Interactive effect of increased high sensitive C-reactive protein and dyslipidemia on cardiovascular diseases: a 12-year prospective cohort study

• Published in: Lipids in health and disease Vol. 22; no. 1; pp. 95 - 11
• Main Authors: Bafei, Solim Essomandan Clémence, Zhao, Xianghai, Chen, Changying, Sun, Junxiang, Zhuang, Qian, Lu, Xiangfeng, Chen, Yanchun, Gu, Xincheng, Liu, Fangyuan, Mu, Jialing, Wei, Lai, Wei, Pengfei, Yin, Yunjie, Xie, Hankun, Yang, Song, Shen, Chong
• Format: Journal Article
• Language: English
• Published: London BioMed Central 04.07.2023; BioMed Central Ltd; BMC
• Subjects: Alcohol; Apolipoproteins; Biomarkers; Biomedical and Life Sciences; Blood pressure; Body mass index; C-reactive protein; Cardiovascular diseases; Cardiovascular diseases risk; Care and treatment; Cholesterol; Cholesterol, LDL; Clinical Nutrition; Cohort analysis; Diabetes; Diagnosis; Disease control; Disease prevention; Dyslipidemia; Dyslipidemias; Health aspects; High density lipoprotein; hs-CRP; Hypertension; Inflammation; Interactive effect; Life Sciences; Lipidology; Lipids; Lipoproteins; Low density lipoprotein; Measurement; Medical Biochemistry; Metabolic disorders; Population; Prevention; Proteins; Risk factors; Self report; Stroke; China; Cardiovascular diseases risk; Interactive effect; hs-CRP; Dyslipidemia
• ISSN: 1476-511X; 1476-511X
• DOI: 10.1186/s12944-023-01836-w

Background Dyslipidemia and inflammation are significant factors for the onset of cardiovascular diseases (CVD); however, studies regarding their interactions on the risk of CVD are scarce. This study aimed to assess the interaction of dyslipidemia and high-sensitivity C-reactive protein (hs-CRP) on CVD. Methods This prospective cohort enrolled 4,128 adults at baseline in 2009 and followed them up until May 2022 for collecting CVD events. Cox-proportional hazard regression analysis estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of the associations of increased hs-CRP (≥ 1 mg/L) and dyslipidemia with CVD. The additive interactions were explored using the relative excess risk of interaction (RERI) and the multiplicative interactions were assessed with HRs (95% CI ) while the multiplicative interactions were assessed by the HRs (95% CI) of interaction terms. Results The HRs of the association between increased hs-CRP and CVD were 1.42 (95% CI : 1.14–1.79) and 1.17 (95% CI : 0.89–1.53) among subjects with normal lipid levels and subjects with dyslipidemia, respectively. Stratified analyses by hs-CRP levels showed that among participants with normal hs-CRP (< 1 mg/L), TC ≥ 240 mg/dL, LDL-C ≥ 160 mg/dL, non-HDL-C ≥ 190 mg/dL, ApoB < 0.7 g/L, and LDL/HDL-C ≥ 2.02 were associated with CVD [ HRs (95% CIs ): 1.75 (1.21–2.54), 2.16 (1.37–3.41), 1.95 (1.29–2.97), 1.37 (1.01–1.67), and 1.30 (1.00-1.69), all P  < 0.05, respectively]. While in the population with increased hs-CRP, only ApoAI > 2.10 g/L had a significant association with CVD [ HR (95% CI): 1.69 (1.14–2.51)]. Interaction analyses showed that increased hs-CRP had multiplicative and additive interactions with LDL-C ≥ 160 mg/dL and non-HDL-C ≥ 190 mg/dL on the risk of CVD [ HRs (95% CIs ): 0.309 (0.153–0.621), and 0.505 (0.295–0.866); RERIs (95% CIs ): -1.704 (-3.430-0.021 and − 0.694 (-1.476-0.089), respectively, all P  < 0.05]. Conclusion Overall our findings indicate negative interactions between abnormal blood lipid levels and hs-CRP on the risk of CVD. Further large-scale cohort studies with trajectories measurement of lipids and hs-CRP might verify our results as well explore the biological mechanism behind that interaction.