{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:55:34Z","timestamp":1791640534972,"version":"4.3.4"},"reference-count":39,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Outstanding Leaders Training Program of Shanghai Pudong New Area Health Commission","award":["PWRI2024-10"],"award-info":[{"award-number":["PWRI2024-10"]}]},{"name":"the Investigator-initiated Trial Program of Shanghai Pudong New Area Health Commission","award":["2024-PWDL-03"],"award-info":[{"award-number":["2024-PWDL-03"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,22]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the role of C-reactive protein (CRP) in predicting all-cause and cause-specific mortality in a community-based Chinese cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A community-based prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>34 communities in Pudong New Area, Shanghai, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 9360 permanent residents from 34 randomly selected communities were enrolled in 2013. Follow-up began at baseline and continued until death or 30 September 2023, whichever occurred first.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The primary outcome of this study was death, as recorded in the Vital Registry of Pudong New Area, Shanghai, China. Associations between CRP and risks of all-cause and cause-specific mortality were studied. Cox proportional hazards models were applied to estimate HR and 95% CI. Adjustments were made for age, sex, area, marriage status, education, current smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, diastolic blood pressure, type 2 diabetes, dyslipidaemia and chronic kidney disease. Competing risk analyses were performed for cause-specific mortality. Restricted cubic splines were used to assess potential non-linear associations. We evaluated improvements in mortality prediction by calculating changes in the C-index, integrated discrimination improvement and net reclassification improvement after adding CRP to conventional risk factor models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow-up of 10.52 (IQR: 10.43\u201310.56) years, 920 deaths (9.68 per 1000 person-years) were recorded. After adjusting for traditional risk factors, higher baseline CRP levels were significantly associated with increased risk of all-cause mortality, cardiovascular mortality and cancer mortality. Non-linear associations were observed between CRP levels and all-cause and cancer mortality. The addition of CRP level significantly improved the reclassification and discrimination ability beyond the conventional risk factor models for all-cause mortality and cancer mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated CRP levels, indicative of low-grade inflammation, are an independent risk factor for all-cause, cardiovascular and cancer mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101532","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T04:30:42Z","timestamp":1755059442000},"page":"e101532","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Prognostic value of C-reactive protein predicting all-cause and cause-specific mortality: a prospective cohort study in Shanghai, China"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0921-4492","authenticated-orcid":false,"given":"Juzhong","family":"Ke","sequence":"first","affiliation":[{"name":"Shanghai Pudong New Area Center for Disease Control and Prevention (Shanghai Pudong New Area Health Supervision Institute), Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingping","family":"Liu","sequence":"additional","affiliation":[{"name":"Shanghai Pudong New Area Center for Disease Control and Prevention (Shanghai Pudong New Area Health Supervision Institute), Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolin","family":"Liu","sequence":"additional","affiliation":[{"name":"Shanghai Pudong New Area Center for Disease Control and Prevention (Shanghai Pudong New Area Health Supervision Institute), Shanghai, 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