Veza između koncentracije C-reaktivnog proteina visoke osetljivosti u plazmi i tradicionalnih kardiovaskularnih faktora rizika kod aktivnih vojnih lica u Republici Srbiji
Sažetak
Uvod/Cilj. Skoro trećina osoba bez ili sa jednim faktorom kardiovaskularnog (KV) rizika, kao i 40% osoba sa koncentracijom holesterola manjom od prosečne, umire od KV bolesti (KVB). Nedavna istraživanja su potvrdila značajnu ulogu upale u aterosklerozi i njenim komplikacijama. Cilj rada bio je da se utvrdi povezanost C-reaktivnog proteina visoke osetljivosti (hs-CRP) sa tradicionalnim faktorima rizika za koronarnu bolest kod profesionalnih vojnika. Ovo je prvo takvo istraživanje u Srbiji. Metode. Studija preseka obuhvatila je aktivna vojna lica sličnih socio-epidemioloških osobina i ekonomskog statusa. Ispitani su hs-CRP u plazmi i tradicionalni faktori KV rizika. Relativni KV rizik definisan je kao nizak (hs-CRP < 1 mg /L), srednji (hs-CRP između 1 i 3 mg/L) i visok (hs-CRP > 3 mg/L). Skala sistemske procene koronarnog rizika (SCORE) je korišćena za procenu apsolutnog i ukupnog KV rizika (fatalni i nefatalni događaji). Rezultati. Studija je obuhvatila 205 ispitanika prosečne starosti 39 (35–43) godina, sa srednjom vrednošću i vrednostima interkvartilnog raspona hs-CRP 0,80 mg/L (0,43–1,75 mg/L), sa srednjom vrednošću hs-CRP 0,71 mg/L kod mlađih od 40 godina, odnosno 1,2 mg/L kod starijih od 40 godina. Razlika u vrednosti hs-CRP između ove dve grupe bila je statistički značajna (p = 0,006). Zabeležena je značajna pozitivna korelacija između hs-CRP i životnog doba (r = 0,266, p < 0,001), telesne mase (r = 0,223, p = 0,001), indeksa telesne mase (ITM) (r = 0,344, p <0,001), vrednosti dijastolnog pritiska (r = 0,190, p = 0,007), LDL holesterola (r = 0,152, p = 0,032), triglicerida (r = 0,144, p = 0,039), i broja faktora rizika (r = 0,210, p < 0,003), kao i negativna korelacija sa koncentracijom HDL holesterola (r = -0,148 p <0,035). Nije bilo značajne korelacije između koncentracije hs-CRP i ukupnog holesterola (r = 0,131, p = 0,062). Prema vrednosti hs-CRP, visok rizik od KVB ustanovljen je kod 17,7% ispitanika starijih od 40 godina, a na osnovu vrednosti SCORE sistema, njih 90% je imalo srednji rizik od razvoja KVB. Rezulati multiple regresione analize pokazali su da je ITM bio nezavisno udružen sa koncentracijom hs-CRP-a u grupi ispitanika mlađih od 40 godina. Kod starijih ispitanika nađena je povezanost godina života i koncentracije fibrinogena. Zaključak. U populaciji aktivnih vojnih lica u Republici Srbiji, hs-CRP je u korelaciji sa nekim od faktora rizika od KVB, a samo je BMI u nezavisnoj korelaciji sa hs-CRP i to kod mlađih od 40 godina. Koncentracija hs-CRP u plazmi raste sa starenjem, što ukazuje na to da bi određivanje hs-CRP moglo biti značajno za precizniju procenu profila individualnog rizika od KVB u populaciji vojnog osoblja Srbije.
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