Journal
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 179, Issue 5, Pages 375-382Publisher
AMER THORACIC SOC
DOI: 10.1164/rccm.200810-1540OC
Keywords
chronic obstructive pulmonary disease; C-reactive protein; genetics epidemiology
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Funding
- The Netherlands Organization for Scientific Research [90461-093 and 918-46-615]
- The Netherlands Genomics Initiative/Netherlands Organization for Scientific Research [050-060-810]
- Belgian Thoracic Society
- Scientific Research Flanders
- Erasmus Medical Center Rotterdam
- Erasmus University Rotterdam
- Netherlands Organization for Scientific Research
- The Netherlands Organization for Health Research and Development
- Research Institute for Diseases in the Elderly
- Ministry of Education, Culture and Science
- Ministry of Health
- Welfare and Sports
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Rationale Chronic obstructive pulmonary disease (COPD) is characterized by substantial chronic inflammation in the pulmonary compartment as well as in the systemic circulation. Objectives: To investigate potentially causal association, we examined whether serum levels of high-sensitivity C-reactive protein (hsCRP) and variations in the CRP gene are associated with the risk of developing COPD. Methods: This study is part of the Rotterdam Study, a prospective population-based cohort study among subjects aged 55 years or older. At baseline, 6,836 subjects without COPD had a blood sample available for assessment of hsCRP serum levels and haplotypes of the CRP gene. We analyzed the association between hsCRP levels, CRIP gene haplotypes, and incident COPD with Cox proportional hazard models, adjusted for age, sex, and other confounders. Measurements and Main Results: High levels of hsCRP (>3 mg/L) were associated with a significantly increased risk of incident COPD (hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.16-2.49) compared with persons with low levels (< 1 mg/L). The risk remained increased after adjusting for potential confounders and introducing a latency period of 3 years. The risk was most pronounced in former smokers (HR, 2.2; 95% CI, 1.12-3.74). hsCRP was not a risk factor in never smokers. No CRP single nucleoticle polymorphism or haplotype was associated with a significantly increased or decreased COPD risk. Conclusions: Increased hsCRP levels are predictive for the occurrence of COPD in smokers. However, haplotypes of the CRP gene, which influence hsCRP levels, are not associated with an altered risk of developing COPD.
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