Change in C-reactive protein levels and FEV1 decline: a longitudinal population-based study.
Reduced pulmonary function is an important predictor of cardiovascular morbidity and mortality. The mechanisms underlying this association are unknown but may involve systemic inflammation. We assessed the cross-sectional and longitudinal relationships between C-reactive protein (CRP) levels and forced expiratory volume in 1s (FEV1) and its decline in the general population, over a period of 8.5 years. The analyzes were based on 531 subjects (mean age at baseline: 37+/-7 years, 50% women and 42% non-smokers), recruited at two French centers participating in the European Community Respiratory Health Survey. Lung function was expressed as a percentage of predicted FEV1. CRP was measured centrally, by means of a highly sensitive assay. In cross-sectional analysis, FEV1 as a % of predicted values was negatively associated with serum CRP concentration (P=0.002). Multivariate adjustment did not alter these results (P=0.002). In longitudinal analysis, annual FEV1 decline tended to increase from the lower to the upper tertile for baseline CRP concentration but the association was borderline significant (P=0.14). Mean values of annual FEV1 decline were 26+/-32, 31+/-32, and 34+/-32 ml/year for the lower, middle and upper tertiles of baseline CRP concentration, respectively, after adjusting for potential confounders (P=0.09). Changes in CRP levels during follow-up were associated with annual FEV1 decline. The mean annual FEV1 declines in subjects with increasing CRP, in those with stable CRP and in those with decreasing CRP were 36+/-31, 30+/-31 and 24+/-31 ml/year, respectively (P<0.001). These findings were not affected by adjustment for potential confounders (P=0.002). In conclusion, increases in CRP levels over time were associated with a steeper FEV1 decline.
Shaaban
Rafea
R
National Institute of Health and Medical Research (INSERM), Unit 700, Epidémiologie des Maladies Respiratoires, Faculté Xavier Bichat, BP 416, 16 rue Henri Huchard, 75018 Paris, France. shaaban@bichat.inserm.fr
Kony
Sabine
S
Driss
Fathi
F
Leynaert
Bénédicte
B
Soussan
David
D
Pin
Isabelle
I
Neukirch
Françoise
F
Zureik
Mahmoud
M
D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000502:physiology; D008297:Male; D012907:Smoking / Q000453:epidemiology; D013557:Switzerland / Q000453:epidemiology
D002097:C-Reactive Protein; D002784:Cholesterol