Change in C-reactive protein levels and FEV1 decline: a longitudinal population-based study

Respir Med. 2006 Dec;100(12):2112-20. doi: 10.1016/j.rmed.2006.03.027. Epub 2006 May 2.


Reduced pulmonary function is an important predictor of cardiovascular morbidity and mortality. The mechanisms underlying this association are unknown but may involve systemic inflammation. We assessed the cross-sectional and longitudinal relationships between C-reactive protein (CRP) levels and forced expiratory volume in 1s (FEV1) and its decline in the general population, over a period of 8.5 years. The analyzes were based on 531 subjects (mean age at baseline: 37+/-7 years, 50% women and 42% non-smokers), recruited at two French centers participating in the European Community Respiratory Health Survey. Lung function was expressed as a percentage of predicted FEV1. CRP was measured centrally, by means of a highly sensitive assay. In cross-sectional analysis, FEV1 as a % of predicted values was negatively associated with serum CRP concentration (P=0.002). Multivariate adjustment did not alter these results (P=0.002). In longitudinal analysis, annual FEV1 decline tended to increase from the lower to the upper tertile for baseline CRP concentration but the association was borderline significant (P=0.14). Mean values of annual FEV1 decline were 26+/-32, 31+/-32, and 34+/-32 ml/year for the lower, middle and upper tertiles of baseline CRP concentration, respectively, after adjusting for potential confounders (P=0.09). Changes in CRP levels during follow-up were associated with annual FEV1 decline. The mean annual FEV1 declines in subjects with increasing CRP, in those with stable CRP and in those with decreasing CRP were 36+/-31, 30+/-31 and 24+/-31 ml/year, respectively (P<0.001). These findings were not affected by adjustment for potential confounders (P=0.002). In conclusion, increases in CRP levels over time were associated with a steeper FEV1 decline.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Body Mass Index
  • C-Reactive Protein / analysis*
  • Cholesterol / blood
  • Cross-Sectional Studies
  • Female
  • Forced Expiratory Volume / physiology*
  • France / epidemiology
  • Health Surveys
  • Humans
  • Longitudinal Studies
  • Lung / physiology
  • Male
  • Smoking / epidemiology
  • Switzerland / epidemiology


  • C-Reactive Protein
  • Cholesterol