Baseline high-sensitivity C-reactive protein predicts the risk of incident ankylosing spondylitis

Results of a community-based prospective study

Jinmei Su, Liufu Cui, Wenhao Yang, Huijing Shi, Cheng Jin, Rong Shu, Hongfen Li, Xiaofeng Zeng, Shouling Wu, Xiang Gao

Research output: Contribution to journalArticle

Abstract

Background A hospitalized-based cohort study suggested that elevated C-reactive protein (CRP) levels are associated with radiographic sacroiliitis progression in ankylosing spondylitis (AS) patients. However, data from community-based populations are limited. Objective We sought to determine the association between elevated CRP levels and AS diagnosis in a prospective community-based study of 129,681 Chinese adults over a follow-up period of 8 years. Methods We measured the plasma CRP concentration at baseline and every 2 years thereafter with the high-sensitivity (hs)-CRP test. Incident AS cases were confirmed on the basis of modified New York diagnostic criteria after review of medical records. We used Cox proportional-hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for AS on the basis of hs-CRP concentrations, adjusting for age, sex, education, income, cigarette smoking, alcohol intake, physical activity, body mass index, blood-pressure status, blood glucose status, total cholesterol, history of cardiovascular disease, and use of antihypertensives, lipid-lowering agents, and aspirin. Results During 1,033,609 person-years (average 7.97 ± 1.36 years per person) of follow-up, we identified 55 incident AS cases. Baseline hs-CRP was positively associated with the risk of future AS. Compared with hs-CRP <1 mg/L, the HR was 1.28 (95% CI 0.54–3.08) for hsCRP of 1.00–2.99 mg/L, 4.71 (95% CI 2.26–9.81) for hs-CRP of 3.00–9.99 mg/L, and 19.8 (95% CI 9.6–40.9) for hs-CRP 10.00 mg/L (P-trend <0.001) after adjustment for potential confounders. We found similar results after excluding AS cases that occurred in the first 2 years of follow-up, and using the cumulative average hs-CRP concentration as a predictor. Conclusion This is the first study in a community-based cohort to demonstrate that CRP plasma concentrations predict the risk of future AS, thus providing a test that is easy to routinely perform in the clinic to assess for AS risk.

Original languageEnglish (US)
Article numbere0211946
JournalPloS one
Volume14
Issue number2
DOIs
StatePublished - Feb 1 2019

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Ankylosing Spondylitis
C-reactive protein
prospective studies
C-Reactive Protein
Prospective Studies
confidence interval
Confidence Intervals
Hazards
antilipemic agents
Sacroiliitis
Plasmas
antihypertensive agents
Sex Education
smoking (habit)
aspirin
Blood pressure
cohort studies
Proportional Hazards Models
Tobacco Products
physical activity

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Su, Jinmei ; Cui, Liufu ; Yang, Wenhao ; Shi, Huijing ; Jin, Cheng ; Shu, Rong ; Li, Hongfen ; Zeng, Xiaofeng ; Wu, Shouling ; Gao, Xiang. / Baseline high-sensitivity C-reactive protein predicts the risk of incident ankylosing spondylitis : Results of a community-based prospective study. In: PloS one. 2019 ; Vol. 14, No. 2.
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abstract = "Background A hospitalized-based cohort study suggested that elevated C-reactive protein (CRP) levels are associated with radiographic sacroiliitis progression in ankylosing spondylitis (AS) patients. However, data from community-based populations are limited. Objective We sought to determine the association between elevated CRP levels and AS diagnosis in a prospective community-based study of 129,681 Chinese adults over a follow-up period of 8 years. Methods We measured the plasma CRP concentration at baseline and every 2 years thereafter with the high-sensitivity (hs)-CRP test. Incident AS cases were confirmed on the basis of modified New York diagnostic criteria after review of medical records. We used Cox proportional-hazard models to calculate hazard ratios (HRs) and 95{\%} confidence intervals (95{\%} CIs) for AS on the basis of hs-CRP concentrations, adjusting for age, sex, education, income, cigarette smoking, alcohol intake, physical activity, body mass index, blood-pressure status, blood glucose status, total cholesterol, history of cardiovascular disease, and use of antihypertensives, lipid-lowering agents, and aspirin. Results During 1,033,609 person-years (average 7.97 ± 1.36 years per person) of follow-up, we identified 55 incident AS cases. Baseline hs-CRP was positively associated with the risk of future AS. Compared with hs-CRP <1 mg/L, the HR was 1.28 (95{\%} CI 0.54–3.08) for hsCRP of 1.00–2.99 mg/L, 4.71 (95{\%} CI 2.26–9.81) for hs-CRP of 3.00–9.99 mg/L, and 19.8 (95{\%} CI 9.6–40.9) for hs-CRP 10.00 mg/L (P-trend <0.001) after adjustment for potential confounders. We found similar results after excluding AS cases that occurred in the first 2 years of follow-up, and using the cumulative average hs-CRP concentration as a predictor. Conclusion This is the first study in a community-based cohort to demonstrate that CRP plasma concentrations predict the risk of future AS, thus providing a test that is easy to routinely perform in the clinic to assess for AS risk.",
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Baseline high-sensitivity C-reactive protein predicts the risk of incident ankylosing spondylitis : Results of a community-based prospective study. / Su, Jinmei; Cui, Liufu; Yang, Wenhao; Shi, Huijing; Jin, Cheng; Shu, Rong; Li, Hongfen; Zeng, Xiaofeng; Wu, Shouling; Gao, Xiang.

