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Relationship between high-sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study.

ABSTRACT: OBJECTIVES:Gallstone disease (GSD) can be caused by various health and clinical factors such as obesity, dyslipidaemia and an unhealthy diet, all of which are associated with higher high-sensitivity C reactive protein (hs-CRP) concentrations. Whether hs-CRP represents an independent risk factor for GSD is still unclear. We prospectively investigated hs-CRP in relation to the occurrence of GSD based on the Kailuan study. STUDY DESIGN:Prospective cohort study. SETTING:The Kailuan cohort study was conducted in Tangshan City in northern China. PARTICIPANTS:95?319 participants who were free from GSD were recruited in this study. Epidemiological data, anthropometric parameters and biochemical data of participants were collected. PRIMARY AND SECONDARY OUTCOME MEASURES:Cox proportional hazards regression models were used to evaluate the association between hs-CRP concentrations and the risk of GSD after adjustments for potential confounders. RESULTS:During the mean 7.58 years of follow-up among 95?319 participants, 4205 participants were identified as newly diagnosed with GSD or having undergone cholecystectomy for cholelithiasis. Compared with the hs-CRP<1?mg/L group, elevated hs-CRP concentrations were significantly associated with higher risk of GSD with the corresponding HR of 1.11 (95% CI 1.03 to 1.19), 1.12 (95%?CI 1.04 to 1.22) in the 1?hs-CRP?3?mg/L and hs-CRP>3?mg/L group, respectively. The multivariate model which included hs-CRP not only had a better line of fitness but also had better predictive values to help identify new cases of GSD during follow-up. CONCLUSION:Elevated hs-CRP concentration is an independent risk factor for new-onset GSD among the Chinese population. TRIAL REGISTRATION NUMBER:ChiCTR-TNC-11001489.

SUBMITTER: Liu T

PROVIDER: S-EPMC7509952 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Relationship between high-sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study.

Liu Tong T Siyin Sarah Tan ST Yao Nan N Duan Ning N Xu Guoshuai G Li Wenqiang W Qu Jun J Liu Siqing S

BMJ open 20200922 9

<h4>Objectives</h4>Gallstone disease (GSD) can be caused by various health and clinical factors such as obesity, dyslipidaemia and an unhealthy diet, all of which are associated with higher high-sensitivity C reactive protein (hs-CRP) concentrations. Whether hs-CRP represents an independent risk factor for GSD is still unclear. We prospectively investigated hs-CRP in relation to the occurrence of GSD based on the Kailuan study.<h4>Study design</h4>Prospective cohort study.<h4>Setting</h4>The Kai ...[more]

PMID: 32963062

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Project description:BackgroundThe biological pathways through which vitamin D is involved in the regulation of systemic inflammation remain largely unknown.ObjectiveThe objective of this study was to evaluate the role of vitamin D status on the relationship between lipid profile and high-sensitivity C-reactive protein (hs-CRP) in pregnant women.DesignSerum 25-hydroxyvitamin D (25(OH)D), hs-CRP, and indicators of lipid profiles (total cholesterol, TC; triglyceride, TG; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C), were measured in 2479 pregnant women during the second trimester. Potential confounding including maternal sociodemographic characteristics, perinatal health status, diet, and lifestyle was prospectively collected. Multiple regression models and cubic models were used to evaluate the associations.ResultsThere was a significant non-linear relationship between lipid profile (TC, TG, HDL-C, LDL-C) and hs-CRP (P < 0.05). Increased serum 25(OH)D was significantly associated with decreasing TC, TG, HDL-C, LDL-C, and hs-CRP levels. Compared with medium levels of lipids group, pregnant women with higher levels of TC or TG have higher levels of hs-CRP, and pregnant women with lower levels of TC, HDL-C or LDL-C also have higher levels of hs-CRP in the vitamin D deficient group, and there was a significant correlation between low levels of TG and decreased hs-CRP (adjusted β for TG: -0.063, 95%CI: - 0.120,-0.007) in the non-vitamin D deficient group. Mediators that had appreciable shares of the associations between 25(OH)D and hs-CRP was TG (10.2% of the association; β = - 0.011; total indirect effect: 95% CI: - 0.019, - 0.002). The cubic model suggested that a steep increase in the adjusted regression coefficient of lipid with hs-CRP up to 50 nmol/L of 25(OH)D, and the highest adjusted regression coefficients were observed in pregnant women with 25(OH)D above 50 nmol/L.ConclusionOur findings suggest that high levels of vitamin D during pregnancy may improve lipid profile levels and inhibit elevated hs-CRP induced by high lipid metabolism.

