C-reactive protein levels and risk of mortality from cardiovascular disease in Japanese: the JACC Study.
Atherosclerosis 2009;
207:291-7. [PMID:
19482283 DOI:
10.1016/j.atherosclerosis.2009.04.020]
[Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2008] [Revised: 04/12/2009] [Accepted: 04/13/2009] [Indexed: 11/22/2022]
Abstract
OBJECTS
Limited evidence of association between C-reactive protein levels and cardiovascular disease has been produced for Japanese whose median protein levels are low by western standards.
METHODS
We conducted a nested case-control study as part of the Japan Collaborative Cohort Study for evaluation of cancer risk (JACC Study). A total of 39,242 subjects 40-79 years of age provided serum samples at baseline between 1988 and 1990. During the 13-year follow-up, there were 525 deaths from total strokes (ICD10: I60-I69), 209 coronary heart diseases (I20-I25) and 939 total cardiovascular diseases (I00-I99). The control subjects were matched for sex, age, area of residence and year of serum storage, and analyses were conducted after further adjustment for cardiovascular risk factors. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured with ultra-sensitive latex-enhanced immunoassay.
RESULTS
Median hs-CRP levels for controls were 0.40 mg/L for men and 0.41 mg/L for women. Hs-CRP levels were positively associated with risks of mortality from stroke, coronary heart disease, and total cardiovascular disease for men. The respective multivariable odds ratios (OR 95% CI) for the highest (>or=0.85 mg/L) vs. lowest (<0.19 mg/L) quartiles of hs-CRP for men were 1.60 (0.90-2.85), 3.68 (1.02-13.3), and 2.31 (1.49-3.59). For women, positive associations with hs-CRP levels were weaker, reaching statistical significance only for total cardiovascular disease: OR=1.69 (1.06-2.68). The positive association with total cardiovascular disease did not vary according to sex, age, smoking status, or body mass index.
CONCLUSIONS
Higher serum hs-CRP levels were associated with higher mortality from cardiovascular disease in Japanese.
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