In: PloS one, Vol. 14, No. 2, e0211946, 01.02.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Baseline high-sensitivity C-reactive protein predicts the risk of incident ankylosing spondylitis

T2 - Results of a community-based prospective study

AU - Su, Jinmei

AU - Cui, Liufu

AU - Yang, Wenhao

AU - Shi, Huijing

AU - Jin, Cheng

AU - Shu, Rong

AU - Li, Hongfen

AU - Zeng, Xiaofeng

AU - Wu, Shouling

AU - Gao, Xiang

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Background A hospitalized-based cohort study suggested that elevated C-reactive protein (CRP) levels are associated with radiographic sacroiliitis progression in ankylosing spondylitis (AS) patients. However, data from community-based populations are limited. Objective We sought to determine the association between elevated CRP levels and AS diagnosis in a prospective community-based study of 129,681 Chinese adults over a follow-up period of 8 years. Methods We measured the plasma CRP concentration at baseline and every 2 years thereafter with the high-sensitivity (hs)-CRP test. Incident AS cases were confirmed on the basis of modified New York diagnostic criteria after review of medical records. We used Cox proportional-hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for AS on the basis of hs-CRP concentrations, adjusting for age, sex, education, income, cigarette smoking, alcohol intake, physical activity, body mass index, blood-pressure status, blood glucose status, total cholesterol, history of cardiovascular disease, and use of antihypertensives, lipid-lowering agents, and aspirin. Results During 1,033,609 person-years (average 7.97 ± 1.36 years per person) of follow-up, we identified 55 incident AS cases. Baseline hs-CRP was positively associated with the risk of future AS. Compared with hs-CRP <1 mg/L, the HR was 1.28 (95% CI 0.54–3.08) for hsCRP of 1.00–2.99 mg/L, 4.71 (95% CI 2.26–9.81) for hs-CRP of 3.00–9.99 mg/L, and 19.8 (95% CI 9.6–40.9) for hs-CRP 10.00 mg/L (P-trend <0.001) after adjustment for potential confounders. We found similar results after excluding AS cases that occurred in the first 2 years of follow-up, and using the cumulative average hs-CRP concentration as a predictor. Conclusion This is the first study in a community-based cohort to demonstrate that CRP plasma concentrations predict the risk of future AS, thus providing a test that is easy to routinely perform in the clinic to assess for AS risk.

AB - Background A hospitalized-based cohort study suggested that elevated C-reactive protein (CRP) levels are associated with radiographic sacroiliitis progression in ankylosing spondylitis (AS) patients. However, data from community-based populations are limited. Objective We sought to determine the association between elevated CRP levels and AS diagnosis in a prospective community-based study of 129,681 Chinese adults over a follow-up period of 8 years. Methods We measured the plasma CRP concentration at baseline and every 2 years thereafter with the high-sensitivity (hs)-CRP test. Incident AS cases were confirmed on the basis of modified New York diagnostic criteria after review of medical records. We used Cox proportional-hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for AS on the basis of hs-CRP concentrations, adjusting for age, sex, education, income, cigarette smoking, alcohol intake, physical activity, body mass index, blood-pressure status, blood glucose status, total cholesterol, history of cardiovascular disease, and use of antihypertensives, lipid-lowering agents, and aspirin. Results During 1,033,609 person-years (average 7.97 ± 1.36 years per person) of follow-up, we identified 55 incident AS cases. Baseline hs-CRP was positively associated with the risk of future AS. Compared with hs-CRP <1 mg/L, the HR was 1.28 (95% CI 0.54–3.08) for hsCRP of 1.00–2.99 mg/L, 4.71 (95% CI 2.26–9.81) for hs-CRP of 3.00–9.99 mg/L, and 19.8 (95% CI 9.6–40.9) for hs-CRP 10.00 mg/L (P-trend <0.001) after adjustment for potential confounders. We found similar results after excluding AS cases that occurred in the first 2 years of follow-up, and using the cumulative average hs-CRP concentration as a predictor. Conclusion This is the first study in a community-based cohort to demonstrate that CRP plasma concentrations predict the risk of future AS, thus providing a test that is easy to routinely perform in the clinic to assess for AS risk.

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