DOI QR코드

DOI QR Code

High-Sensitivity C-Reactive Protein and Risks of All-Cause and Cause-Specific Mortality in a Japanese Population

  • Nisa, Hoirun (Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University) ;
  • Hirata, Akie (Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University) ;
  • Kohno, Michiko (Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University) ;
  • Kiyohara, Chikako (Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University) ;
  • Ohnaka, Keizo (Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University)
  • Published : 2016.05.01

Abstract

Background: High-sensitivity C-reactive protein (hsCRP) levels are lower in Japanese compared with Western subjects. Since it is uncertain whether hsCRP is a potent predictor of mortality at low CRP concentrations, the present study examined associations with all-cause and cause-specific mortality in a large population of Japanese. Materials and Methods: Subjects were 4,737 men and 6,343 women aged 49-76 years participating in the baseline survey of an ongoing cohort study of lifestyle-related diseases between February 2004 and July 2006. Hazard ratios for all-cause and cause-specific mortality associated with hsCRP levels were estimated using Cox proportional hazards regression. Results: A total of 436 all-cause deaths occurred during a median follow-up of 8 years. The main cause of death was cancer. In men, hsCRP levels were positively associated with the risk of all-cause mortality as well as deaths from cancer and cardiovascular disease (CVD). All-cause mortality hazards for the 2nd (0.34-0.84 mg/L) and the 3rd (${\geq}0.85mg/L$) tertiles of hsCRP were 1.27 (95% confidence interval [CI], 0.93-1.73) and 1.75 (1.30-2.37), respectively (p for trend=0.001). In women, increased risk of all-cause and cause-specific mortality associated with elevated hsCRP levels was observed, but the associations were not statistically significant. Conclusions: HsCRP may be an independent predictor of all-cause, cancer and CVD mortality in apparently healthy Japanese men, but not women. The differential effect of hsCRP in predicting mortality risk by sex warrants further investigation.

Keywords

C-reactive protein;mortality;cancer;cardiovascular disease;inflammation

Acknowledgement

Supported by : Japan Society of the Promotion Science

References

  1. Ahmadi-Abhari S, Luben RN, Wareham NJ, et al (2013). Seventeen year risk of all-cause and cause-specific mortality associated with C-reactive protein, fibrinogen and leukocyte count in men and women: the EPIC-Norfolk study. Eur J Epidemiol, 28, 541-50. https://doi.org/10.1007/s10654-013-9819-6
  2. Allin KH, Nordestgaard BG (2011). Elevated C-reactive protein in the diagnosis, prognosis, and cause of cancer. Crit Rev Clin Lab Sci, 48, 155-70. https://doi.org/10.3109/10408363.2011.599831
  3. Arima H, Kubo M, Yonemoto K, et al (2008). High-sensitivity C-reactive protein and coronary heart disease in a general population of Japanese: the Hisayama study. Arterioscler Thromb Vasc Biol, 28, 1385-91. https://doi.org/10.1161/ATVBAHA.107.157164
  4. De Martinis M, Franceschi C, Monti D, et al (2006). Inflammation markers predicting frailty and mortality in the elderly. Exp Mol Pathol, 80, 219-27. https://doi.org/10.1016/j.yexmp.2005.11.004
  5. Doran B, Zhu W, Muennig P (2013). Gender differences in cardiovascular mortality by C-reactive protein level in the United States: evidence from the National Health and Nutrition Examination Survey III. Am Heart J, 166, 45-51. https://doi.org/10.1016/j.ahj.2013.03.017
  6. Gaskins AJ, Wilchesky M, Mumford SL, et al (2012). Endogenous reproductive hormones and C-reactive protein across the menstrual cycle: the Bio Cycle Study. Am J Epidemiol, 175, 423-31. https://doi.org/10.1093/aje/kwr343
  7. Guo YZ, Pan L, Du CJ, et al (2013). Association between C-reactive protein and risk of cancer: a meta-analysis of prospective cohort studies. Asian Pac J Cancer Prev, 14, 243-8. https://doi.org/10.7314/APJCP.2013.14.1.243
  8. Heikkila K, Ebrahim S, Rumley A, et al (2007). Associations of circulating C-reactive protein and interleukin-6 with survival in women with and without cancer: findings from the British Women's Heart and Health Study. Cancer Epidemiol Biomarkers Prev, 16, 1155-9. https://doi.org/10.1158/1055-9965.EPI-07-0093
  9. Hirata A, Ohnaka K, Morita M, et al (2012). Behavioral and clinical correlates of high-sensitivity C-reactive protein in Japanese men and women. Clin Chem Lab Med, 50, 1469-76.
  10. Hotamisligil GS (2006). Inflammation and metabolic disorders. Nature, 444, 860-7. https://doi.org/10.1038/nature05485
  11. Il'yasova D, Colbert LH, Harris TB, et al (2005). Circulating levels of inflammatory markers and cancer risk in the health aging and body composition cohort. Cancer Epidemiol Biomarkers Prev, 14, 2413-8. https://doi.org/10.1158/1055-9965.EPI-05-0316
  12. Iso H, Cui R, Date C, et al (2009). C-reactive protein levels and risk of mortality from cardiovascular disease in Japanese: the JACC Study. Atherosclerosis, 207, 291-7. https://doi.org/10.1016/j.atherosclerosis.2009.04.020
  13. Kaptoge S, Di Angelantonio E, Lowe G, et al (2010). C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet, 375, 132-40. https://doi.org/10.1016/S0140-6736(09)61717-7
  14. Ko YJ, Kwon YM, Kim KH, et al (2012). High-sensitivity C-reactive protein levels and cancer mortality. Cancer Epidemiol Biomarkers Prev, 21, 2076-86. https://doi.org/10.1158/1055-9965.EPI-12-0611
  15. Lee YJ, Lee JH, Shin YH, et al (2009). Gender difference and determinants of C-reactive protein level in Korean adults. Clin Chem Lab Med, 47, 863-9.
  16. MacGregor AJ, Gallimore JR, Spector TD, et al (2004). Genetic effects on baseline values of C-reactive protein and serum amyloid a protein: a comparison of monozygotic and dizygotic twins. Clin Chem, 50, 130-4. https://doi.org/10.1373/clinchem.2003.028258
  17. Nanri A, Yoshida D, Yamaji T, et al (2008). Dietary patterns and C-reactive protein in Japanese men and women. Am J Clin Nutr, 87, 1488-96. https://doi.org/10.1093/ajcn/87.5.1488
  18. Nanri H, Nakamura K, Hara M, et al (2011). Association between dietary pattern and serum C-reactive protein in Japanese men and women. J Epidemiol, 21, 122-31. https://doi.org/10.2188/jea.JE20100110
  19. Parrinello CM, Lutsey PL, Ballantyne CM, et al (2015). Six-year change in high-sensitivity C-reactive protein and risk of diabetes, cardiovascular disease, and mortality. Am Heart J, 170, 380-9. https://doi.org/10.1016/j.ahj.2015.04.017
  20. Pepys MB, Hirschfield GM (2003). C-reactive protein: a critical update. J Clin Invest, 111, 1805-12. https://doi.org/10.1172/JCI200318921
  21. Ridker PM (2016). A Test in Context: High-Sensitivity C-Reactive Protein. J Am Coll Cardiol, 67, 712-23.
  22. Saito I, Maruyama K, Eguchi E (2014). C-reactive protein and cardiovascular disease in East asians: a systematic review. Clin Med Insights Cardiol, 8, 35-42.
  23. Saito I, Sato S, Nakamura M, et al (2007). A low level of C-reactive protein in Japanese adults and its association with cardiovascular risk factors: the Japan NCVC-collaborative inflammation cohort (JNIC) study. Atherosclerosis, 194, 238-44. https://doi.org/10.1016/j.atherosclerosis.2006.07.032
  24. Shimano H, Arai H, Harada-Shiba M, et al (2008). Proposed guidelines for hypertriglyceridemia in Japan with non-HDL cholesterol as the second target. J Atheroscler Thromb, 15, 116-21. https://doi.org/10.5551/jat.E560
  25. Sung KC, Ryu S, Chang Y, et al (2014). C-reactive protein and risk of cardiovascular and all-cause mortality in 268 803 East Asians. Eur Heart J, 35, 1809-16. https://doi.org/10.1093/eurheartj/ehu059
  26. Swede H, Hajduk AM, Sharma J, et al (2014). Baseline serum C-reactive protein and death from colorectal cancer in the NHANES III cohort. Int J Cancer, 134, 1862-70. https://doi.org/10.1002/ijc.28504
  27. Tokudome S, Goto C, Imaeda N, et al (2004). Development of a data-based short food frequency questionnaire for assessing nutrient intake by middle-aged Japanese. Asian Pac J Cancer Prev, 5, 40-3.
  28. Wulaningsih W, Holmberg L, Ng T, et al (2016). Serum leptin, C-reactive protein, and cancer mortality in the NHANES III. Cancer Med, 5, 120-8. https://doi.org/10.1002/cam4.570
  29. Zacho J, Tybjaerg-Hansen A, Nordestgaard BG (2010). C-reactive protein and all-cause mortality--the Copenhagen city heart study. Eur Heart J, 31, 1624-32. https://doi.org/10.1093/eurheartj/ehq103
  30. Zuo H, Ueland PM, Ulvik A, et al (2016). Plasma biomarkers of inflammation, the kynurenine pathway, and risks of all-cause, cancer, and cardiovascular disease mortality: the hordaland health study. Am J Epidemiol, 183, 249-58. https://doi.org/10.1093/aje/kwv242