アルカリリンフォスファターゼ,血清リン酸,全原因または心血管疾患による死亡率との関連
Marcello Tonelli1, Gary Curhan, Marc Pfeffer
1Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. mtonelli-admin@med.ualberta.ca
Circulation
|October 21, 2009
まとめ
血清アルカリリンフォスファターゼ (AlkP) 濃度の上昇は,心臓発作の生存者および一般の人々を含む,腎不全のない個人の死亡リスクの増加と関連しています. この関連性は,他の健康要因をコントロールしても持続します.
科学分野:
- バイオケミストリー バイオケミストリー
- クリニカル・メディシン 臨床医学
- エピデミオロジー エピデミオロジー
背景:
- 血清アルカリリンフォスファターゼ (AlkP) の上昇は,透析患者における死亡のリスク因子として知られています.
- 腎不全のない個体におけるAlkPレベルと有害な結果の関連性は,依然としてほとんど不明である.
研究 の 目的:
- 血清アルカリリンフォスファターゼ (AlkP) レベルと健康への悪影響,特に心血管疾患と死亡率との関係を調査する.
- 慢性腎臓病のない集団で,この関連性が存在するかどうかを判断する.
主な方法:
- コレステロールと再発性イベント (CARE) 研究の分析 (n=4115) 心血管疾患のアウトカムについて.
- 第3回全国保健栄養調査調査 (NHANES III) (n=14,716) を用いて,全因および心血管疾患による死亡率の検証.
- 血清リン酸と肝臓酵素を含む潜在的な混同因子に対する統計的調整.
主要な成果:
- CARE参加者において,より高いAlkP率と全因死亡率の増加との間には,段階的,独立した関連性が見られた (P (傾向) =0.02).
- 最も高いAlkPテリルの個人は,最も低いテリルの個人に比べて,死亡リスク比 (aHR=1.43) が43%増加しました.
- 同様の関連性は,NHANES IIIコホートで発見され,高いAlkPは,腎臓疾患の状態に関係なく,全因および心血管疾患による死亡率の増加 (P ((傾向) =0.006および0.038) と関連付けられました.
結論:
- 血清アルカリリンフォスファタゼ (AlkP) 濃度の上昇は,死亡率を含む有害な結果と独立して関連しています.
- このリスクは,心筋梗塞の生存者および一般の人々において,腎臓疾患のない個人でも明らかです.
- 死亡リスクは,高レベルのAlkPと血清リン酸が同時に存在する個体において特に高くなります.
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