Mainous Arch G, Wells Brian J, Everett Charles J, Gill James M, King Dana E
Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Am J Cardiol. 2004 Mar 1;93(5):559-62. doi: 10.1016/j.amjcard.2003.11.018.
C-reactive protein (CRP) and lipids (e.g., low-density lipoprotein [LDL]) are both markers of cardiovascular disease risk, yet they are not highly correlated. Oxidative stress of lipids induced by iron may play a role in vascular inflammation, as indicated by CRP. The purpose of this study was to examine, in a representative sample of United States adults, the relation between ferritin, lipids, and CRP. We analyzed data on adults (aged > or =25 years) in the National Health and Nutrition Examination Survey III, a national public-use data set collected between 1988 and 1994. Ferritin, total cholesterol, LDL, high-density lipoprotein, and ferritin-lipid combinations were analyzed in relation to CRP in age-, gender-, and race-adjusted models as well as models with other potential confounding variables. In adjusted models, neither elevated ferritin (odds ratio [OR] 1.11, 95% confidence interval [CI] 0.94 to 1.32) nor elevated LDL was significantly associated with elevated CRP (OR 1.03, 95% CI 0.79 to 1.33). Patients with elevated ferritin and elevated LDL were more likely to have elevated CRP (OR 1.68; 95% CI 1.06 to 2.68). Patients with elevated ferritin and low high-density lipoprotein were also more likely to have elevated CRP (OR 1.71; 95% CI 1.28 to 2.27). These results suggest that both iron and lipids induce inflammation. Future research needs to focus on preventive medicine to decrease iron in patients with elevated lipids.
C反应蛋白(CRP)和血脂(如低密度脂蛋白[LDL])都是心血管疾病风险的标志物,但它们之间的相关性并不高。铁诱导的脂质氧化应激可能在血管炎症中起作用,正如CRP所表明的那样。本研究的目的是在美国成年人的代表性样本中,研究铁蛋白、血脂和CRP之间的关系。我们分析了第三次全国健康和营养检查调查中成年人(年龄≥25岁)的数据,这是一个在1988年至1994年期间收集的全国性公共数据集。在年龄、性别和种族调整模型以及包含其他潜在混杂变量的模型中,分析了铁蛋白、总胆固醇、低密度脂蛋白、高密度脂蛋白以及铁蛋白 - 脂质组合与CRP的关系。在调整模型中,铁蛋白升高(比值比[OR] 1.11,95%置信区间[CI] 0.94至1.32)和低密度脂蛋白升高均与CRP升高无显著关联(OR 1.03,95% CI 0.79至1.33)。铁蛋白升高且低密度脂蛋白升高的患者更有可能出现CRP升高(OR 1.68;95% CI 1.06至2.68)。铁蛋白升高且高密度脂蛋白降低的患者也更有可能出现CRP升高(OR 1.71;95% CI 1.28至2.27)。这些结果表明铁和血脂都会诱发炎症。未来的研究需要聚焦于预防医学,以降低血脂升高患者体内的铁含量。