老年人群动脉粥样硬化的临床表现与血浆新蝶呤、中性粒细胞明胶酶相关脂质运载蛋白及内皮素-1有关，而与肺炎衣原体血清学无关。

Clinical manifestations of atherosclerosis in an elderly population are related to plasma neopterin, NGAL and endothelin-1, but not to Chlamydia pneumoniae serology.

作者信息

Forsblad J, Gottsäter A, Persson K, Jacobsson L, Lindgärde F

机构信息

Department of Vascular Diseases, University of Lund, Sweden.

出版信息

Int Angiol. 2002 Jun;21(2):173-9.

PMID:12110780

Abstract

BACKGROUND

Inflammatory mediators secreted by leukocytes are implicated in atherogenesis. Chlamydia (C.) pneumoniae infection has been suggested as a trigger of this process. We investigated relationships between C. Pneumoniae serology, inflammatory mediators and symptomatic cardiovascular disease in old age.

METHODS

In a cross-sectional study at baseline with a prospective 4 year follow-up, intraplatelet cyclic 3'-5'adenosine monophosphate (cAMP) and cyclic 3'-5'guanosine monophosphate (cGMP), plasma neutrophil gelatinase associated lipocalin (NGAL), plasma soluble tumor necrosis factor receptor-1 (TNFR-1) plasma neopterin and plasma endothelin-1 (ET-1) were analysed together with IgG and IgA antibodies for C. Pneumoniae in an elderly reference population (n=140, median age 71 years, 71 females). Twenty-one subjects had clinical manifestations of cardiovascular disease at baseline and another 21 were diagnosed with cardiovascular disease during follow-up.

RESULTS

In age adjusted logistic regression, subjects with cardiovascular disease showed higher plasma levels of neopterin (p=0.02), NGAL (p=0.04), and ET-1 (p<0.01). If subjects with cardiovascular disease at baseline were excluded from the analysis, higher plasma neopterin (p=0.01) and lower serum HDL cholesterol (p=0.03) predicted cardiovascular disease during follow-up. The presence of IgG or IgA against C. pneumoniae was not associated with cardiovascular disease. Neither were there any associations between inflammatory or endothelial parameters and C. pneumoniae serology.

CONCLUSIONS

The inflammatory mediators neopterin and NGAL and endothelial derived vasoconstrictive ET-1 were increased in elderly subjects with symptomatic cardiovascular disease. Increased plasma neopterin predicted cardiovascular disease during follow-up. No relationships were found between C. Pneumoniae serology and cardiovascular disease.

摘要

背景

白细胞分泌的炎症介质与动脉粥样硬化的发生有关。肺炎衣原体感染被认为是这一过程的触发因素。我们研究了老年人群中肺炎衣原体血清学、炎症介质与有症状心血管疾病之间的关系。

方法

在一项基线横断面研究及为期4年的前瞻性随访中，对老年参考人群（n = 140，中位年龄71岁，71名女性）的血小板内3'-5'环磷酸腺苷（cAMP）和3'-5'环磷酸鸟苷（cGMP）、血浆中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、血浆可溶性肿瘤坏死因子受体-1（TNFR-1）、血浆新蝶呤和血浆内皮素-1（ET-1）以及肺炎衣原体的IgG和IgA抗体进行了分析。21名受试者在基线时有心血管疾病的临床表现，另外21名在随访期间被诊断为心血管疾病。

结果

在年龄校正的逻辑回归分析中，患有心血管疾病的受试者血浆新蝶呤水平较高（p = 0.02）、NGAL水平较高（p = 0.04）以及ET-1水平较高（p < 0.01）。如果将基线时患有心血管疾病的受试者排除在分析之外，较高的血浆新蝶呤水平（p = 0.01）和较低的血清高密度脂蛋白胆固醇水平（p = 0.03）可预测随访期间的心血管疾病。抗肺炎衣原体IgG或IgA的存在与心血管疾病无关。炎症或内皮参数与肺炎衣原体血清学之间也没有任何关联。