脂联素和高敏C反应蛋白在预测伊朗队列研究中心血管事件中的预测作用：伊斯法罕队列研究
Predictive role of adiponectin and high-sensitivity C-reactive protein for prediction of cardiovascular event in an Iranian cohort Study: The Isfahan Cohort Study.
作者信息
Kazemi-Saleh Davoud, Koosha Pooya, Sadeghi Masoumeh, Sarrafzadegan Nizal, Karbasi-Afshar Reza, Boshtam Mansoureh, Oveis-Gharan Shahram
机构信息
Professor, Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Resident, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
ARYA Atheroscler. 2016 May;12(3):132-137.
BACKGROUND
Numerous studies have been conducted on the predictive effects of high-sensitivity C-reactive protein (hs-CRP) on cardiovascular events. Few studies have been conducted to investigate the effects of adiponectin for the prediction of the incident of cardiovascular events in the Middle East area. This study compared the predictive effect of hs-CRP and adiponectin on healthy volunteers for the prediction of cerebrovascular disease (CVD).
METHODS
This nested case-control in original Isfahan Cohort Study (ICS) was conducted from 2001 to 2011. Participants were selected from ICS. The case group included participants with CVD while the control group included participants without CVD. The level of hs-CRP and adiponectin was measured in the blood samples collected in the year 2007. Thereafter, the statistical analyses were performed to determine the predictive value of hs-CRP and adiponectin in CVD prediction.
RESULTS
The results showed that before the elimination of diabetes effect; there was a significant difference between the two groups, in terms of the mean of adiponectin (P = 0.019) and no significant difference was observed in hs-CRP levels (P = 0.673). However, after eliminating the factor of diabetes, there was no significant difference between the case and control groups in adiponectin and hs-CRP levels (P = 0.184, P = 0.946). The results showed that the odds ratio (OR) of the adiponectin level was 0.879 [95% confidence interval (CI): 0.719-1.075, P = 0.210] while the OR of hs-CRP was 1.045 (95% CI: 0.922-1.185, P = 0.491). Furthermore, it was shown that after adjustment for age, sex, and diabetes; the OR of adiponectine was 0.875 (95% CI: 0.701-1.091, P = 0.235) and that of hs-CRP was 1.068 (95% CI: 0.935-1.219, P = 0.333).
CONCLUSION
The results show that adiponectin and hs-CRP cannot be predictors for cardiovascular events in a healthy population. Risk factors such as diabetes limit the use of adiponectin as a CVD predictor.
背景
关于高敏C反应蛋白（hs-CRP）对心血管事件的预测作用已开展了大量研究。而在中东地区，针对脂联素对心血管事件发生的预测作用的研究较少。本研究比较了hs-CRP和脂联素对健康志愿者脑血管疾病（CVD）的预测效果。
方法
本巢式病例对照研究纳入了2001年至2011年期间的原始伊斯法罕队列研究（ICS）。研究对象从ICS中选取。病例组包括患有CVD的参与者，对照组包括未患CVD的参与者。于2007年采集血液样本，测定其中hs-CRP和脂联素的水平。之后进行统计分析，以确定hs-CRP和脂联素在CVD预测中的价值。
结果
结果显示，在排除糖尿病影响之前；两组在脂联素均值方面存在显著差异（P = 0.019），而hs-CRP水平无显著差异（P = 0.673）。然而，在排除糖尿病因素后，病例组和对照组在脂联素和hs-CRP水平上无显著差异（P = 0.184，P = 0.946）。结果表明，脂联素水平的比值比（OR）为0.879 [95%置信区间（CI）：0.719 - 1.075，P = 0.210]，而hs-CRP的OR为1.045（95% CI：0.922 - 1.185，P = 0.491）。此外，结果表明，在对年龄、性别和糖尿病进行校正后；脂联素的OR为0.875（第九十五% CI：0.701 - 1.091，P = 0.235），hs-CRP的OR为1.068（95% CI：0.935 - 1.219，P = 0.333）。
结论
结果表明，脂联素和hs-CRP不能作为健康人群心血管事件的预测指标。糖尿病等危险因素限制了脂联素作为CVD预测指标的应用。
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