{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:15:30Z","timestamp":1790622930088,"version":"4.1.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Arthritis poses a significant public health challenge, contributing to increased healthcare resource utilization and reduced quality of life. C-reactive protein (CRP), a key inflammatory biomarker, plays a critical role in monitoring disease progression and guiding health promotion strategies. This study aims to investigate the association between CRP levels and all-cause mortality in Chinese arthritis patients, highlighting its implications for public health education and intervention programs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. Individuals diagnosed with arthritis in 2011 were included, with CRP levels as the primary exposure variable and mortality as the outcome of interest. Kaplan\u2013Meier survival curves and Cox proportional hazards regression models were employed to assess the relationship between CRP levels and mortality risk, emphasizing the potential for targeted health education and promotion interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3,413 participants were analyzed, with 87 deaths recorded during the 10-year follow-up period. Deceased individuals were older and exhibited higher levels of CRP, creatinine, and uric acid, alongside lower BMI, MET, eGFR, and HGB. Across three Cox regression models, elevated CRP levels (\u22653\u202fmg\/L) were significantly associated with increased mortality risk [hazard ratio (HR)\u202f=\u202f3.73 (2.23\u20136.23), HR\u202f=\u202f3.00 (1.79\u20135.01), HR\u202f=\u202f4.94 (1.77\u201313.78), respectively]. Kaplan\u2013Meier survival curves further confirmed that arthritis patients with CRP levels \u22653\u202fmg\/L faced a markedly higher mortality risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated CRP levels are strongly associated with increased all-cause mortality in arthritis patients, underscoring the importance of integrating CRP monitoring into public health education and promotion strategies. Efforts to control inflammation and promote health literacy regarding arthritis management may improve survival outcomes and reduce the public health burden associated with arthritis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1511860","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T07:10:23Z","timestamp":1738825823000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The role of C-reactive protein in predicting all-cause mortality among Chinese arthritis patients: implications for public health education and promotion"],"prefix":"10.3389","volume":"13","author":[{"given":"Shuchao","family":"Ye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damei","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changyi","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongming","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuelan","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoyan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongyang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12916-021-01905-w","article-title":"Pattern and trend of five major musculoskeletal disorders in China from 1990 to 2017: findings from the global burden of disease study 2017","volume":"19","author":"Wu","year":"2021","journal-title":"BMC Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.1002\/art.42089","article-title":"Prevalence trends of site-specific osteoarthritis from 1990 to 2019: findings from the global burden of disease study 2019","volume":"74","author":"Long","year":"2022","journal-title":"Arthritis Rheumatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1002\/acr.23425","article-title":"Medical expenditures and earnings losses among US adults with arthritis in 2013","volume":"70","author":"Murphy","year":"2018","journal-title":"Arthritis Care Res"},{"key":"ref4","first-page":"646","article-title":"Burden of major musculoskeletal conditions","volume":"81","author":"Woolf","year":"2003","journal-title":"Bull World Health Organ"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1186\/s12911-022-01845-2","article-title":"Telemedicine application in patients with chronic disease: a systematic review and meta-analysis","volume":"22","author":"Ma","year":"2022","journal-title":"BMC Med Inform Decis Mak"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1001212","DOI":"10.3389\/fmolb.2022.1001212","article-title":"The role of oxidative stress in the development of knee osteoarthritis: a comprehensive research review","volume":"9","author":"Liu","year":"2022","journal-title":"Front Mol Biosci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s13075-022-02722-z","article-title":"Rheumatoid arthritis, as a clinical disease, but not rheumatoid arthritis-associated autoimmunity, is linked to cardiovascular events","volume":"24","author":"Gouze","year":"2022","journal-title":"Arthritis Res Ther"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.bbrc.2008.12.117","article-title":"Suppression of interleukin-6-induced C-reactive protein expression by FXR agonists","volume":"379","author":"Zhang","year":"2009","journal-title":"Biochem Biophys Res Commun"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.3390\/cancers12071966","article-title":"Combined C-reactive protein and novel inflammatory parameters as a predictor in Cancer-what can we learn from the hematological experience?","volume":"12","author":"Bruserud","year":"2020","journal-title":"Cancers"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0127550","DOI":"10.1371\/journal.pone.0127550","article-title":"Blood-borne biomarkers of mortality risk: systematic review of cohort studies","volume":"10","author":"Barron","year":"2015","journal-title":"PLoS One"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/8613986","article-title":"C-reactive protein knockout attenuates temporomandibular joint inflammation in rats","volume":"2022","author":"He","year":"2022","journal-title":"J Immunol Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New creatinine- and cystatin C-based equations to estimate GFR without race","volume":"385","author":"Inker","year":"2021","journal-title":"N Engl J Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"24","DOI":"10.3390\/molecules24112062","article-title":"The multiple faces of C-reactive protein-physiological and pathophysiological implications in cardiovascular disease","volume":"24","author":"Boncler","year":"2019","journal-title":"Molecules"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"9129","DOI":"10.3390\/ijms24119129","article-title":"C-reactive protein levels and risk of cardiovascular diseases: a two-sample bidirectional Mendelian randomization study","volume":"24","author":"Kuppa","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"817","DOI":"10.3899\/jrheum.220635","article-title":"Clustering patients with gout based on comorbidities and biomarkers: a cross-sectional study","volume":"50","author":"Alduraibi","year":"2023","journal-title":"J Rheumatol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1136\/jech-2019-213289","article-title":"Association between C reactive protein and all-cause mortality in the ELSA-Brasil cohort","volume":"74","author":"Maluf","year":"2020","journal-title":"J Epidemiol Community Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1093\/ndt\/17.suppl_8.29","article-title":"C-reactive protein a marker for all-cause and cardiovascular mortality in haemodialysis patients","volume":"17","author":"Wanner","year":"2002","journal-title":"Nephrol Dial Transplant"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1093\/eurheartj\/ehu059","article-title":"C-reactive protein and risk of cardiovascular and all-cause mortality in 268 803 east Asians","volume":"35","author":"Sung","year":"2014","journal-title":"Eur Heart J"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"824783","DOI":"10.3389\/fpubh.2022.824783","article-title":"Associations between high-sensitivity C-reactive protein and all-cause mortality among oldest-old in Chinese longevity areas: a community-based cohort study","volume":"10","author":"Chen","year":"2022","journal-title":"Front Public Health"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.ahj.2013.03.017","article-title":"Gender differences in cardiovascular mortality by C-reactive protein level in the United States: evidence from the National Health and nutrition examination survey III","volume":"166","author":"Doran","year":"2013","journal-title":"Am Heart J"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2286","DOI":"10.1186\/s12889-024-19825-8","article-title":"Association of serum calcium, vitamin D, and C-reactive protein with all-cause and cause-specific mortality in an osteoarthritis population in the UK: a prospective cohort study","volume":"24","author":"Fu","year":"2024","journal-title":"BMC Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1186\/s40001-024-01923-3","article-title":"Association of C-reactive protein with all-cause and cause-specific mortality in people with gout","volume":"29","author":"Han","year":"2024","journal-title":"Eur J Med Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1421497","DOI":"10.3389\/fmed.2024.1421497","article-title":"Association between the inflammatory burden index and rheumatoid arthritis and its all-cause mortality: data from NHANES 1999-2018","volume":"11","author":"Zhai","year":"2024","journal-title":"Front Med"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1511860\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T07:10:25Z","timestamp":1738825825000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1511860\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,6]]},"references-count":23,"alternative-id":["10.3389\/fpubh.2025.1511860"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1511860","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,6]]},"article-number":"1511860"}}