The Association Between High-Sensitivity C-Reactive Protein and the Progression of Arteriosclerosis: The Kailuan Study

Weizhe Li,1,* Pei Liang,2,* Xueliang Ma,1 Yanling Gao,1 Xiaoxin Bai,1 Shasha An,3 Xin Wang,1 Shuohua Chen,4 Shouling Wu4 1Department of Emergency Internal Medicine No. I, Handan Central Hospital, Handan, Hebei, 056001, People’s Republic of China; 2Department of Intensive Care Rehabilitation, Handan Mingren Hospital, Handan, Hebei, 056001, People’s Republic of China; 3Department of General Medicine, Handan Central Hospital, Handan, Hebei, 056001, People’s Republic of China; 4Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, 063001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xueliang Ma, Department of Emergency Internal Medicine No. I, Handan Central Hospital, NO. 15, Zhonghuanan Street, Hanshan District, Handan, Hebei, 056001, People’s Republic of China, Tel +86 13333008705, Email [email protected] Xin Wang, Department of Emergency Internal Medicine No. I, Handan Central Hospital, NO. 15, Zhonghuanan Street, Hanshan District, Handan, Hebei, 056001, People’s Republic of China, Tel +86 18103300116, Email [email protected]: To explore the association between high-sensitivity C-reactive protein (hs-CRP) and the progression of arteriosclerosis.Methods: Using a prospective cohort study design, 11,577 participants from the Kailuan Study cohort who underwent at least two brachial-ankle pulse wave velocity (baPWV) examinations and met the inclusion criteria were included as the study subjects. Based on baseline hs-CRP levels, they were divided into three groups: hs-CRP < 1 mg/L group, 1 mg/L≤hs-CRP≤ 3 mg/L group, and hs-CRP > 3 mg/L group. Poisson regression analysis was employed for longitudinal comparison to assess the impact of different hs-CRP levels on baPWV≥ 1,400 cm/s.Results: (1) After a mean follow-up of 5.12 ± 2.84 years, the detection rates of baPWV≥ 1,400 cm/s at the end of follow-up were 28.54%, 33.36%, and 36.25% in the hs-CRP< 1 mg/L (n=5,998), 1 mg/L≤ hs-CRP≤ 3 mg/L (n=4,101), and hs-CRP> 3 mg/L (n=1,578) groups, respectively (P< 0.001). (2) Multivariable-adjusted Poisson regression analysis for baPWV≥ 1,400 cm/s showed that, after adjusting for confounding factors, compared to the hs-CRP< 1 mg/L group, the 1 mg/L≤hs-CRP≤ 3 mg/L group had a 2.4% higher risk of arterial stiffness (RR: 1.024; 95% CI: 1.002 to 1.047; P< 0.05) and hs-CRP> 3 mg/L group had a 6.3% higher risk (RR: 1.063; 95% CI: 1.031 to 1.095; P< 0.001). Sensitivity analysis validated the robustness of the results.Conclusion: Elevated hs-CRP is an independent risk factor for arteriosclerosis progression.Keywords: high-sensitivity C-reactive protein, brachial-ankle pulse wave velocity, arteriosclerosis, poisson regression