Associations of plasma high-sensitivity C-reactive protein concentrations with all-cause and cause-specific mortality among middle-aged and elderly individuals

Zhi-Hao Li,Qing-Mei Huang,Virginia Byers Kraus,Xiang Gao,Xiao-Ming Shi,Jin-Dong Ni,Yue-Bin Lv,Xian-Bo Wu,Wen-Fang Zhong,Pei-Liang Chen,Chen Mao

doi:10.1186/s12979-019-0168-5

Abstract

BackgroundThe association of high-sensitivity C-reactive protein (hsCRP) with mortality is controversial. We aimed to investigate the associations of hsCRP concentrations with the risks of all-cause and cause-specific mortality and identify potential modifying factors affecting these associations among middle-aged and elderly individuals.MethodsThis community-based prospective cohort study included 14,220 participants aged 50+ years (mean age: 64.9 years) from the Health and Retirement Study. Cox proportional hazard models were employed to estimate the associations between the hsCRP concentrations and the risk of all-cause and cause-specific mortality with adjustment for sociodemographic and lifestyle factors, self-reported medical history, and other potential confounders.ResultsIn total, 1730 all-cause deaths were recorded, including 725 cardiovascular- and 417 cancer-related deaths, after an 80,572 person-year follow-up (median: 6.4 years; range: 3.6–8.1 years). The comparisons of the groups with the highest (quartile 4) and lowest (quartile 1) hsCRP concentrations revealed that the adjusted hazard ratios and 95% confidence intervals were 1.50 (1.31–1.72) for all-cause mortality, 1.44 (1.13–1.82) for cardiovascular mortality, and 1.67 (1.23–2.26) for cancer mortality. The associations between high hsCRP concentrations and the risks of all-cause, cardiovascular, and cancer mortality were similar in the men and women (P for interaction > 0.05).ConclusionsAmong middle-aged and older individuals, elevated hsCRP concentration could increase the risk of all-cause, cardiovascular, and cancer mortality in men and women.

Highlights

Inflammation plays a key role in the initiation and progression of atherosclerosis and other diseases processes [1,2,3]
Using community-based cohort data from the Health and Retirement Study (HRS), we aimed to investigate the associations of high-sensitivity C-reactive protein (hsCRP) concentrations with all-cause and cause-specific mortality and to identify potential modifying factors affecting these associations, among middle-aged and older individuals (≥50 years)
We evaluated the hazard ratios (HRs) of all-cause and specific-cause mortality per each 1 mg/L increase in the hsCRP concentration

Summary

Introduction

Inflammation plays a key role in the initiation and progression of atherosclerosis and other diseases (e.g., hypertension and stroke) processes [1,2,3]. Multiple biomarkers of inflammation exist, hsCRP remains an extensively used marker of Numerous studies have investigated the associations between hsCRP concentrations and mortality. For instance elevated hsCRP concentrations were shown to be associated with the risk of all-cause mortality in both men and women in many [6,7,8,9], but not all studies [10]. Two other prospective studies were conducted in the United States and indicated that high CRP levels were associated with significantly increased risks of all-cause and CVDrelated mortality [11, 12]. The association of high-sensitivity C-reactive protein (hsCRP) with mortality is controversial. We aimed to investigate the associations of hsCRP concentrations with the risks of all-cause and cause-specific mortality and identify potential modifying factors affecting these associations among middle-aged and elderly individuals

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Results

Conclusion