Project description:BackgroundSymptomatic gallstones cause high financial and disease burden for public health systems. The combined role of diet and other lifestyle factors has not been studied so far.ObjectivesWe aimed to investigate the association between an a priori defined healthy lifestyle score (HLS, including healthy diet, moderate alcohol and regular coffee intakes, never smoking, physical activity, and normal weight) and the risk of symptomatic gallstone disease, and to estimate the proportion of cases potentially preventable by lifestyle modification.MethodsWe followed 60,768 women from the Nurses' Health Study (NHS) and 40,744 men from the Health Professionals Follow-up Study (HPFS), both ongoing prospective cohort studies, from baseline (1986) until 2012. Symptomatic gallstone disease was self-reported and validated by review of medical records. The association between the HLS and the risk of symptomatic gallstone disease was investigated using Cox proportional hazards regression.ResultsDuring 1,156,079 and 769,287 person-years of follow-up, respectively, 6946 women and 2513 men reported symptomatic gallstone disease. Comparing 6 with 0 points of the HLS, the multivariable HR of symptomatic gallstone disease was 0.26 (95% CI: 0.15, 0.45) for women, and 0.17 (95% CI: 0.07, 0.43) for men. For individual lifestyle factors, multivariable and mutually adjusted partial population attributable risks (women and men) were 33% and 23% for BMI <25 kg/m2, 10% and 18% for ≥2 cups of coffee per day, 13% and 7% for moderate alcohol intake, 8% and 11% for a high Alternate Healthy Eating Index 2010, 9% and 5% for being physically active, and 1% and 5% for never smoking. The full population attributable risk percentage for all factors combined was 62% and 74%, respectively.ConclusionsFindings from these large prospective studies indicate that adopting a healthy lifestyle, especially maintaining a healthy weight, can help to prevent a considerable proportion of symptomatic gallstone diseases.

Project description:BACKGROUND:A hospitalized-based cohort study suggested that elevated C-reactive protein (CRP) levels are associated with radiographic sacroiliitis progression in ankylosing spondylitis (AS) patients. However, data from community-based populations are limited. OBJECTIVE:We sought to determine the association between elevated CRP levels and AS diagnosis in a prospective community-based study of 129,681 Chinese adults over a follow-up period of 8 years. METHODS:We measured the plasma CRP concentration at baseline and every 2 years thereafter with the high-sensitivity (hs)-CRP test. Incident AS cases were confirmed on the basis of modified New York diagnostic criteria after review of medical records. We used Cox proportional-hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for AS on the basis of hs-CRP concentrations, adjusting for age, sex, education, income, cigarette smoking, alcohol intake, physical activity, body mass index, blood-pressure status, blood glucose status, total cholesterol, history of cardiovascular disease, and use of antihypertensives, lipid-lowering agents, and aspirin. RESULTS:During 1,033,609 person-years (average 7.97 ± 1.36 years per person) of follow-up, we identified 55 incident AS cases. Baseline hs-CRP was positively associated with the risk of future AS. Compared with hs-CRP <1 mg/L, the HR was 1.28 (95% CI 0.54-3.08) for hs-CRP of 1.00-2.99 mg/L, 4.71 (95% CI 2.26-9.81) for hs-CRP of 3.00-9.99 mg/L, and 19.8 (95% CI 9.6-40.9) for hs-CRP ?10.00 mg/L (P-trend <0.001) after adjustment for potential confounders. We found similar results after excluding AS cases that occurred in the first 2 years of follow-up, and using the cumulative average hs-CRP concentration as a predictor. CONCLUSION:This is the first study in a community-based cohort to demonstrate that CRP plasma concentrations predict the risk of future AS, thus providing a test that is easy to routinely perform in the clinic to assess for AS risk.

Project description:Background There are different opinions on haemoglobin A1c (HbA1c) in predicting cardiovascular events after percutaneous coronary intervention (PCI). Some factors may affect the ability of HbA1c to predict cardiovascular events, resulting in this inconsistency. Inflammation is a direct and whole-process participant in atherosclerosis. However, no one has studied the effect of inflammation on the correlation between HbA1c and cardiovascular events. Therefore, we aimed to test the hypothesis that high-sensitivity C-reactive protein (hsCRP) modulates HbA1c-related cardiovascular events in patients with the acute coronary syndrome (ACS) undergoing PCI. Methods This was a retrospective cohort study. We enrolled patients with ACS who were hospitalized for PCI and followed up for 24 months. The primary outcome was the composite of major adverse cardiovascular and cerebrovascular events (MACCEs), including all-cause death, nonfatal myocardial infarction, nonfatal stroke, and unplanned repeat revascularization. We stratified the overall population by HbA1c tertiles and hsCRP median. The relationship between HbA1c, hsCRP, and cardiovascular events was analysed by the Cox proportional hazard regression model. Results A total of 2,023 patients were enrolled in this study (age: 59.7±10.03 years old, 78.1% male patients). After the 24-month follow-up, 152 (7.51%) events occurred. Patients with hsCRP >1.21 mg/L had an increased cardiovascular risk compared with patients with hsCRP ≤1.21 mg/L [hazard ratio (HR) 1.58, 95% confidence interval (CI): 1.12–2.24, P=0.010]. We did not observe a significant correlation between HbA1c and cardiovascular events. Furthermore, we stratified patients by hsCRP ≤1.21 or >1.21 mg/L and found that the correlation between HbA1c and cardiovascular events was only significant in patients with hsCRP ≤1.21 mg/L (tertile 2 vs. tertile 1: HR 1.76, 95% CI: 0.79–3.90, P=0.165, tertile 3 vs. tertile 1: HR 3.03, 95% CI: 1.50–6.12, P=0.002; P=0.008 for trend) but not in patients with hsCRP >1.21 mg/L. Conclusions This study showed that hsCRP may affect the relationship between HbA1c and the risk of cardiovascular events in patients with ACS after PCI. This finding suggests that the risk of cardiovascular events may be underestimated when only HbA1c is used as a predictor of cardiovascular risk. HbA1c has a better predictive value in the absence or low levels of inflammation states represented by hsCRP as a predictor of cardiovascular events.

Dataset Information

Relationship between high-sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study.

Publications

Relationship between high-sensitivity C reactive protein and the risk of gallstone disease: results from the Kailuan cohort study.

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