title: Baseline C-Reactive Protein Levels and Life Prognosis in Parkinson Disease.
abstract: BACKGROUND
  C-reactive protein (CRP) is a biomarker of inflammation, and high levels of CRP correlate with vascular death. Chronic inflammation is considered to be involved in neurodegeneration, although there is no evidence linking it with the process of neurodegenerative diseases.
  
  
  OBJECTIVE
  To determine the role of baseline CRP levels in the prognosis of patients with Parkinson disease (PD).
  
  
  METHODS
  A cohort of 313 patients with a mean age of 69.1 and mean PD duration of 7.9 years was retrospectively followed for a mean observation time of 1,753 days. CRP was measured when patients were not diagnosed with any infections, and levels were repetitively measured to investigate a tendency of "regression to mean." The primary outcome measure was a survival time from study enrollment to death.
  
  
  RESULTS
  During the observation period 56 patients died. Baseline CRP was log-linearly associated with a risk of death in PD. Mean survival time was 3,149 (95% confidence interval; 3,009-3,289) days in patients with CRP ≤ 0.8mg/L (lower two thirds) and 2,620 (2,343-2,897) days in those with CRP > 0.8 mg/L (top third, p < 0.001, log-rank test). The adjusted hazard ratio (HR) per two-fold higher CRP concentration for all deaths was 1.29 (1.10-1.52), and after excluding PD-unrelated deaths, such as cancer or stroke, HR was 1.23 (1.01-1.49) (adjusted for age, sex, PD duration, modified Hohen-Yahr stages, MMSE scores, and serum albumin).
  
  
  CONCLUSIONS
  Baseline CRP concentrations were associated with the risk of death and predicted life prognosis of patients with PD. The associations were independent from PD duration, PD severity, cognitive function, ages, and nutritional conditions, suggesting the possibility that subclinical chronic inflammation is associated with a neurodegenerative process in PD.
authors.affiliation: Department of Neurology and Clinical Research Center, National Hospital of Utano, National Hospital Organization, Kyoto, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sawada
authors.affiliation: Department of Neurology and Clinical Research Center, National Hospital of Utano, National Hospital Organization, Kyoto, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Oeda
authors.affiliation: Department of Neurology and Clinical Research Center, National Hospital of Utano, National Hospital Organization, Kyoto, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Umemura
authors.affiliation: Department of Neurology and Clinical Research Center, National Hospital of Utano, National Hospital Organization, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tomita
authors.affiliation: Department of Neurology and Clinical Research Center, National Hospital of Utano, National Hospital Organization, Kyoto, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kohsaka
authors.affiliation: Department of Neurology and Clinical Research Center, National Hospital of Utano, National Hospital Organization, Kyoto, Japan.
authors.forename: Kwiyoung
authors.initials: K
authors.lastname: Park
authors.affiliation: Department of Neurology and Clinical Research Center, National Hospital of Utano, National Hospital Organization, Kyoto, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Neurology and Clinical Research Center, National Hospital of Utano, National Hospital Organization, Kyoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sugiyama
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000097:blood* / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein