Cardiovascular Research Unit, Department of Internal Medicine, Copenhagen University Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark.
Atherosclerosis. 2011 May;216(1):237-43. doi: 10.1016/j.atherosclerosis.2011.01.049. Epub 2011 Feb 26.
The soluble urokinase plasminogen activator receptor (suPAR) is a plasma marker of low grade inflammation and has been associated with cardiovascular risk. We wanted to investigate whether suPAR was associated with markers of subclinical organ damage.
In a population sample of 2038 individuals, aged 41, 51, 61 and 71 years, without diabetes, prior stroke or myocardial infarction, not receiving any cardiovascular, anti-diabetic or lipid-lowering medications, we measured urine albumin/creatinine ratio (UACR), carotid atherosclerotic plaques and carotid/femoral pulse wave-velocity (PWV) together with traditional cardiovascular risk factors and high sensitivity C-reactive protein (hsCRP).
suPAR was significantly associated with the presence of plaques (P = 0.003) and UACR (P < 0.001), but not PWV (P = 0.17) when adjusting for age, gender, systolic blood pressure, cholesterol, plasma glucose, waist/hip ratio, smoking and hsCRP. However, suPAR explained only a small part of the variation in the markers of subclinical organ damage (R(2) 0.02-0.04). During a median follow-up of 12.7 years (5th-95th percentile 5.1-13.4 years) a total of 174 composite endpoints (CEP) of cardiovascular death, non-fatal myocardial infarction and stroke occurred. suPAR was associated with CEP independent of plaques, PWV, UACR, and hsCRP as well as age, gender, systolic blood pressure, cholesterol, plasma glucose, waist/hip ratio and smoking with a standardized hazard ratio of 1.16 (95% confidence interval 1.04-1.28, P = 0.006).
suPAR was associated with subclinical organ damage, but predicted cardiovascular events independent of subclinical organ damage, traditional risk factors and hsCRP. Further studies must investigate whether suPAR plays an independent role in the pathogenesis of cardiovascular disease.
可溶性尿激酶型纤溶酶原激活物受体（suPAR）是一种低水平炎症的血浆标志物，与心血管风险相关。我们旨在研究 suPAR 是否与亚临床器官损伤标志物相关。
在一个无糖尿病、无中风或心肌梗死病史、未服用任何心血管、抗糖尿病或降脂药物的 2038 名年龄为 41、51、61 和 71 岁的人群样本中，我们测量了尿白蛋白/肌酐比值（UACR）、颈动脉粥样硬化斑块以及颈动脉/股动脉脉搏波速度（PWV），同时还测量了传统心血管危险因素和高敏 C 反应蛋白（hsCRP）。
调整年龄、性别、收缩压、胆固醇、血浆葡萄糖、腰围/臀围比、吸烟和 hsCRP 后，suPAR 与斑块（P = 0.003）和 UACR（P < 0.001）的存在显著相关，但与 PWV 无关（P = 0.17）。然而，suPAR 仅能解释亚临床器官损伤标志物变异的一小部分（R² 0.02-0.04）。在中位随访 12.7 年（第 5 百分位数至第 95 百分位数为 5.1-13.4 年）期间，共发生了 174 例心血管死亡、非致死性心肌梗死和中风的复合终点事件（CEP）。suPAR 与 CEP 相关，独立于斑块、PWV、UACR 和 hsCRP 以及年龄、性别、收缩压、胆固醇、血浆葡萄糖、腰围/臀围比和吸烟相关，标准化风险比为 1.16（95%置信区间 1.04-1.28，P = 0.006）。
suPAR 与亚临床器官损伤相关，但与亚临床器官损伤、传统危险因素和 hsCRP 无关，可预测心血管事件。进一步的研究必须探讨 suPAR 是否在心血管疾病的发病机制中发挥独立作用。
