St-Pierre Annie C, Cantin Bernard, Bergeron Jean, Pirro Matteo, Dagenais Gilles R, Després Jean-Pierre, Lamarche Benoît
Department of Nutrition, Institute on Nutraceuticals and Functional Foods, Laval University, 2440 Hochelaga Blvd., Ste-Foy, Qué., Canada G1K 7P4.
Atherosclerosis. 2005 Oct;182(2):315-21. doi: 10.1016/j.atherosclerosis.2005.02.009.
We tested the hypothesis that elevated plasma interleukin-6 (IL-6), C-reactive protein (CRP) and fibrinogen concentrations are independent risk factors and interact in increasing the long-term risk of ischemic heart disease (IHD) in men. A total of 1982 IHD-free men from the Quebec Cardiovascular Study were followed over a period of 13 years during which 210 first fatal IHD events and non-fatal myocardial infarctions were recorded. Increased CRP levels (4th versus 1st quartile) were not associated with an increased risk of IHD after adjustment for non-lipid risk factors (age, body mass index, systolic blood pressure, diabetes, smoking and medication use at baseline), lipid risk factors (LDL and HDL cholesterol and triglyceride levels) and for IL-6 and fibrinogen (RR=0.70, 95% CI=0.43-1.13). High plasma IL-6 levels (4th versus 1st quartile) were associated with a 70% greater risk of IHD independent of confounding risk factors and of the other 2 inflammatory markers (RR=1.71, 95% CI=1.07-2.75). The relationship between high fibrinogen levels (4th versus 1st quartile) and IHD risk was borderline significant in multivariate analyses (RR=1.53, 95% CI=0.97-2.43). An inflammation score based on plasma IL-6 and fibrinogen levels improved the IHD risk predictive value of a multivariate model of traditional risk factors (p=0.03). Including plasma CRP levels into the inflammatory score provided no additional predictive value. In conclusion, elevated plasma IL-6 concentrations are more strongly related to IHD risk than CRP and fibrinogen. An inflammation score based on high plasma IL-6 and fibrinogen levels used in combination with traditional risk factors may improve our ability to adequately identify high risk individuals.
血浆白细胞介素-6（IL-6）、C反应蛋白（CRP）和纤维蛋白原浓度升高是男性缺血性心脏病（IHD）长期风险增加的独立危险因素，且它们之间存在相互作用。魁北克心血管研究中共有1982名无IHD的男性被随访了13年，在此期间记录了210例首次致命IHD事件和非致命性心肌梗死。在校正非脂质危险因素（年龄、体重指数、收缩压、糖尿病、吸烟及基线时的用药情况）、脂质危险因素（低密度脂蛋白和高密度脂蛋白胆固醇以及甘油三酯水平）以及IL-6和纤维蛋白原后，CRP水平升高（第4四分位数与第1四分位数相比）与IHD风险增加无关（风险比[RR]=0.70，95%置信区间[CI]=0.43 - 1.13）。血浆IL-6水平高（第4四分位数与第1四分位数相比）与IHD风险增加70%相关，且独立于混杂危险因素及其他两种炎症标志物（RR=1.71，95% CI=1.07 - 2.75）。在多变量分析中，纤维蛋白原水平高（第4四分位数与第1四分位数相比）与IHD风险之间的关系接近显著（RR=1.53，95% CI=0.97 - 2.43）。基于血浆IL-6和纤维蛋白原水平的炎症评分提高了传统危险因素多变量模型对IHD风险的预测价值（p=0.03）。将血浆CRP水平纳入炎症评分未提供额外的预测价值。总之，血浆IL-6浓度升高与IHD风险的相关性比CRP和纤维蛋白原更强。基于高血浆IL-6和纤维蛋白原水平的炎症评分与传统危险因素联合使用，可能会提高我们充分识别高危个体的能力。
