Association of the High-Sensitivity C-Reactive Protein-to-Albumin Ratio with Carotid Atherosclerotic Plaque: A Community-Based Cohort Study

Figures & data

Figure 1 Flow chart of the study participants.

Abbreviations: MRI, magnetic resonance imaging; TCD, transcranial Doppler.

Table 1 Baseline Characteristics of Study Participants

Characteristics	Total Sample	Carotid Plaque
	(n=2003)	No (n=1226)	Yes (n=777)	p-value
Age (years)	56(49–65)	52(47–60)	63(55–71)	<0.001
Male, n (%)	962(48.03)	566(46.17)	396(50.97)	0.036
BMI (kg/m^2)	25.00(22.77–27.27)	25.08(23.00–27.44)	24.77(22.38–26.89)	0.002
Smoking, n (%)	453(22.62)	248(20.23)	205(26.38)	0.001
Alcohol drinking, n (%)	657(32.80)	400(32.63)	257(33.08)	0.845
Dyslipidemia, n (%)	800(39.94)	434(35.40)	366(47.10)	<0.001
Hypertension, n (%)	1153(57.56)	592(48.29)	561(72.20)	<0.001
Diabetes mellitus, n (%)	305(15.23)	137(11.17)	168(21.62)	<0.001
Use of antihypertensive medication, n (%)	326(16.28)	128(10.44)	198(25.48)	<0.001
Use of glucose-lowering medications, n (%)	137(6.84)	56(4.57)	81(10.42)	<0.001
hs-CRP (mg/L)	0.66(0.26–1.57)	0.51(0.21–1.35)	0.86(0.37–2.04)	<0.001
ALB (g/L)	45.20(43.20–47.00)	45.30(43.30–47.10)	45.00(43.10–46.80)	0.059
CAR (mg/g)	0.01(0.01–0.03)	0.01(0.00–0.03)	0.02(0.01–0.05)	<0.001

Notes: Data was shown as numbers (%) and median (25–75 percentiles). Comparison according to carotid plaque using Mann–Whitney U-test and χ² test appropriately.

Abbreviations: BMI, body mass index; hs-CRP, high-sensitivity C-reactive protein; ALB, albumin.; CAR, high-sensitivity C-reactive protein to albumin ratio.

Table 2 Association of CAR with Carotid Plaque

CAR (mg/g)	n/N	Model 1		Model 2
		OR (95% CI)	P value	OR (95% CI)	P value
Total sample (n=2003)
Tertiles
Lower	194/668	1.00(reference)		1.00(reference)
Medium	264/668	1.45(1.13,1.87)	0.004	1.30(1.00,1.68)	0.050
Upper	319/667	1.68(1.31,2.17)	<0.001	1.46(1.13,1.90)	0.004
P for trend			<0.001		0.011
Age <65 years (n=1458)
Tertiles
Lower	115/541	1.00(reference)		1.00(reference)
Medium	149/489	1.55(1.15,2.09)	0.004	1.37(1.01,1.86)	0.044
Upper	150/428	1.72(1.27,2.35)	0.001	1.44(1.05,1.99)	0.024
P for trend			0.003		0.061
Age ≥65 years (n=545)
Tertiles
Lower	79/127	1.00(reference)		1.00(reference)
Medium	115/179	1.13(0.70,1.84)	0.610	1.00(0.61,1.64)	0.991
Upper	169/239	1.43(0.90,2.27)	0.132	1.35(0.84,2.19)	0.216
P for trend			0.116		0.128
Male (n=962)
Tertiles
Lower	114/374	1.00(reference)		1.00(reference)
Medium	135/314	1.31(0.92,1.86)	0.136	1.13(0.79,1.63)	0.504
Upper	147/274	1.49(1.03,2.16)	0.035	1.26(0.86,1.85)	0.230
P for trend			0.053		0.255
Female (n=1041)
Tertiles
Lower	80/294	1.00(reference)		1.00(reference)
Medium	129/354	1.61(1.11,2.33)	0.012	1.30(1.00,1.68)	0.050
Upper	172/393	1.86(1.30,2.66)	0.001	1.46(1.13,1.90)	0.004
P for trend			0.004		0.011

Notes: OR and 95% CIs were calculated by logistic regression. Model 1 was adjusted for age, sex; Model 2 was additionally adjusted for dyslipidemia, smoking, drinking, hypertension, and diabetes mellitus. n/N indicates number of carotid plaque/number of participants.

Abbreviations: OR, odds ratio; CI, confidence interval.

Figure 2 The participants distribution of carotid plaque and vulnerable plaque in different CAR levels.

Table 3 Association of CAR with Stable and Vulnerable Plaque

CAR (mg/g), Tertiles	Carotid Plaque
	Vulnerable			Stable
	n	OR (95% CI)	P value	n	OR (95% CI)	P value
Lower	66	1.00(reference)		128	1.00(reference)
Medium	118	1.68(1.15,2.45)	0.007	146	1.15(0.86,1.53)	0.342
Upper	166	2.06(1.42,2.98)	<0.001	153	1.22(0.91,1.64)	0.188
P for trend			<0.001			0.235

Note: OR and 95% CI were estimated from the multivariable logistic regression models that were adjusted for sex, age, dyslipidemia, smoking, drinking, hypertension, and diabetes mellitus.

Abbreviations: OR, odds ratio; CI, confidence interval.

Data Sharing Statement

The raw data supporting the conclusions of this article will be made available by the corresponding author.