血副甲状腺激素和社区心血管死亡风险
Emil Hagström1, Per Hellman, Tobias E Larsson
1Uppsala Clinical Research Center, Uppsala University, Sweden. emil.hagstrom@ucr.uu.se
Circulation
|May 20, 2009
概括
偏甲状腺激素 (PTH) 水平升高预测了一般人群中心血管疾病死亡率. 这种关联甚至适用于正常范围内的PTH个体,突出PTH.
科学领域:
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
- 流行病学 流行病学
背景情况:
- 副甲状腺激素 (PTH) 的升高与心血管疾病 (CVD) 和死亡率有关.
- 在一般人群中对PTH和CVD死亡率的前性数据有限.
研究的目的:
- 在一个社区的老年男性队列中调查血PTH水平和心血管死亡率之间的关联.
- 为了确定PTH是否能够预测心脏病死亡率,而不依赖于已确定的风险因素.
主要方法:
- 利用了来自成人男性乌普萨拉纵向研究 (ULSAM) 的数据,该研究对958名老年男性进行了队列研究.
- 采用考克斯的比例风险模型来分析血PTH与心血管死亡率之间的关联,平均随访时间为9.7年.
- 根据多种心血管风险因素进行调整,包括血压,糖尿病,吸烟,BMI,胆固醇水平和药物使用.
主要成果:
- 较高的血PTH水平与心血管死亡风险增加显著相关 (HR每1SD增加1.38;P<0.001).
- 这种关联在没有先前心血管疾病的参与者和具有正常PTH和矿物代谢的参与者中持续存在.
- 升高的PTH (>5.27 pmol/L) 占人口可归因的心血管死亡风险的20%.
结论:
- 血PTH水平是社区心血管死亡率的重要预测因素.
- PTH可以预测风险,即使在正常范围内,在没有明显代谢障碍的个体中.
- 需要进行进一步的研究,以探索PTH在心血管疾病风险预测中的临床实用性及其作为可修改目标的潜力.
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