title: C-reactive protein levels, haplotypes, and the risk of incident chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is characterized by substantial chronic inflammation in the pulmonary compartment as well as in the systemic circulation.
  
  
  OBJECTIVE
  To investigate potentially causal association, we examined whether serum levels of high-sensitivity C-reactive protein (hsCRP) and variations in the CRP gene are associated with the risk of developing COPD.
  
  
  METHODS
  This study is part of the Rotterdam Study, a prospective population-based cohort study among subjects aged 55 years or older. At baseline, 6,836 subjects without COPD had a blood sample available for assessment of hsCRP serum levels and haplotypes of the CRP gene. We analyzed the association between hsCRP levels, CRP gene haplotypes, and incident COPD with Cox proportional hazard models, adjusted for age, sex, and other confounders.
  
  
  RESULTS
  High levels of hsCRP (>3 mg/L) were associated with a significantly increased risk of incident COPD (hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.16-2.49) compared with persons with low levels (<1 mg/L). The risk remained increased after adjusting for potential confounders and introducing a latency period of 3 years. The risk was most pronounced in former smokers (HR, 2.2; 95% CI, 1.12-3.74). hsCRP was not a risk factor in never smokers. No CRP single nucleotide polymorphism or haplotype was associated with a significantly increased or decreased COPD risk.
  
  
  CONCLUSIONS
  Increased hsCRP levels are predictive for the occurrence of COPD in smokers. However, haplotypes of the CRP gene, which influence hsCRP levels, are not associated with an altered risk of developing COPD.
authors.affiliation: Department of Respiratory Medicine, Ghent University and Ghent University Hospital, Ghent, Belgium.
authors.forename: Yannick M T A
authors.initials: YM
authors.lastname: van Durme
authors.forename: Katia M C
authors.initials: KM
authors.lastname: Verhamme
authors.forename: Albert-Jan L H J
authors.initials: AJ
authors.lastname: Aarnoudse
authors.forename: Geert R
authors.initials: GR
authors.lastname: Van Pottelberge
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Guy F
authors.initials: GF
authors.lastname: Joos
authors.forename: Guy G
authors.initials: GG
authors.lastname: Brusselle
authors.forename: Bruno H C
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000235:genetics* / Q000378:metabolism*; D005260:Female; D020022:Genetic Predisposition to Disease; D006239:Haplotypes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein