Jenny N S, Blumenthal R S, Kronmal R A, Rotter J I, Siscovick D S, Psaty B M
Department of Pathology, University of Vermont College of Medicine, Burlington, VT, USA.
J Thromb Haemost. 2014 Jun;12(6):999-1005. doi: 10.1111/jth.12557.
Pentraxin 3 (PTX3) is probably a specific marker of vascular inflammation. However, associations of PTX3 with cardiovascular disease (CVD) risk have not been well studied in healthy adults or multi-ethnic populations. We examined associations of PTX3 with CVD risk factors, measures of subclinical CVD, coronary artery calcification (CAC) and CVD events in the Multi-Ethnic Study of Atherosclerosis.
Two thousand eight hundred and thirty-eight participants free of prevalent CVD with measurements of PTX3 were included in the present study. After adjustment for age, sex, and ethnicity, PTX3 was positively associated with age, obesity, insulin, systolic blood pressure, C-reactive protein (CRP), and carotid intima-media thickness (all P < 0.045). A one standard deviation increase in PTX3 level (1.62 ng mL(-1) ) was associated with the presence of CAC in fully adjusted models including multiple CVD risk factors (relative risk of 1.05; 95% confidence interval [CI] 1.01-1.08). In fully adjusted models, a standard deviation higher level of PTX3 was associated with an increased risk of myocardial infarction (hazard ratio [HR] 1.51; 95% [CI] 1.16-1.97), combined CVD events (HR 1.23; 95% [CI] 1.05-1.45), and combined CHD events (HR 1.33; 95% [CI] 1.10-1.60), but not stroke, CVD-related mortality, or all-cause death.
In these apparently healthy adults, PTX3 was associated with CVD risk factors, subclinical CVD, CAC and incident coronary heart disease events independently of CRP and CVD risk factors. These results support the hypothesis that PTX3 reflects different aspects of inflammation than CRP, and may provide additional insights into the development and progression of atherosclerosis.
五聚体3(PTX3)可能是血管炎症的一种特异性标志物。然而,在健康成年人或多民族人群中,PTX3与心血管疾病(CVD)风险之间的关联尚未得到充分研究。我们在动脉粥样硬化多民族研究中考察了PTX3与CVD危险因素、亚临床CVD指标、冠状动脉钙化(CAC)及CVD事件之间的关联。
本研究纳入了2838名无CVD病史且检测了PTX3的参与者。在对年龄、性别和种族进行校正后,PTX3与年龄、肥胖、胰岛素、收缩压、C反应蛋白(CRP)及颈动脉内膜中层厚度均呈正相关(所有P<0.045)。在包含多个CVD危险因素的完全校正模型中,PTX3水平升高一个标准差(1.62 ng/mL)与CAC的存在相关(相对风险为1.05;95%置信区间[CI]为1.01-1.08)。在完全校正模型中,PTX3水平高于标准差与心肌梗死风险增加(风险比[HR]为1.51;95%[CI]为1.16-1.97)、合并CVD事件(HR为1.23;95%[CI]为1.05-1.45)及合并冠心病事件(HR为1.33;95%[CI]为1.10-1.60)相关,但与中风、CVD相关死亡率或全因死亡无关。
在这些看似健康的成年人中,PTX3与CVD危险因素、亚临床CVD、CAC及冠心病事件独立相关,与CRP和CVD危险因素无关。这些结果支持了以下假设:PTX3反映的炎症方面与CRP不同,可能为动脉粥样硬化的发生和发展提供更多见解。