The Association Between High-Sensitivity C-Reactive Protein and the Progression of Arteriosclerosis: The Kailuan Study

Objective: To explore the association between high-sensitivity C-reactive protein (hs-CRP) and the progression of arteriosclerosis. Methods: Using a prospective cohort study design, 11,577 participants from the Kailuan Study cohort who underwent at least two brachial-ankle pulse wave velocity (baPWV) examinations and met the inclusion criteria were included as the study subjects. Based on baseline hs-CRP levels, they were divided into three groups: hs-CRP < 1 mg/L group, 1 mg/L≤hs-CRP≤ 3 mg/L group, and hs-CRP > 3 mg/L group. Poisson regression analysis was employed for longitudinal comparison to assess the impact of different hs-CRP levels on baPWV≥ 1,400 cm/s. Results: (1) After a mean follow-up of 5.12 ± 2.84 years, the detection rates of baPWV≥ 1,400 cm/s at the end of follow-up were 28.54%, 33.36%, and 36.25% in the hs-CRP< 1 mg/L (n=5,998), 1 mg/L≤ hs-CRP≤ 3 mg/L (n=4,101), and hs-CRP> 3 mg/L (n=1,578) groups, respectively ( P < 0.001). (2) Multivariable-adjusted Poisson regression analysis for baPWV≥ 1,400 cm/s showed that, after adjusting for confounding factors, compared to the hs-CRP< 1 mg/L group, the 1 mg/L≤hs-CRP≤ 3 mg/L group had a 2.4% higher risk of arterial stiffness (RR: 1.024; 95% CI: 1.002 to 1.047; P < 0.05) and hs-CRP> 3 mg/L group had a 6.3% higher risk (RR: 1.063; 95% CI: 1.031 to 1.095; P < 0.001). Sensitivity analysis validated the robustness of the results. Conclusion: Elevated hs-CRP is an independent risk factor for arteriosclerosis progression.