Division of Cardiovascular Disease Morehouse School of Medicine Atlanta GA.
Cardiovascular Health Research Unit University of Washington Seattle WA.
J Am Heart Assoc. 2020 Apr 7;9(7):e014070. doi: 10.1161/JAHA.119.014070. Epub 2020 Apr 6.
Background FABP-4 (fatty acid binding protein-4) is a lipid chaperone in adipocytes and has been associated with prognosis in selected clinical populations. We investigated the associations between circulating FABP-4, risk of incident cardiovascular disease (CVD), and risk of CVD mortality among older adults with and without established CVD. Methods and Results In the Cardiovascular Health Study, we measured FABP4 levels in stored specimens from the 1992-993 visit and followed participants for incident CVD if they were free of prevalent CVD at baseline and for CVD mortality through June 2015. We used Cox regression to estimate hazard ratios for incident CVD and CVD mortality per doubling in serum FABP-4 adjusted for age, sex, race, field center, waist circumference, blood pressure, lipids, fasting glucose, and C-reactive protein. Among 4026 participants free of CVD and 681 with prevalent CVD, we documented 1878 cases of incident CVD and 331 CVD deaths, respectively. In adjusted analyses, FABP-4 was modestly associated with risk of incident CVD (mean, 34.24; SD, 18.90; HR, 1.10 per doubling in FABP-4, 95% CI, 1.00-1.21). In contrast, FABP-4 was more clearly associated with risk of CVD mortality among participants without (HR hazard ratio 1.24, 95% CI, 1.10-1.40) or with prevalent CVD (HR hazard ratio 1.57, 95% CI, 1.24-1.98). These associations were not significantly modified by sex, age, and waist circumference. Conclusions Serum FABP-4 is modestly associated with risk of incident CVD even after adjustment for standard risk factors, but more strongly associated with CVD mortality among older adults with and without established CVD.
脂肪酸结合蛋白-4（FABP-4）是脂肪细胞中的一种脂质伴侣，与某些临床人群的预后相关。我们研究了循环 FABP-4 与老年人中无或有已确诊心血管疾病（CVD）人群的 CVD 发病风险以及 CVD 死亡率之间的关联。
在心血管健康研究中，我们在 1992-1993 年就诊时测量了 FABP4 水平，并在基线时无 CVD 的参与者中观察到 CVD 发病事件，或在有 CVD 病史的参与者中观察到 CVD 死亡事件，随访至 2015 年 6 月。我们使用 Cox 回归估计血清 FABP-4 每增加一倍的 CVD 发病和 CVD 死亡率的风险比，通过年龄、性别、种族、研究中心、腰围、血压、血脂、空腹血糖和 C 反应蛋白进行调整。在 4026 名无 CVD 的参与者和 681 名有 CVD 病史的参与者中，我们分别记录了 1878 例 CVD 发病事件和 331 例 CVD 死亡事件。在调整分析中，FABP-4 与 CVD 发病风险有适度关联（平均 34.24；SD，18.90；HR，FABP-4 每增加一倍的风险比为 1.10，95%CI，1.00-1.21）。相比之下，FABP-4 与无 CVD 或有 CVD 病史的参与者的 CVD 死亡率更密切相关（无 CVD 参与者的 HR 为 1.24，95%CI，1.10-1.40；有 CVD 病史的参与者的 HR 为 1.57，95%CI，1.24-1.98）。这些关联在性别、年龄和腰围方面没有明显改变。
即使在调整了标准风险因素后，血清 FABP-4 与 CVD 发病风险也仅有适度关联，但与有或无已确诊 CVD 的老年人的 CVD 死亡率更密切相关。
