College of Pharmacy and Nutrition, University of Saskatchewan, Saskatchewan, SK, Canada.
Clin Transplant. 2013 Jul-Aug;27(4):E391-9. doi: 10.1111/ctr.12159. Epub 2013 Jun 19.
While the Framingham risk score (FRS) predicts cardiovascular risk in the general population, it underestimates cardiovascular events in renal transplant recipients (RTR). Inflammation is common in RTR, and it is also a hallmark of vascular injury contributing to cardiovascular events.
To explore the relationship between inflammatory chemokines (CCL family) and FRS in a stable RTR.
The modified FRS (2009) was used to calculate the 10-yr probability of CVE in 150 RTR. A cross-sectional study measured plasma levels of 14 CCLs by Luminex technique in 53% (79/150) of the cohort and 28 controls.
43.3% of RTR was classified as low, 16% moderate, and 40.7% high FRS. FRS correlated with eGFR and all CCLs with R of <0.2(p = n.s). Compared with controls, CCL 1,4,8,15, and 27 were equally increased in both the high and low FRS groups (p < 0.04 and 0.03, respectively). The percentage of patients with low FRS and CCL 8,15, and 27 values above the 95% cutoff control levels was 46.1%, 76.9%, and 53.8%, respectively.
Over one half of stable RTR, including those with low FRS, have increased inflammatory chemokine levels. Inflammation is not accounted for in the FRS, and this may explain the poor performance of FRS in transplant patients.
弗明汉风险评分（FRS）可预测普通人群的心血管风险，但它低估了肾移植受者（RTR）的心血管事件。炎症在 RTR 中很常见，也是导致心血管事件的血管损伤的标志。
探讨稳定的 RTR 中炎症趋化因子（CCL 家族）与 FRS 的关系。
使用改良的 FRS（2009）计算了 150 名 RTR 中 CVE 的 10 年概率。在队列的 53%（79/150）和 28 名对照者中，通过 Luminex 技术测量了血浆中 14 种 CCL 的水平，进行了一项横断面研究。
43.3%的 RTR 被分类为低风险，16%为中度风险，40.7%为高风险。FRS 与 eGFR 相关，所有 CCL 与 R 的相关性均<0.2（p=n.s）。与对照组相比，高 FRS 和低 FRS 组的 CCL 1、4、8、15 和 27 均有同等程度的升高（分别为 p<0.04 和 0.03）。低 FRS 且 CCL 8、15 和 27 值高于对照组 95%截点的患者比例分别为 46.1%、76.9%和 53.8%。
超过一半的稳定的 RTR，包括那些低 FRS 的患者，都有炎症趋化因子水平升高。炎症并未被纳入 FRS 中，这可能解释了 FRS 在移植患者中表现不佳的原因。
