4 mg/L) 是缺血性中风和全因死亡风险的预测因素.
- 没有发现C-反应蛋白对中风或全因死亡风险的因果遗传影响.
- CRP似乎是潜在风险的标记,而不是这些结果的直接因果因素.
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