{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:34:13Z","timestamp":1792787653084,"version":"4.5.0"},"reference-count":59,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Joint project of Chongqing Health Commission and Science and Technology Bureau","award":["2024QNXM017"],"award-info":[{"award-number":["2024QNXM017"]}]},{"name":"Scientific and Technological Research Program of Chongqing Municipal Education Commission","award":["KJQN202300454"],"award-info":[{"award-number":["KJQN202300454"]}],"id":[{"id":"https:\/\/ror.org\/031nm5713","id-type":"ROR","asserted-by":"crossref"}]},{"name":"the Medical Science and Technology Research Program of Chongqing Banan Science and Technology Bureau and Chongqing Banan Health Commission","award":["BNWJ202300106"],"award-info":[{"award-number":["BNWJ202300106"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Cardiovascular-Kidney-Metabolic (CKM) syndrome, characterized by interconnected metabolic, cardiovascular, and renal dysfunctions, is linked to chronic low-grade inflammation, a key driver of comorbidities like chronic obstructive pulmonary disease (COPD). C-reactive protein (CRP), a sensitive inflammation biomarker, may predict COPD risk in CKM stages 0\u20133 (no overt CVD), but longitudinal patterns of CRP remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective cohort study, we included 4,887 participants aged \u226545 years with CKM stages 0\u20133 and without prior COPD from the China Health and Retirement Longitudinal Study (CHARLS). CRP was measured in 2012 and 2015. Longitudinal change patterns were identified using k-means clustering. Cumulative CRP exposure (cumCRP) was calculated as the area under the curve. Incident COPD was defined based on self-reported physician diagnosis plus objective evidence of airflow limitation (peak expiratory flow &lt;80% predicted) in 2018. Multivariable logistic regression was used to assess associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four CRP change patterns were identified: stable low-risk (Class 1), rapidly increasing (Class 2), significant improvement (Class 3), and persistently high-risk (Class 4). Compared to Class 1, Class 4 was associated with a 69% higher COPD risk (adjusted OR=1.69, 95% CI: 1.28\u20132.23). High cumCRP (tertile 3 vs. 1) increased COPD risk by 65% (OR=1.65, 95% CI: 1.32\u20132.08). The association was stronger in advanced CKM stages 0\u20133 (no overt CVD), particularly Stage 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Longitudinal CRP change patterns and cumulative CRP exposure are independently associated with incident COPD in individuals with CKM stages 0\u20133 (no overt CVD). Persistently elevated or rapidly increasing CRP may help identify high-risk individuals for targeted monitoring and early intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504261477194","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:36:03Z","timestamp":1787236563000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cumulative C-reactive protein exposure links to COPD risk in adults with cardiovascular-kidney-metabolic syndrome stages 0\u20133 (no overt CVD): A prospective cohort study"],"prefix":"10.1177","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9178-4538","authenticated-orcid":false,"given":"Yunyu","family":"Liu","sequence":"first","affiliation":[{"name":"Affiliated Banan Hospital of Chongqing Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Gong","sequence":"additional","affiliation":[{"name":"People\u2019s Hospital of Chongqing Hechuan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[{"name":"The People\u2019s Hospital of Yubei District of Chongqing City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juntao","family":"Tan","sequence":"additional","affiliation":[{"name":"Chongqing Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Tan","sequence":"additional","affiliation":[{"name":"ChongQing University Cancer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001184"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001186"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000664"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.6892"},{"key":"e_1_3_8_6_2","first-page":"101474","article-title":"Long-term trends in the prevalence of cardiovascular-kidney-metabolic syndrome in South Korea, 2011\u20132021: a representative longitudinal serial study","volume":"55","author":"Yim Y","year":"2025","unstructured":"Yim Y, Lee JE, Son Y, et al. 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