Shimizu Yuji, Sato Shimpei, Koyamatsu Jun, Yamanashi Hirotomo, Nagayoshi Mako, Kadota Koichiro, Kawashiri Shin-Ya, Inoue Keita, Nagata Yasuhiro, Maeda Takahiro
Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
Oncotarget. 2017 Sep 1;8(41):69362-69369. doi: 10.18632/oncotarget.20618. eCollection 2017 Sep 19.
Age-related disruption of microvascular endothelium exacerbates hypertension and sarcopenia; and atherosclerosis is a well-known biological response to vascular endothelial injury. Therefore, prevalence of atherosclerosis among hypertensive elderly subjects may partly indicate the presence of an appropriate response to endothelial injury. We conducted a cross-sectional study of 795 elderly hypertensive Japanese subjects aged 60-89 years. Since platelet level is an indicator of vascular repair activity, subjects were stratified by platelet counts. No significant association between handgrip strength and subclinical carotid atherosclerosis (carotid intima-media thickness (CIMT) ≥1.1mm) was observed for subjects with lower platelet counts, while a significant positive association was observed for subjects with higher platelets. Adjusted odds and 95% confidence intervals of subclinical carotid atherosclerosis for 1 standard deviation increments in handgrip strength were 0.86 (0.61, 1.22) for subjects with lower platelets and 1.82 (1.26, 2.64) for subjects with higher platelets. A positive association between handgrip strength and subclinical carotid atherosclerosis exists in hypertensive elderly subjects with higher, but not lower, platelet counts. These results lead us to speculate that subjects with a beneficial influence on prevention of sarcopenia (maintenance of handgrip strength) may possess the capacity of active endothelial repair that causes atherosclerosis.
与年龄相关的微血管内皮破坏会加剧高血压和肌肉减少症；动脉粥样硬化是对血管内皮损伤的一种众所周知的生物学反应。因此，老年高血压患者中动脉粥样硬化的患病率可能部分表明存在对内皮损伤的适当反应。我们对795名年龄在60 - 89岁的日本老年高血压患者进行了一项横断面研究。由于血小板水平是血管修复活动的一个指标，因此根据血小板计数对受试者进行分层。血小板计数较低的受试者，握力与亚临床颈动脉粥样硬化（颈动脉内膜中层厚度（CIMT）≥1.1mm）之间未观察到显著关联，而血小板计数较高的受试者则观察到显著的正相关。握力每增加1个标准差，血小板计数较低的受试者发生亚临床颈动脉粥样硬化的调整比值和95%置信区间为0.86（0.61, 1.22），血小板计数较高的受试者为1.82（1.26, 2.64）。在血小板计数较高而非较低的老年高血压患者中，握力与亚临床颈动脉粥样硬化之间存在正相关。这些结果使我们推测，对预防肌肉减少症（维持握力）有有益影响的受试者可能具有导致动脉粥样硬化的活跃内皮修复能力。
