英国中年人的C反应蛋白、肥胖、遗传性过敏症及哮喘症状
2008/09/28
最近的研究提示在没有过敏症的人群中，C反应蛋白（C-reactive protein，CRP)和成人哮喘的发病率有关。为了调查吸烟和肥胖对这一关系的作用，Butland等进行了一项队列研究。
研究以1958年出生的英国人(n = 18,558)为研究对象，2000年（研究对象42岁）采集研究对象的吸烟史和呼吸症状，并在2002年对研究对象（44～45岁）进行以下生化测定，包括CRP测定、针对草、猫和尘螨的特异性IgE测定、身高、体重等。研究结束时，共有6490例研究对象获得了完整的资料。
研究结果显示，CRP水平与体块指数（body mass index, BMI）呈正相关，而且女性CRP水平高于男性，重度吸烟(每天超过20支)患者的CRP比从不吸烟者高。校正性别和地区差异后，在没有过敏症的人群中，CRP水平最高的1/4人群中哮喘发病率与CRP水平最低的1/4人群哮喘发病率的比值比为1.85 (95%CI, 1.15～ 2.99)，而在有过敏症的人群中这一值为0.94 (95%CI, 0.62 ～ 1.41)。如果再校正吸烟和BMI的差异后，无过敏症群体的比值比为1.36 (95%CI, 0.80 ～ 2.32)，而有过敏症群体的比值比为1.07 (95%CI, 0.67～1.69)。
因此，作者认为在非过敏症群体中CRP和哮喘发病率之间的相关性可能是一种混淆，而这种相关性可能是CRP与吸烟相关气道阻塞性疾病关联的一种反映。
(韩伟 青岛大学附属青岛市立医院东院呼吸科266071 摘译)
（Eur. Respir. J., Jul 2008; 32: 77 - 84)
C-reactive protein, obesity, atopy and asthma symptoms in middle-aged British adults.
Butland BK, Strachan DP, Rudnicka AR
Butland BK, Strachan DP, Rudnicka AR
Keywords: Asthma, atopy, body mass index, C-reactive protein
Recent research suggested an association between circulating C-reactive protein (CRP) and adult asthma, confined to those without evidence of allergic predisposition. We investigated the role of smoking and obesity as explanations for this relationship. At age 44-45, members of the British 1958 birth cohort participated in a biomedical survey involving the measurement of CRP, specific IgE to grass, cat and dust mite, standing height and weight. Information on asthma and related symptoms was collected by computer aided interview at age 42. Complete data were available for 6490 subjects.CRP levels were positively correlated with body mass index (BMI), higher among women than men and among heavy smokers (>=20 cigarettes.day(-1)) than never smokers. Adjusted for sex and region, odds ratios comparing asthma prevalence in subjects above the fourth CRP quartile with subjects below the first were 1.85 (95% confidence interval 1.15 to 2.99) for non-atopics and 0.94 (0.62 to 1.41) for atopics changing to 1.36 (0.80 to 2.32) and 1.07 (0.67 to 1.69) respectively when additionally adjusted for smoking and BMI. Any association between CRP and asthma prevalence confined to non-atopics may be due to confounding or may reflect a more general association of CRP with smoking-related obstructive airways disease.
Eur Respir J 2008; 32:344-349
Eur Respir J 2008; 32:344-349
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