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[大学生论坛]:炎性标志物与男性和女性的冠心病危险的关系

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歪歪歪 发表于 2019-1-4 10:52:57 | 显示全部楼层 |阅读模式
本帖最后由 歪歪歪 于 2019-1-4 11:10 编辑

Inflammatory Markers and the Risk of Coronary HeartDisease in Men and Women
炎性标志物与男性和女性的冠心病危险的关系
ABSTRACT
摘要

Background:Few studies havesimultaneously investigated the role of soluble tumor necrosisfactor (TNF-α) receptors types 1and 2 (sTNF-R1 and sTNF-R2), C-reactive protein, and interleukin-6 aspredictors of cardiovascular events. The value of these inflammatory markersas independent predictors remains controversial.
背景:很少有研究同时探讨1型和2型可溶性肿瘤坏死因子α(TNF-α)受体(sTNF-R1 和STNF-R2)、C反应蛋白和白细胞介素6作为心血管事件预测因子的作用。这些炎性因子作为独立预测因子的价值仍存在争议。

Methods:We examined plasma levelsof sTNF-R1, sTNF-R2, interleukin-6, and C-reactive protein asmarkers of risk for coronary heart disease among women participatingin the Nurses' Health Study and men participating in the HealthProfessionals Follow-up Study in nested case–control analyses. Amongparticipants who provided a blood sample and who were free ofcardiovascular disease at baseline, 239 women and 265 men had anonfatal myocardial infarction or fatal coronary heart diseaseduring eight years and six years of follow-up, respectively. Usingrisk-set sampling, we selected controls in a 2:1 ratio with matchingfor age, smoking status, and date of blood sampling.
方法:在一项巢式病例对照分析中,我们在护士健康研究中的女性研究对象和健康专业人员随访研究中的男性研究对象中,检测冠心病危险标志物sTNF-R1、sTNF-R2、白细胞介素6和C反应蛋白的血浆水平。在有血标本、且基线时无心血管疾病的研究对象中,分别在8年和6年的随访期内有239名女性研究对象和265名男性研究对象发生非致死性心肌梗死或致死性冠心病。采用危险设定采样方法,我们以2∶1的比例选取年龄、吸烟状况及采集血标本时间相匹配的对照研究对象。

Results:After adjustment formatching factors, high levels of interleukin-6 and C-reactiveprotein were significantly related to an increased risk of coronaryheart disease in both sexes, whereas high levels of soluble TNF-α receptors weresignificant only among women. Further adjustment for lipid andnonlipid factors attenuated all associations; only C-reactiveprotein levels remained significant. The relative risk among allparticipants was 1.79 for those with C-reactive protein levels of atleast 3.0 mg per liter, as compared with those with levels of lessthan 1.0 mg per liter (95 percent confidence interval, 1.27 to2.51; P for trend <0.001). Additional adjustment for the presenceor absence of diabetes and hypertension moderately attenuated therelative risk to 1.68 (95 percent confidence interval, 1.18 to 2.38;P for trend = 0.008).
结果:在对匹配因素进行校正后,白细胞介素6和C反应蛋白水平升高与男性和女性研究对象的冠心病危险增加显著相关,而可溶性TNFα受体水平升高仅与女性冠心病危险增加显著相关。进一步校正血脂和非血脂因素后,上述所有的相关性降低,仅C反应蛋白水平仍具有显著性。在所有研究对象中,与C反应蛋白<1.0 mg/L者相比,C反应蛋白≥3.0 mg/L者的相对危险为1.79。又对是否有糖尿病和高血压进行校正后,相对危险适度降低,降为1.68(95%可信区间为1.18~2.38,趋势P值为0.008)。


Conclusions:Elevated levels ofinflammatory markers, particularly C-reactive protein, indicate anincreased risk of coronary heart disease. Although plasma lipidlevels were more strongly associated with an increased risk thanwere inflammatory markers, the level of C-reactive protein remaineda significant contributor to the prediction of coronary heartdisease.
结论:炎性标志物水平升高,特别是C反应蛋白升高,表明冠心病危险增加。尽管血脂水平与冠心病危险增加的相关性较炎性标志物更强,但是,C反应蛋白仍是一个冠心病的显著预测因子。

Source:New England Journal of Medicine

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