Boekholdt S Matthijs, Peters Ron J G, Day Nicholas E, Luben Robert, Bingham Sheila A, Wareham Nicholas J, Hack C Erik, Reitsma Pieter H, Khaw Kay-Tee
Department of Cardiology, Academic Medical Center, Amsterdam, The netherlands.
Am J Med. 2004 Sep 15;117(6):390-7. doi: 10.1016/j.amjmed.2004.04.010.
To determine whether plasma levels of macrophage migration inhibitory factor, a proinflammatory cytokine involved in atherogenesis, are predictive of myocardial infarction or death from coronary artery disease.
We performed a prospective case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort. We selected men and women who did not report a history of myocardial infarction or stroke at baseline. Baseline concentrations of macrophage migration inhibitory factor were measured among 777 patients who had a myocardial infarction or died of coronary artery disease during follow-up, and 1554 matched controls who remained free of coronary artery disease.
Baseline macrophage migration inhibitory factor concentrations were higher in cases than controls (median, 107.4 microg/L vs. 90.7 microg/L, P = 0.001). The risk of myocardial infarction or death from coronary artery disease increased with increasing quartiles of macrophage migration inhibitory factor (P for linearity <0.0001). Patients in the highest quartile had the greatest likelihood of myocardial infarction or death due to coronary artery disease (unadjusted odds ratio [OR] = 1.6; 95% confidence interval [CI]: 1.2 to 2.0). After adjustment for traditional risk factors and C-reactive protein level, the odds ratio decreased slightly (OR = 1.3; 95% CI: 1.0 to 1.7). Upon additional adjustment for white cell count, this association was no longer statistically significant.
Prospective data suggest that the relation between macrophage migration inhibitory factor and the risk of myocardial infarction or death due to coronary artery disease in adults without a history of myocardial infarction or stroke is not very strong. However, the data support a regulatory role for macrophage migration inhibitory factor in the process of atherosclerosis.
确定参与动脉粥样硬化形成的促炎细胞因子巨噬细胞移动抑制因子的血浆水平是否可预测心肌梗死或冠状动脉疾病死亡。
我们在欧洲癌症与营养前瞻性调查（EPIC）-诺福克队列中进行了一项前瞻性病例对照研究。我们选择了在基线时未报告有心肌梗死或中风病史的男性和女性。在随访期间发生心肌梗死或死于冠状动脉疾病的777例患者以及1554例未患冠状动脉疾病的匹配对照中测量巨噬细胞移动抑制因子的基线浓度。
病例组的基线巨噬细胞移动抑制因子浓度高于对照组（中位数，107.4μg/L对90.7μg/L，P = 0.001）。随着巨噬细胞移动抑制因子四分位数的增加，心肌梗死或冠状动脉疾病死亡的风险增加（线性P<0.0001）。最高四分位数组的患者因冠状动脉疾病发生心肌梗死或死亡的可能性最大（未调整优势比[OR]=1.6；95%置信区间[CI]：1.2至2.0）。在调整传统危险因素和C反应蛋白水平后，优势比略有下降（OR = 1.3；95%CI：1.0至1.7）。在进一步调整白细胞计数后，这种关联不再具有统计学意义。
前瞻性数据表明，在没有心肌梗死或中风病史的成年人中，巨噬细胞移动抑制因子与心肌梗死或冠状动脉疾病死亡风险之间的关系不是很强。然而，数据支持巨噬细胞移动抑制因子在动脉粥样硬化过程中起调节作用。
