Dynamic changes in hs-CRP and risk of all-cause mortality among middle-aged and elderly adults: findings from a nationwide prospective cohort and mendelian randomization

IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Zhonghai Wang, Feng Xiong, Quanbo Zhang, Han Wang
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引用次数: 0

Abstract

Introduction

The general population experiences mortality rates that are related to high levels of high-sensitivity C-reactive protein (hs-CRP). We aim to assess the linkage of longitudinal trajectories in hs-CRP levels with all-cause mortality in Chinese participants.

Methods

We utilized data from the China Health and Retirement Longitudinal Study (CHARLS). The exposures were dynamic changes in the hs-CRP and cumulative hs-CRP from 2012 to 2015, and the outcome was all-cause mortality. All participants were categorized into four trajectories according to hs-CRP levels. Multivariable logistic regression analysis, adjusted for potential confounders, was employed to evaluate the relationship of different trajectories of hs-CRP with mortality risk. A two-sample Mendelian randomization (TSMR) method and SHapley Additive exPlanations (SHAP) for identifying determinants of mortality risk were also employed.

Results

The study included 5,445 participants with 233 deaths observed, yielding a mortality proportion of 4.28%. Compared to individuals maintaining low, stable levels of hs-CRP (Class 1), individuals with sustained elevated levels of hs-CRP (Class 4), those experiencing a progressive rise in hs-CRP levels (Class 2), or those transitioning from elevated to reduced hs-CRP levels (Class 3) all faced a significantly heighted death risk, with adjusted Odds Ratios (ORs) ranging from 2.34 to 2.47 across models. Moreover, a non-linear relationship was found between them. Further TSMR analysis also supported these findings. SHAP showed that hs-CRP was the fifth most important determinant of mortality risk.

Conclusions

Our study shows all-cause mortality increases with dynamic changes in hs-CRP levels among middle-aged and elderly adults in China, and cumulative hs-CRP shows an L-shaped relationship with all-cause mortality.

中老年人 hs-CRP 的动态变化与全因死亡风险:全国性前瞻性队列和孟德尔随机化的研究结果。
导言:普通人群的死亡率与高水平的高敏C反应蛋白(hs-CRP)有关。我们旨在评估中国参与者的 hs-CRP 水平纵向轨迹与全因死亡率之间的联系:我们利用了中国健康与退休纵向研究(CHARLS)的数据。方法:我们利用了中国健康与退休纵向研究(CHARLS)的数据,暴露因子为2012年至2015年间hs-CRP和累积hs-CRP的动态变化,结局为全因死亡率。根据hs-CRP水平将所有参与者分为四个轨迹。在对潜在混杂因素进行调整后,采用多变量逻辑回归分析来评估不同轨迹的hs-CRP与死亡风险的关系。研究还采用了双样本孟德尔随机化(TSMR)方法和SHAPLE Additive exPlanations(SHAP)方法来确定死亡风险的决定因素:研究共纳入 5445 名参与者,观察到 233 例死亡,死亡率为 4.28%。与保持低水平、稳定的 hs-CRP(1 级)相比,hs-CRP 水平持续升高者(4 级)、hs-CRP 水平逐渐升高者(2 级)或 hs-CRP 水平从升高向降低过渡者(3 级)的死亡风险都显著升高,各模型的调整比值比(ORs)从 2.34 到 2.47 不等。此外,它们之间还存在非线性关系。进一步的 TSMR 分析也支持这些发现。SHAP显示,hs-CRP是决定死亡风险的第五大因素:我们的研究表明,中国中老年人的全因死亡率随着 hs-CRP 水平的动态变化而增加,累积 hs-CRP 与全因死亡率呈 L 型关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.90
自引率
5.00%
发文量
283
审稿时长
1 months
期刊介绍: Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.
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