C-reactive protein levels and risk of mortality from cardiovascular disease in Japanese: The JACC Study

Objects: Limited evidence of association between C-reactive protein levels and cardiovascular disease has been produced for Japanese whose median protein levels are low by western standards. Methods: We conducted a nested case-control study as part of the Japan Collaborative Cohort Study for evaluation of cancer risk (JACC Study). A total of 39,242 subjects 40-79 years of age provided serum samples at baseline between 1988 and 1990. During the 13-year follow-up, there were 525 deaths from total strokes (ICD10: I60-I69), 209 coronary heart diseases (I20-I25) and 939 total cardiovascular diseases (I00-I99). The control subjects were matched for sex, age, area of residence and year of serum storage, and analyses were conducted after further adjustment for cardiovascular risk factors. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured with ultra-sensitive latex-enhanced immunoassay. Results: Median hs-CRP levels for controls were 0.40 mg/L for men and 0.41 mg/L for women. Hs-CRP levels were positively associated with risks of mortality from stroke, coronary heart disease, and total cardiovascular disease for men. The respective multivariable odds ratios ( OR 95% CI) for the highest (>= 0.85 mg/L) vs. lowest (< 0.19 mg/L) quartiles of hs-CRP for men were 1.60 (0.90-2.85), 3.68 (1.02-13.3), and 2.31 (1.49-3.59). For women, positive associations with hs-CRP levels were weaker, reaching statistical significance only for total cardiovascular disease: OR = 1.69 (1.06-2.68). The positive association with total cardiovascular disease did not vary according to sex, age, smoking status, or body mass index. Conclusions: Higher serum hs-CRP levels were associated with higher mortality from cardiovascular disease in Japanese. (C) 2009 Published by Elsevier Ireland Ltd.