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静息心率与炎症生物标志物(高敏 C 反应蛋白、白细胞介素 6 和纤维蛋白原)之间的关系(来自动脉粥样硬化多民族研究)。

Association between resting heart rate and inflammatory biomarkers (high-sensitivity C-reactive protein, interleukin-6, and fibrinogen) (from the Multi-Ethnic Study of Atherosclerosis).

机构信息

Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland.

Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California.

出版信息

Am J Cardiol. 2014 Feb 15;113(4):644-9. doi: 10.1016/j.amjcard.2013.11.009. Epub 2013 Nov 23.

Abstract

Heart rate (HR) at rest is associated with adverse cardiovascular events; however, the biologic mechanism for the relation is unclear. We hypothesized a strong association between HR at rest and subclinical inflammation, given their common interrelation with the autonomic nervous system. HR at rest was recorded at baseline in the Multi-Ethnic Study of Atherosclerosis, a cohort of 4 racial or ethnic groups without cardiovascular disease at baseline and then divided into quintiles. Subclinical inflammation was measured using high-sensitivity C-reactive protein, interleukin-6, and fibrinogen. We used progressively adjusted regression models with terms for physical activity and atrioventricular nodal blocking agents in the fully adjusted models. We examined inflammatory markers as both continuous and categorical variables using the clinical cut point of ≥3 mg/L for high-sensitivity C-reactive protein and the upper quartiles of fibrinogen (≥389 mg/dl) and interleukin-6 (≥1.89 pg/ml). Participants had a mean age of 62 years (SD 9.7), mean resting heart rate of 63 beats/min (SD 9.6) and were 47% men. Increased HR at rest was significantly associated with higher levels of all 3 inflammatory markers in both continuous (p for trend <0.001) and categorical (p for trend <0.001) models. Results were similar among all 3 inflammatory markers, and there was no significant difference in the association among the 4 racial or ethnic groups. In conclusion, an increased HR at rest was associated with a higher level of inflammation among an ethnically diverse group of subjects without known cardiovascular disease.

摘要

静息心率与不良心血管事件有关;然而,两者之间的关系的生物学机制尚不清楚。鉴于静息心率和亚临床炎症与自主神经系统之间存在共同的相互关系,我们假设静息心率与亚临床炎症之间存在很强的关联。在无心血管疾病的基线状态下,多民族动脉粥样硬化研究(Multi-Ethnic Study of Atherosclerosis)的队列中记录了静息心率,然后将其分为五分位数。使用高敏 C 反应蛋白、白细胞介素-6 和纤维蛋白原来测量亚临床炎症。我们使用逐步调整的回归模型,在完全调整的模型中包含体力活动和房室结阻滞剂的术语。我们使用临床切点(高敏 C 反应蛋白≥3mg/L 和纤维蛋白原≥389mg/dl 和白细胞介素-6≥1.89pg/ml)将炎症标志物作为连续和分类变量进行检验。参与者的平均年龄为 62 岁(标准差 9.7),静息心率的平均值为 63 次/分钟(标准差 9.6),其中 47%为男性。在连续(趋势 p<0.001)和分类(趋势 p<0.001)模型中,静息心率的增加与所有 3 种炎症标志物的水平升高显著相关。在所有 3 种炎症标志物中,结果相似,在 4 个种族或民族群体中,这种关联没有显著差异。结论:在一个没有已知心血管疾病的种族多样化的人群中,静息心率的增加与更高水平的炎症有关。

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