Division of Cardiology, Department of Medicine, Bronx Veterans Affairs Medical Center, Bronx, New York; Division of Cardiology, Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York.
Division of Cardiology, Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York.
Am J Cardiol. 2018 Jul 1;122(1):33-38. doi: 10.1016/j.amjcard.2018.03.008. Epub 2018 Mar 28.
The complement system consists of a family of proteins that play a critical role in the innate immune system. Complement activation has been implicated in many chronic inflammatory diseases, including atherosclerosis. However, a number of experimental studies have highlighted a beneficial role of component C1q in early atherosclerosis and in diabetes mellitus (DM). Despite these data, there have been no studies that have specifically examined the utility of plasma complement C1q as a clinical biomarker in patients with known or suspected coronary artery disease. In this study, baseline plasma complement C1q levels were measured in 159 men with DM who were referred for coronary angiography and who were followed up prospectively for the development of all-cause mortality for 10 years. After adjustment for baseline clinical, angiographic, and laboratory parameters, reduced plasma complement C1q levels were an independent predictor of all-cause mortality at 10 years (hazard ratio 0.66, 95% confidence interval 0.52 to 0.84, p = 0.0006). In additional multivariate models that adjusted for a variety of biomarkers with established prognostic efficacy, complement C1q remained an independent predictor of all-cause mortality at 10 years. In conclusion, reduced levels of complement C1q are associated with an increased risk of all-cause mortality at 10 years in patients with DM referred for coronary angiography. Furthermore, this association is independent of a variety of clinical, angiographic, laboratory variables, including biomarkers with established prognostic efficacy in the prediction of adverse cardiovascular outcomes.
补体系统由一组在先天免疫系统中起关键作用的蛋白质组成。补体激活与许多慢性炎症性疾病有关，包括动脉粥样硬化。然而，许多实验研究强调了 C1q 成分在早期动脉粥样硬化和糖尿病（DM）中的有益作用。尽管有这些数据，但尚未有研究专门检查血浆补体 C1q 作为已知或疑似冠心病患者的临床生物标志物的效用。在这项研究中，测量了 159 名患有糖尿病的男性的基线血浆补体 C1q 水平，这些男性因冠状动脉造影而被转介，并前瞻性随访了 10 年的全因死亡率。在调整基线临床、血管造影和实验室参数后，降低的血浆补体 C1q 水平是 10 年全因死亡率的独立预测因素（风险比 0.66，95%置信区间 0.52 至 0.84，p=0.0006）。在进一步调整了具有既定预后效果的各种生物标志物的多变量模型中，补体 C1q 仍然是 10 年全因死亡率的独立预测因素。总之，在接受冠状动脉造影检查的糖尿病患者中，补体 C1q 水平降低与 10 年全因死亡率增加相关。此外，这种相关性独立于多种临床、血管造影、实验室变量，包括具有预测不良心血管结局的既定预后效果的生物标志物。
