高密度脂蛋白胆固醇水平降低是普通人群中循环肿瘤坏死因子-α的独立相关因素。
Decreased high-density lipoprotein cholesterol level is an independent correlate of circulating tumor necrosis factor-alpha in a general population.
作者信息
Yamagishi Sho-ichi, Adachi Hisashi, Matsui Takanori, Nakamura Kazuo, Enomoto Mika, Fukami Ako, Otsuka Maki, Kumagae Shun-ichi, Nanjo Yasuki, Imaizumi Tsutomu
机构信息
Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan.
出版信息
Clin Cardiol. 2009 Sep;32(9):E29-32. doi: 10.1002/clc.20517.
BACKGROUND
Recent studies implicate a pathophysiological role of tumor necrosis factor-alpha (TNF-alpha) in atherosclerosis, thus suggesting that serum TNF-alpha levels may be one of the biomarkers for future cardiovascular events. However, which anthropometric, metabolic, and inflammatory variables could regulate circulating TNF-alpha levels in humans is not fully understood. In this study, we examined the independent determinants of serum TNF-alpha levels in a Japanese general population.
HYPOTHESIS
Anthropometric, metabolic , and inflammatory variables could regulate TNF-alpha.
METHODS
A total of 213 Japanese subjects underwent a complete history, physical examination, and determination of blood chemistries, including TNF-alpha levels. Univariate and multivariate analyses were applied for the determinants of TNF-alpha levels.
RESULTS
The average TNF-alpha levels were 13.4 +/- 0.81 pg/ml in males and 13.9 +/- 4.5 pg/ml in females, respectively. Univariate analysis showed that TNF-alpha levels were associated with age (P = 0.007), body mass index (P = 0.034), waist circumference (<0.001), high-density lipoprotein cholesterol (HDL-C; inversely, P < 0.001), triglycerides (P < 0.001), creatinine (P < 0.001), uric acids (P < 0.001), insulin (P = 0.008), homeostasis model assessment of insulin resistance (HOMA-IR; P = 0.015), high sensitivity C-reactive protein (hs-CRP; P < 0.001), and fibrinogen (P = 0.009). By the use of multiple stepwise regression analyses, HDL-C (inversely, P < 0.001) and hs-CRP (P < 0.001) remained significant and were independently related to TNF-alpha levels (R2 = 0.153).
CONCLUSIONS
The present study is the first demonstration that besides hs-CRP, a decreased HDL-C level is an independent determinant of circulating TNF-alpha in the Japanese general population. Elevation of TNF-alpha may partly explain the increased risk of cardiovascular events in patients with low HDL-C levels.
背景
近期研究表明肿瘤坏死因子-α（TNF-α）在动脉粥样硬化的病理生理过程中发挥作用，这提示血清TNF-α水平可能是未来心血管事件的生物标志物之一。然而，哪些人体测量学、代谢及炎症变量能够调节人体循环TNF-α水平，目前尚未完全明确。在本研究中，我们对日本普通人群血清TNF-α水平的独立决定因素进行了研究。
假设
人体测量学、代谢及炎症变量能够调节TNF-α。
方法
共有213名日本受试者接受了全面的病史采集、体格检查及血液生化指标检测，包括TNF-α水平。对TNF-α水平的决定因素进行单因素和多因素分析。
结果
男性的平均TNF-α水平为13.4±0.81 pg/ml，女性为13.9±4.5 pg/ml。单因素分析显示，TNF-α水平与年龄（P = 0.007）、体重指数（P = 0.034）、腰围（<0.001）、高密度脂蛋白胆固醇（HDL-C；呈负相关，P < 0.001）、甘油三酯（P < 0.001）、肌酐（P < 0.001）、尿酸（P < 0.001）、胰岛素（P = 0.008）、胰岛素抵抗稳态模型评估（HOMA-IR；P = 0.015）、高敏C反应蛋白（hs-CRP；P < 0.001）及纤维蛋白原（P = 0.009）相关。通过多步骤逐步回归分析，HDL-C（呈负相关，P < 0.001）和hs-CRP（P < 0.001）仍然具有显著性，且与TNF-α水平独立相关（R2 = 0.153）。
结论
本研究首次证明，除hs-CRP外，HDL-C水平降低是日本普通人群循环TNF-α的独立决定因素。TNF-α升高可能部分解释了HDL-C水平低的患者心血管事件风险增加的原因。
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