title: C-reactive protein levels and risk of mortality from cardiovascular disease in Japanese: the JACC Study.
abstract: OBJECTIVE
  Limited evidence of association between C-reactive protein levels and cardiovascular disease has been produced for Japanese whose median protein levels are low by western standards.
  
  
  METHODS
  We conducted a nested case-control study as part of the Japan Collaborative Cohort Study for evaluation of cancer risk (JACC Study). A total of 39,242 subjects 40-79 years of age provided serum samples at baseline between 1988 and 1990. During the 13-year follow-up, there were 525 deaths from total strokes (ICD10: I60-I69), 209 coronary heart diseases (I20-I25) and 939 total cardiovascular diseases (I00-I99). The control subjects were matched for sex, age, area of residence and year of serum storage, and analyses were conducted after further adjustment for cardiovascular risk factors. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured with ultra-sensitive latex-enhanced immunoassay.
  
  
  RESULTS
  Median hs-CRP levels for controls were 0.40 mg/L for men and 0.41 mg/L for women. Hs-CRP levels were positively associated with risks of mortality from stroke, coronary heart disease, and total cardiovascular disease for men. The respective multivariable odds ratios (OR 95% CI) for the highest (>or=0.85 mg/L) vs. lowest (<0.19 mg/L) quartiles of hs-CRP for men were 1.60 (0.90-2.85), 3.68 (1.02-13.3), and 2.31 (1.49-3.59). For women, positive associations with hs-CRP levels were weaker, reaching statistical significance only for total cardiovascular disease: OR=1.69 (1.06-2.68). The positive association with total cardiovascular disease did not vary according to sex, age, smoking status, or body mass index.
  
  
  CONCLUSIONS
  Higher serum hs-CRP levels were associated with higher mortality from cardiovascular disease in Japanese.
authors.affiliation: Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita-shi, Osaka 565-0871, Japan. iso@pbhel.med.osaka-u.ac.jp
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.forename: Renzhe
authors.initials: R
authors.lastname: Cui
authors.forename: Chigusa
authors.initials: C
authors.lastname: Date
authors.forename: Shogo
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000276:immunology* / Q000401:mortality*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007118:Immunoassay; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein