可溶性细胞间黏附分子1与血流介导的血管舒张相互独立地与冠心病的估计风险相关。

Soluble intercellular adhesion molecule 1 and flow-mediated dilatation are related to the estimated risk of coronary heart disease independently from each other.

作者信息

Witte D R, Broekmans W M R, Kardinaal A F M, Klöpping-Ketelaars I A A, van Poppel G, Bots M L, Kluft C, Princen J M G

机构信息

Julius Center for Health Sciences and Primary Care, D.01.335, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

出版信息

Atherosclerosis. 2003 Sep;170(1):147-53. doi: 10.1016/s0021-9150(03)00253-3.

DOI:10.1016/s0021-9150(03)00253-3

PMID:12957693

Abstract

BACKGROUND

Flow mediated dilatation (FMD) of the brachial artery and soluble intercellular adhesion molecule 1 (sICAM-1) are measures of distinct functions of the endothelium, reflecting nitric oxide (NO)-mediated and pro-inflammatory status, respectively. The comparative value of the two measures in relation to cardiovascular risk is unknown.

OBJECTIVE

To study and quantify the relation between these two measures, and their relative value in relation to the risk of coronary heart disease as estimated by the Framingham risk function.

METHODS

We performed a single centre population-based study of 85 men and 81 women, aged 18-73 years. Endothelial function was assessed biochemically by sICAM-1 and functionally by FMD. In addition traditional cardiovascular risk factors, CRP, leukocyte count, homocysteine and fibrinogen were determined. Analyses were performed with multivariate linear regression, adjusted for age, gender, and CRP.

RESULTS

Median sICAM-1 levels were 217.0 microg/l (interquartile range: 174.0-348.5). Mean FMD was 4.5% (S.D.: 3.9). The regression coefficient for the association between sICAM-1 and FMD was -3.3 microg/l (95% CI: -6.0;-0.6) per percentage rise in FMD, after adjustment for age, gender, smoking, oral contraceptives (OC) use, classical risk factors and CRP. After adjustment for CRP and sICAM-1, the estimated risk of coronary heart disease in the next 10 years varied from 1.55% (95%CI: 0.89; 2.70) in the highest quintile of FMD to 3.92% (95% CI: 2.23; 6.92) in the lowest quintile. For sICAM-1, estimated risk, adjusted for FMD and CRP varied from 1.50% (95%CI: 0.85; 2.64) in the lowest quintile of sICAM-1 to 4.15% (95%CI: 2.35; 7.34) in the highest quintile. P-values for trends were 0.02 and 0.01 for quintiles of FMD and quintiles of sICAM-1, respectively.

CONCLUSION

These findings indicate that sICAM-1 and FMD are related in healthy individuals, independently of cardiovascular risk factors and CRP, and that they are both related to the estimated risk of coronary heart disease, independently of each other.

摘要

背景

肱动脉血流介导的血管舒张功能（FMD）和可溶性细胞间黏附分子-1（sICAM-1）是内皮细胞不同功能的指标，分别反映一氧化氮（NO）介导的状态和促炎状态。这两种指标在心血管风险方面的比较价值尚不清楚。

目的

研究并量化这两种指标之间的关系，以及它们相对于通过弗雷明汉风险函数估计的冠心病风险的相对价值。

方法

我们对85名男性和81名年龄在18至73岁之间的女性进行了一项基于单中心人群的研究。通过sICAM-1进行生化评估内皮功能，通过FMD进行功能评估。此外，还测定了传统心血管危险因素、CRP、白细胞计数、同型半胱氨酸和纤维蛋白原。采用多变量线性回归分析，并对年龄、性别和CRP进行了校正。

结果

sICAM-1水平中位数为217.0μg/L（四分位间距：174.0 - 348.5）。平均FMD为4.5%（标准差：3.9）。在对年龄、性别、吸烟、口服避孕药（OC）使用、经典危险因素和CRP进行校正后，FMD每升高1个百分点，sICAM-1与FMD之间关联的回归系数为-3.3μg/L（95%置信区间：-6.0；-0.6）。在对CRP和sICAM-1进行校正后，未来10年冠心病的估计风险在FMD最高五分位数中为1.55%（95%置信区间：0.89；2.70），在最低五分位数中为3.92%（95%置信区间：2.23；6.92）。对于sICAM-1，在对FMD和CRP进行校正后，估计风险在sICAM-1最低五分位数中为1.50%（95%置信区间：0.85；2.64），在最高五分位数中为4.15%（95%置信区间：2.35；7.34）。FMD五分位数和sICAM-1五分位数趋势的P值分别为0.02和0.01。