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脂蛋白相关磷脂酶A2质量和活性与年轻成年人冠状动脉钙化斑块的关联:CARDIA研究

Association of lipoprotein-associated phospholipase A2 mass and activity with calcified coronary plaque in young adults: the CARDIA study.

作者信息

Iribarren Carlos, Gross Myron D, Darbinian Jeanne A, Jacobs David R, Sidney Stephen, Loria Catherine M

机构信息

Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA, USA.

出版信息

Arterioscler Thromb Vasc Biol. 2005 Jan;25(1):216-21. doi: 10.1161/01.ATV.0000148322.89911.44. Epub 2004 Oct 21.

Abstract

OBJECTIVE

To examine the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity with calcified coronary plaque in young adults.

METHODS AND RESULTS

Nested case-control study among CARDIA participants at the year 15 examination (2000 to 2001, 33 to 45 years old). Cases (n=266) were those with and controls (n=266) those without evidence of calcified coronary plaque by computed tomography matched 1:1 on sex and race. Lp-PLA2 mass and activity were significantly higher in cases (296+/-101 ng/mL and 36.4+/-12.3 nmol/mL per minute) than in controls (267+/-80 ng/mL and 32.9+/-11.8 nmol/mL per minute). In age-adjusted conditional logistic regression, the odds ratio (OR) of calcified coronary plaque per 1 standard deviation (SD) increment was 1.40 (95% CI, 1.17 to 1.67) and 1.39 (95% CI, 1.14 to 1.70) for Lp-PLA2 mass and activity, respectively. After adjusting for multiple covariates including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and C-reactive protein, a statistically significant association remained for Lp-PLA2 mass (OR, 1.28; 95% CI, 1.03 to 1.60) but not for activity (OR, 1.09; 95% CI, 0.84 to 1.42). No evidence was found for interaction between Lp-PLA2 mass or activity with LDL-C as predictors of calcified coronary plaque.

CONCLUSIONS

An independent association of Lp-PLA2 mass with calcified coronary plaque existed in young adults. Therefore, Lp-PLA2 mass may be a useful marker of subclinical cardiovascular risk.

摘要

目的

研究脂蛋白相关磷脂酶A2(Lp-PLA2)质量和活性与年轻成人冠状动脉钙化斑块的相关性。

方法与结果

对冠心病风险发展研究(CARDIA)参与者在第15年检查时(2000年至2001年,33至45岁)进行巢式病例对照研究。病例组(n = 266)为经计算机断层扫描显示有冠状动脉钙化斑块的患者,对照组(n = 266)为无冠状动脉钙化斑块证据的患者,两组按性别和种族1:1匹配。病例组的Lp-PLA2质量和活性(分别为296±101 ng/mL和36.4±12.3 nmol/mL每分钟)显著高于对照组(267±80 ng/mL和32.9±11.8 nmol/mL每分钟)。在年龄调整的条件逻辑回归中,Lp-PLA2质量和活性每增加1个标准差(SD),冠状动脉钙化斑块的比值比(OR)分别为1.40(95%CI,1.17至1.67)和1.39(95%CI,1.14至1.70)。在调整了包括低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯和C反应蛋白在内的多个协变量后,Lp-PLA2质量仍存在统计学显著相关性(OR,1.28;95%CI,1.03至1.60),而活性则无相关性(OR,1.09;95%CI,0.84至1.42)。未发现Lp-PLA2质量或活性与LDL-C之间存在作为冠状动脉钙化斑块预测指标的相互作用。

结论

年轻成人中Lp-PLA2质量与冠状动脉钙化斑块存在独立相关性。因此,Lp-PLA2质量可能是亚临床心血管风险的有用标志物。

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