Association Between High-Sensitivity C-Reactive Protein and Longitudinal Changes in Arteriosclerosis Over Time: The Kailuan Prospective Cohort Study

Weizhe Li,1,* Pei Liang,2,* Zhao Han,3 Xiaohui Liu,4 Shasha An,5 Xin Wang,1 Yanling Gao,1 Shuohua Chen,6 Shouling Wu6 1Department of Emergency Internal Medicine No. I, Handan Central Hospital, Handan, Hebei, 056001, People’s Republic of China; 2Rehabilitation Department Three, Handan Mingren Hospital, Handan, Hebei, 056001, People’s Republic of China; 3Department of Dermatology, The Affiliated Hospital of Hebei Engineering University, Handan, Hebei, 056002, People’s Republic of China; 4Department of General Surgery II, Handan Central Hospital, Handan, Hebei, 056001, People’s Republic of China; 5Department of General Medicine, Handan Central Hospital, Handan, Hebei, 056001, People’s Republic of China; 6Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, 063001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaohui Liu, Department of General Surgery II, Handan Central Hospital, NO. 15, Zhonghuanan Street, Hanshan District, Handan, Hebei, 056001, People’s Republic of China, Tel: +86 18630004402, Email [email protected]: To investigate the relationship between high-sensitivity C-reactive protein (hs-CRP) and the longitudinal changes in arterial Arteriosclerosis over time.Methods: Using a prospective cohort study design, 25,336 participants from the Kailuan study cohort, who had completed at least two baPWV measurements and met the inclusion criteria, included in the analysis. Participants were divided into three groups based on baseline hs-CRP levels: hs-CRP< 1 mg/L, 1 mg/L≤hs-CRP≤ 3 mg/L, and hs-CRP > 3 mg/L. The relationship between hs-CRP and the longitudinal changes in baPWV was analyzed using a linear mixed-effects model.Results: (1) The average follow-up duration was 4.62 ± 2.86 years. At the end of the follow-up, the baPWV of the three groups:hs-CRP < 1 mg/L (n=11,651), 1 mg/L ≤ hs-CRP ≤ 3 mg/L (n=9,369), and hs-CRP > 3 mg/L (n=4,316) increased over time. The average rate of increase in baPWV was 84.26 cm/s, 88.06 cm/s, and 73.92 cm/s, respectively. (2) The linear mixed-effects model analysis of factors affecting the progression of Arteriosclerosis, after adjusting for confounding factors, showed that compared to the hsCRP_1 group, the baPWV increase rate in the hsCRP_2 and hsCRP_3 groups was progressively higher. The effect Estimate were 14.4 cm/s (95% CI 6.54 to 22.34, P< 0.001) and 40.67 cm/s (95% CI 5.28 to 51.02, P< 0.001), respectively. Stratifying by gender showed that the impact was more pronounced in males, with effect Estimate of 20.56 cm/s (95% CI 6.18 to 8.45, P< 0.001) and 43.06 cm/s (95% CI 27.82 to 58.31, P< 0.001), respectively. Sensitivity analysis confirmed that this longitudinal association was more pronounced.Conclusion: There is a significant “dose-response” relationship between hs-CRP and the longitudinal progression of Arteriosclerosis, with a more pronounced effect observed in the male population.Keywords: high-sensitivity C-reactive protein, ankle-brachial pulse wave velocity, arteriosclerosis, linear mixed-effects model