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β-地中海贫血携带者状态对初诊高血压患者炎症状态的影响。

Impact of β-thalassemia trait carrier state on inflammatory status in patients with newly diagnosed hypertension.

机构信息

Department of Cardiology, Evangelismos General Hospital, Athens, Greece.

Department of Cardiology, Athens University Hospital Attikon, Athens, Greece.

出版信息

J Cardiovasc Med (Hagerstown). 2019 May;20(5):284-289. doi: 10.2459/JCM.0000000000000787.

Abstract

BACKGROUND

B-thalassemia carrier state or thalassemia minor confers cardiovascular protection through favorable lipidemic and blood pressure profile. However, its impact on inflammatory status-a common denominator of the above conditions-has not been addressed.

METHODS

We investigated a wide range of inflammatory markers [white blood cell (WBC) count, homocysteine, C-reactive protein (CRP), serum amyloid A (SAA), fibrinogen, plasminogen, fibronectin, plasminogen activator inhibitor-1 (PAI-1), and uric acid] in a large cohort of 15 805 newly diagnosed hypertensive patients (8299 men, 7506 women); 626 of them (4.0%) had thalassemia minor.

RESULTS

The levels of WBC, homocysteine, CRP, SAA, fibrinogen, and PAI-1 were significantly lower in thalassemia minor patients, but not of plasminogen, fibronectin, and uric acid. In multivariate linear regression analyses, the lower values of WBC (<0.001), CRP (<0.001), homocysteine (<0.001), fibrinogen (<0.001), and PAI-1 (0.008), but not of SAA, were independently associated with thalassemia minor. The interaction between thalassemia minor and body mass index had a significant impact only on WBC and CRP (P for the interaction 0.010 and 0.005, respectively), whereas the interaction between thalassemia minor and sex had a significant impact only on fibrinogen (P for the interaction 0.007).

CONCLUSION

Thalassemia minor is followed by a favorable inflammatory profile that may contribute to the overall better cardiovascular health of the carriers.

摘要

背景

β-地中海贫血携带者或轻度地中海贫血通过有利的血脂和血压特征提供心血管保护。然而,其对炎症状态的影响(上述情况的共同特征)尚未得到解决。

方法

我们在一个由 15805 名新诊断为高血压的患者(8299 名男性,7506 名女性)组成的大队列中研究了广泛的炎症标志物[白细胞计数、同型半胱氨酸、C 反应蛋白(CRP)、血清淀粉样蛋白 A(SAA)、纤维蛋白原、纤溶酶原、纤维连接蛋白、纤溶酶原激活物抑制剂-1(PAI-1)和尿酸];其中 626 名(4.0%)患者患有轻度地中海贫血。

结果

地中海贫血患者的白细胞计数(WBC)、同型半胱氨酸、CRP、SAA、纤维蛋白原和 PAI-1 水平显著降低,但纤溶酶原、纤维连接蛋白和尿酸水平没有降低。在多元线性回归分析中,较低的 WBC(<0.001)、CRP(<0.001)、同型半胱氨酸(<0.001)、纤维蛋白原(<0.001)和 PAI-1(0.008)值与轻度地中海贫血独立相关,但 SAA 除外。地中海贫血与体重指数之间的相互作用仅对 WBC 和 CRP 有显著影响(P 交互作用分别为 0.010 和 0.005),而地中海贫血与性别之间的相互作用仅对纤维蛋白原有显著影响(P 交互作用为 0.007)。

结论

轻度地中海贫血患者表现出有利的炎症特征,这可能有助于携带者整体更好的心血管健康。

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