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在预测冠状动脉心脏病风险方面,可溶性血栓模块和细胞间粘附分子-1之间的相互作用

Kenneth K Wu¹, Nena Aleksic, Christie M Ballantyne

¹Vascular Biology Research Center and Department of Internal Medicine, University of Texas-Houston Health Science Center, Houston, Tex, USA. Kenneth.K.Wu@uth.tmc.edu

|April 2, 2003

概括

高溶性细胞间粘附分子-1 (sICAM) 增加了冠心病 (CHD) 的风险,而高溶性血栓模块素 (sTM) 降低了风险. 它们的相互作用显著影响心脏病风险,特别是当sTM低而sICAM高时.

科学领域:

心血管疾病流行病学
生物标志物研究生物标志物研究
动脉样硬化风险因素动脉样硬化风险因素

背景情况:

上一篇社区动脉样硬化风险 (ARIC) 研究显示,可溶性细胞间粘附分子-1 (sICAM) 和可溶性血栓模块素 (sTM) 与冠心病 (CHD) 风险存在对立的关联.
升高的sICAM与心脏病风险增加相关,而升高的sTM与心脏病风险降低有关.
在调节心脏病风险方面,sICAM和sTM之间的潜在相互作用仍然未被探索.

研究的目的:

调查sICAM和sTM水平之间的相互作用,以预测发生冠心病 (CHD) 的风险.
量化SICAM和sTM在ARIC队列中对心脏病风险的综合影响.

主要方法:

使用ARIC研究数据,采用了一个嵌套案例-队列设计.
可溶性血栓模块素 (sTM) 和可溶性细胞间粘附分子-1 (sICAM) 水平在317例心血管疾病病例和726例非病例中被测量.
使用权重考克斯比例危险回归模型来评估sTM和sICAM之间的相互作用及其对心脏病风险的影响.

主要成果:

与之前的发现一致,高的sICAM (上三位数) 大约使心脏病风险增加了一倍 (95% CI,1.46-2.87),而低的sTM (下三位数) 大约使心脏病风险增加了四倍 (95% CI,2.80-5.74).
在预测心脏病风险方面,观察到sTM和sICAM之间的统计学显著相互作用 (P=0.038).
组合分析显示,与高sTM和低sICAM组相比,低sTM和高sICAM组的CHD风险比率 (RR=4.66,95%CI,1.89-11.46) 显著增加.
患有高sTM的个体的风险比率低于1,即使sICAM水平高,也显示出高sTM的保护作用.

结论:

在CHD事件的预测中,sTM和sICAM之间存在显著的相互作用.
升高的sICAM仅在sTM水平较低时,才会显著增加心血管疾病的风险.
高sTM似乎可以减轻与高sICAM相关的心脏病风险增加.

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