医学
危险系数
内科学
心肌梗塞
C反应蛋白
肥胖
置信区间
队列研究
比例危险模型
静脉血栓栓塞
风险因素
心脏病学
血栓形成
炎症
作者
Lars Daae Horvei,Gro Grimnes,Kristian Hindberg,Ellisiv B. Mathiesen,Inger Njølstad,Tom Wilsgaard,Jan Brox,Sigrid Kufaas Brækkan,John‐Bjarne Hansen
摘要
Essentials•We performed repeated measurements of C‐reactive protein (CRP) and obesity in a cohort study.•CRP was associated with risk of myocardial infarction and venous thromboembolism.•CRP was a mediator for risk of myocardial infarction in obese men and women.•CRP was a partial mediator for risk of venous thromboembolism in obese women, but not in men.Summary: BackgroundLow‐grade inflammation in obesity may be a shared pathway for the risk of venous thromboembolism (VTE) and myocardial infarction (MI).ObjectivesTo investigate the associations between repeated measurements of C‐reactive protein (CRP) and the risks of MI and VTE, and to explore whether CRP mediated these risks in obese subjects.MethodsCRP and obesity measures were collected from 15 134 subjects who participated in one or more surveys of the Tromsø study in 1994–1995, 2001–2002, or 2007–2008. Incident VTEs and MIs were registered until 1 January 2011. Time‐varying Cox regression models were used to calculate hazard ratios of MI and VTE according to categories of CRP and obesity measures.ResultsThere were 291 VTEs and 920 MIs during follow‐up. High levels of CRP (≥ 3 mg L−1 versus < 1 mg L−1) were associated with increased risks of MI (hazard ratio [HR] 1.73; 95% confidence interval [CI] 1.32–2.26) and VTE (HR 1.84; 95% CI 1.22–2.78) in women, but only with MI in men (HR 1.93; 95% CI 1.53–2.44). All obesity measures showed stronger associations with CRP in women than in men. In obese women (body mass index [BMI] of ≥ 30 kg m−2 versus < 25 kg m−2), adjustment for CRP attenuated the risk estimate for VTE by 22%, whereas the incidence rates of VTE increased with combined categories of higher BMI and CRP. No association was found in men.ConclusionsOur findings suggest that low‐grade inflammation, assessed by measurement of CRP, is associated with the risks of MI and VTE, and may be a shared pathway for MI and VTE in obesity. Essentials•We performed repeated measurements of C‐reactive protein (CRP) and obesity in a cohort study.•CRP was associated with risk of myocardial infarction and venous thromboembolism.•CRP was a mediator for risk of myocardial infarction in obese men and women.•CRP was a partial mediator for risk of venous thromboembolism in obese women, but not in men. •We performed repeated measurements of C‐reactive protein (CRP) and obesity in a cohort study.•CRP was associated with risk of myocardial infarction and venous thromboembolism.•CRP was a mediator for risk of myocardial infarction in obese men and women.•CRP was a partial mediator for risk of venous thromboembolism in obese women, but not in men. Low‐grade inflammation in obesity may be a shared pathway for the risk of venous thromboembolism (VTE) and myocardial infarction (MI). To investigate the associations between repeated measurements of C‐reactive protein (CRP) and the risks of MI and VTE, and to explore whether CRP mediated these risks in obese subjects. CRP and obesity measures were collected from 15 134 subjects who participated in one or more surveys of the Tromsø study in 1994–1995, 2001–2002, or 2007–2008. Incident VTEs and MIs were registered until 1 January 2011. Time‐varying Cox regression models were used to calculate hazard ratios of MI and VTE according to categories of CRP and obesity measures. There were 291 VTEs and 920 MIs during follow‐up. High levels of CRP (≥ 3 mg L−1 versus < 1 mg L−1) were associated with increased risks of MI (hazard ratio [HR] 1.73; 95% confidence interval [CI] 1.32–2.26) and VTE (HR 1.84; 95% CI 1.22–2.78) in women, but only with MI in men (HR 1.93; 95% CI 1.53–2.44). All obesity measures showed stronger associations with CRP in women than in men. In obese women (body mass index [BMI] of ≥ 30 kg m−2 versus < 25 kg m−2), adjustment for CRP attenuated the risk estimate for VTE by 22%, whereas the incidence rates of VTE increased with combined categories of higher BMI and CRP. No association was found in men. Our findings suggest that low‐grade inflammation, assessed by measurement of CRP, is associated with the risks of MI and VTE, and may be a shared pathway for MI and VTE in obesity.
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