绝经后女性亚临床颈动脉粥样硬化的临床及炎症标志物评估

Evaluation of clinical and inflammatory markers of subclinical carotid atherosclerosis in postmenopausal women.

作者信息

Nahas Eliana Aguiar Petri, Nahas-Neto Jorge, Orsatti Claudio Lera, Sobreira Marcone Lima, Tardivo Ana Paula, Witkin Steven Sol

机构信息

From the Departments of 1Gynecology and Obstetrics and 2Surgery, Botucatu Medical School, Sao Paulo State University, São Paulo, Brazil; and 3Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY.

出版信息

Menopause. 2014 Sep;21(9):982-9. doi: 10.1097/GME.0000000000000199.

DOI:10.1097/GME.0000000000000199

PMID:24518151

Abstract

OBJECTIVE

This study aims to evaluate clinical and inflammatory markers of subclinical carotid atherosclerosis (ATS) in asymptomatic postmenopausal women.

METHODS

This cross-sectional study included 268 Brazilian women (aged ≥45 y and amenorrhea ≥12 mo). Subclinical ATS was defined as increased carotid intima-media thickness (>1.0 mm) and/or the presence of plaques evaluated by carotid duplex ultrasound. Inflammatory markers included C-reactive protein (CRP), as well as heat shock protein (HSP) 60 and HSP70 and their antibodies. Pearson's correlation and stepwise logistic regression were used for statistical analysis.

RESULTS

Among the women studied, 45.9% (123 of 268) had a diagnosis of ATS, and 54.1% (145 of 268) had normal carotid ultrasound scans (controls). Women with ATS were older (56.6 vs 52.5 y), and their time since menopause was longer (6.0 vs 4.0 y). In addition, higher prevalences of metabolic syndrome (39.0% vs 25.5%), hypertension (52.0% vs 30.3%), and diabetes (11.4% vs 4.8%), and elevated circulating levels of CRP and HSP60, were observed in women with ATS compared with controls (P < 0.05). Intima-media thickness was positively correlated with anti-HSP70 antibodies (r = 0.110, P = 0.049) and CRP (r = 0.167, P = 0.009). ATS risk increased with age at menopause (odds ratio [OR], 1.18; 95% CI, 1.10-1.26), time since menopause (OR, 1.12; 95% CI, 1.02-1.14), and glucose of 100 mg/dL or higher (OR, 2.17; 95% CI, 1.12-4.20). Serum HSP70 levels (OR, 0.71; 95% CI, 0.47-0.98) were associated with a lower ATS risk (P < 0.05).

CONCLUSIONS

In postmenopausal women, age, menopause status, and hyperglycemia are associated with a higher prevalence of ATS, whereas elevated serum HSP70 is associated with a lower prevalence of ATS.

摘要

目的

本研究旨在评估无症状绝经后女性亚临床颈动脉粥样硬化（ATS）的临床和炎症标志物。

方法

这项横断面研究纳入了268名巴西女性（年龄≥45岁且闭经≥12个月）。亚临床ATS定义为颈动脉内膜中层厚度增加（>1.0 mm）和/或通过颈动脉双功超声评估存在斑块。炎症标志物包括C反应蛋白（CRP）、热休克蛋白（HSP）60和HSP70及其抗体。采用Pearson相关性分析和逐步逻辑回归进行统计分析。

结果

在研究的女性中，45.9%（268名中的123名）被诊断为ATS，54.1%（268名中的145名）颈动脉超声扫描正常（对照组）。患有ATS的女性年龄更大（56.6岁对52.5岁），绝经后的时间更长（6.0年对4.0年）。此外，与对照组相比，患有ATS的女性代谢综合征（39.0%对25.5%）、高血压（52.0%对30.3%）和糖尿病（11.4%对4.8%）的患病率更高，且循环中的CRP和HSP60水平升高（P<0.05）。内膜中层厚度与抗HSP70抗体（r=0.110，P=0.049）和CRP（r=0.167，P=0.009）呈正相关。ATS风险随着绝经年龄（比值比[OR]，1.18；95%置信区间，1.10 - 1.26）、绝经后的时间（OR，1.12；95%置信区间，1.02 - 1.14）以及血糖为100 mg/dL或更高（OR，2.17；95%置信区间，1.12 - 4.20）而增加。血清HSP70水平（OR，0.71；95%置信区间，0.47 - 0.98）与较低的ATS风险相关（P<0.05）。