Association between C reactive protein and all-cause mortality in the ELSA-Brasil cohort. Issue 5 (26th February 2020)

• Record Type: Journal Article
• Authors: Maluf, Chams B; Barreto, Sandhi Maria; Giatti, Luana; Ribeiro, Antonio Luiz; Vidigal, Pedro G; Azevedo, Douglas R M; Griep, Rosane H; Matos, Sheila Maria Alvim; Ji, Chen; Cappuccio, Francesco P; Miller, Michelle A
• Is Part Of: Journal of epidemiology and community health. Volume 74:Issue 5(2020)
• Page Start: 421
• Page End: 427
• Publication Date: 2020-02-26
• Subjects: epidemiology -- mortality -- cohort studies; Public health -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1136/jech-2019-213289
• Languages: English
• ISSNs: 0143-005X

Abstract

Abstract : Background: High-sensitivity C reactive protein (hsCRP) has been proposed as a marker of incident cardiovascular disease and vascular mortality, and may also be a marker of non-vascular mortality. However, most evidence comes from either North American or European cohorts. The present proposal aims to investigate the association of hsCRP with the risk of all-cause mortality in a multiethnic Brazilian population. Methods: Baseline data (2008–2010) of a cohort of 14 238 subjects participating in the Brazilian Longitudinal Study of Adult Health were used. hsCRP was assayed with immunochemistry. The association of baseline covariates with all-cause mortality was calculated by Cox regression for univariate model and adjusted for different confounders after a mean follow-up of 8.0±1.1 years. The final model was adjusted for age, sex, self-rated race/ethnicity, schooling, health behaviours and prevalent chronic disease. Results: The risk of death increased steadily by quartiles of hsCRP, from 1.45 (95% CI 1.05 to 2.01) in quartile 2 to 1.95 (95% CI 1.42 to 2.69) in quartile 4, compared with quartile 1. Furthermore, the persistence of a significant graded association after the exclusion of deaths in the first year of follow-up suggests that these results are unlikely to be due to reverse causality. Finally, the HR was unaffected by the exclusion of participants who had self-reported medical history of diabetes, cancer and chronic obstructive pulmonary disease. Conclusions: Our study shows that hsCRP level is associated with mortality in a highly admixed population, independent of a large set of lifestyle and clinical variables.