Verma Subodh, Wang Chao-Hung, Li Shu-Hong, Lonn Eva, Charbonneau Francois, Title Lawrence M, Anderson Todd J
Division of Cardiac Surgery, Toronto General Hospital, 14 EN-215, 200 Elizabeth Street, Toronto, Ont., Canada M5G 2C4.
Atherosclerosis. 2005 Oct;182(2):361-5. doi: 10.1016/j.atherosclerosis.2005.02.019. Epub 2005 Mar 23.
Elevated soluble CD40 ligand (sCD40L) levels are associated with an increased risk of cardiovascular events in patients with acute coronary syndromes and in middle-aged healthy women. However, the relationship between sCD40L and global risk assessment remains unclear. The present study was designed to examine the relationship between sCD40L and Framingham Coronary Heart Disease Risk Scores (FCRS) in healthy middle-aged men. The study population consisted of 400 active and retired male firefighters, with no previous history of cardiovascular disease, as part of the Firefighters and Their Endothelium (FATE) study. FCRS correlated poorly with sCD40L levels (p=0.14). Soluble CD40L concentrations correlated only with total (r=0.105; p=0.035) and LDL cholesterol (r=0.104; p=0.039), and CRP levels (r=0.11; p=0.03). Compared with participants with sCD40L levels <4.36 ng/mL (75th percentile), participants with sCD40L levels >4.36 ng/mL had higher total (p=0.016) and LDL cholesterol (p=0.018), CRP levels (p=0.034) and FCRS (p=0.012). Multivariate analysis revealed that CRP level was the only parameter that independently correlated with the sCD40L levels (p=0.032). This is the first study to evaluate the relationship between sCD40L levels and Framingham global risk assessment in a large cohort of otherwise healthy individuals. We demonstrate that sCD40L levels poorly correlate with both the individual components and the calculated FCRS. Long-term follow-up of the FATE study will shed light on whether the predictive value of sCD40L is independent of Framingham based global risk assessment.
可溶性CD40配体(sCD40L)水平升高与急性冠脉综合征患者及中年健康女性发生心血管事件的风险增加相关。然而,sCD40L与整体风险评估之间的关系仍不明确。本研究旨在探讨健康中年男性中sCD40L与弗雷明汉冠心病风险评分(FCRS)之间的关系。作为消防员及其内皮(FATE)研究的一部分,研究人群包括400名在职和退休男性消防员,他们既往无心血管疾病史。FCRS与sCD40L水平的相关性较差(p = 0.14)。可溶性CD40L浓度仅与总胆固醇(r = 0.105;p = 0.035)、低密度脂蛋白胆固醇(r = 0.104;p = 0.039)及CRP水平(r = 0.11;p = 0.03)相关。与sCD40L水平<4.36 ng/mL(第75百分位数)的参与者相比,sCD40L水平>4.36 ng/mL的参与者总胆固醇(p = 0.016)、低密度脂蛋白胆固醇(p = 0.018)、CRP水平(p = 0.034)及FCRS(p = 0.012)更高。多变量分析显示,CRP水平是唯一与sCD40L水平独立相关的参数(p = 0.032)。这是第一项评估大量健康个体队列中sCD40L水平与弗雷明汉整体风险评估之间关系的研究。我们证明,sCD40L水平与各个组成部分及计算出的FCRS的相关性均较差。FATE研究的长期随访将阐明sCD40L的预测价值是否独立于基于弗雷明汉的整体风险评估。