Zipursky Rachel T, Press Marcella Calfon, Srikanthan Preethi, Gornbein Jeff, McClelland Robyn, Watson Karol, Horwich Tamara B
David Geffen School of Medicine at UCLA, Los Angeles, California.
UCLA Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Am J Cardiol. 2017 Jun 15;119(12):1963-1971. doi: 10.1016/j.amjcard.2017.03.025. Epub 2017 Mar 29.
The relation between high levels of psychosocial stress and the development of coronary artery disease (CAD) has been increasingly recognized, especially in women. We hypothesized that simple biomarkers of stress, urinary catecholamines/cortisol levels, are associated with more coronary artery calcium (CAC), an indicator of CAD, and that this relation is stronger in women compared with men. Using data from the Multi-Ethnic Study of Atherosclerosis Stress study, we examined the relation between urinary catecholamines/cortisol and CAC. The study cohort (n = 654) was 53% women, and 56.4% of the cohort had detectable CAC. Multivariable regression analyses assessed the relation between urinary catecholamines/cortisol and CAC (odds CAC >0 through logistic and ln CAC through Tobit model). There was an association between increased cortisol and increased CAC and an inverse association between dopamine and CAC. These relations were seen in men and women, with no difference between the genders. In conclusion, higher cortisol and lower dopamine levels are independently associated with higher CAC to a similar degree in men and women. These simple urinary biomarkers contribute to our understanding of the role of stress in the pathogenesis of CAD and may be incorporated into future strategies to prevent and treat CAD.
高水平的心理社会压力与冠状动脉疾病（CAD）的发生之间的关系已日益得到认可，尤其是在女性中。我们假设，压力的简单生物标志物——尿儿茶酚胺/皮质醇水平，与更多的冠状动脉钙化（CAC）相关，冠状动脉钙化是CAD的一个指标，并且这种关系在女性中比在男性中更强。利用动脉粥样硬化应激多族裔研究的数据，我们研究了尿儿茶酚胺/皮质醇与CAC之间的关系。研究队列（n = 654）中53%为女性，56.4%的队列有可检测到的CAC。多变量回归分析评估了尿儿茶酚胺/皮质醇与CAC之间的关系（通过逻辑回归分析CAC >0的比值比，通过托比特模型分析ln CAC）。皮质醇升高与CAC增加之间存在关联，多巴胺与CAC之间存在负相关。这些关系在男性和女性中均可见，且性别之间无差异。总之，较高的皮质醇水平和较低的多巴胺水平在男性和女性中均与较高的CAC独立相关，且程度相似。这些简单的尿液生物标志物有助于我们理解压力在CAD发病机制中的作用，并可能被纳入未来预防和治疗CAD的策略中。
