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英国生物库研究中动脉僵硬度与慢性炎症性疾病的关系。

Arterial stiffness association with chronic inflammatory disorders in the UK Biobank study.

机构信息

School of Population Health Sciences, King's College London, London, UK.

NIHR, Biomedical Research Centre at Guy's and St Thomas NHS Foundation Trust, London, UK.

出版信息

Heart. 2018 Aug;104(15):1257-1262. doi: 10.1136/heartjnl-2017-312610. Epub 2018 Jan 4.

Abstract

OBJECTIVE

The present study tested the hypothesis that arterial stiffness will be elevated across overall and specific inflammatory disorders compared with an inflammation-free comparison group.

METHODS

Adults (n=171 125) aged 40-70 years from the UK Biobank who were cardiovascular disease (CVD) free and who had their arterial stiffness assessed at the time of study recruitment between 2006 and 2010 were included. The main exposure was represented by a global measure of chronic inflammatory disorders. Two inflammatory biomarker measures (eg, leucocytes count, granulocytes count) were included as markers of inflammation severity. The arterial stiffness index assessed by a non-invasive technique represented the study primary outcome measure.

RESULTS

A total of 5976 (3%) participants diagnosed with inflammatory disorders and 165 149 participants without an inflammatory disorder had data on arterial stiffness. Adjusted linear regression analyses revealed a 14% increment in mean arterial stiffness for chronic inflammatory disorders (beta coefficient (β) 1.14, 95% CI 1.05 to 1.24, P=0.002) compared with no chronic inflammatory disorder. Arterial stiffness tended to increase (P value=0.031) with tertiles of leucocytes and granulocytes count. For instance, mean arterial stiffness values increased from 1.11 (95% CI 0.96 to 1.29) in the first tertile to 1.17 (95% CI 1.02 to 1.34) in the second tertile, and 1.21 (95% CI 1.05 to 1.39) in the third tertile of leucocytes count. There was evidence for similar associations with some of the most common individual inflammatory disorders, including psoriasis and rheumatoid arthritis.

CONCLUSION

Arterial stiffness was associated with multiple chronic inflammatory disorders. An increasing trend in mean arterial stiffness was also documented with increasing tertiles of different inflammatory biomarkers. Future studies are needed to investigate the discriminant value of arterial stiffness to predict major CVD events within various inflammatory disorders.

摘要

目的

本研究旨在验证这样一个假设,即与无炎症对照组相比,动脉僵硬程度将在整体和特定炎症性疾病中升高。

方法

本研究纳入了年龄在 40-70 岁之间、无心血管疾病(CVD)且在 2006 年至 2010 年研究招募期间接受动脉僵硬评估的英国生物库(UK Biobank)成年人(n=171125)。主要暴露因素是慢性炎症性疾病的综合衡量指标。还包括两种炎症生物标志物(例如白细胞计数、粒细胞计数)作为炎症严重程度的标志物。通过非侵入性技术评估的动脉僵硬指数是研究的主要结果测量指标。

结果

共有 5976 名(3%)被诊断为炎症性疾病的参与者和 165149 名无炎症性疾病的参与者有动脉僵硬数据。经过调整的线性回归分析显示,与无慢性炎症性疾病相比,慢性炎症性疾病的平均动脉僵硬增加了 14%(β系数(β)1.14,95%CI 1.05-1.24,P=0.002)。白细胞和粒细胞计数的三分位数与动脉僵硬的增加趋势呈正相关(P 值=0.031)。例如,平均动脉僵硬值从白细胞计数的第一个三分位数的 1.11(95%CI 0.96-1.29)增加到第二个三分位数的 1.17(95%CI 1.02-1.34),再增加到第三个三分位数的 1.21(95%CI 1.05-1.39)。在包括银屑病和类风湿关节炎在内的一些最常见的个体炎症性疾病中也存在类似的关联。

结论

动脉僵硬与多种慢性炎症性疾病相关。随着不同炎症标志物三分位数的增加,平均动脉僵硬也呈现出增加的趋势。未来的研究需要调查动脉僵硬预测各种炎症性疾病中主要心血管事件的区分价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d7d/6204972/7a8215e50457/heartjnl-2017-312610f01.jpg

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