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
{"title":"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","authors":"Zhonghai Wang, Feng Xiong, Quanbo Zhang, Han Wang","doi":"10.1007/s40520-024-02865-w","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>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.</p><h3>Methods</h3><p>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.</p><h3>Results</h3><p>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.</p><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02865-w.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aging Clinical and Experimental Research","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s40520-024-02865-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
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.
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.