Hayfron-Benjamin Charles F, Mosterd Charlotte, Maitland-van der Zee Anke H, van Raalte Daniel H, Amoah Albert G B, Agyemang Charles, van den Born Bert-Jan
Department of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Amsterdam, the Netherlands.
Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
EClinicalMedicine. 2021 Jul 7;38:101012. doi: 10.1016/j.eclinm.2021.101012. eCollection 2021 Aug.
evidence shows important ethnic differences in vascular dysfunction rates; however, the mechanisms driving these differences remain unclear. One potential factor is the ethnic differences in the role of inflammation in vascular injury. We tested the hypothesis that low-grade inflammation is unequally associated with vascular dysfunction in different ethnic groups.
we included 5698 participants (similar-sized Dutch, African Surinamese, South-Asian Surinamese, Ghanaians, Turkish, and Moroccans) of the HELIUS study (the Netherlands) conducted between 2011 and 2015. Logistic regression was used to examine the associations of Z-score inflammatory biomarker concentration (high sensitivity C-reactive protein [hs-CRP], fibrinogen, and d-dimer) with vascular dysfunction (aortic stiffness, coronary artery disease [CAD], and peripheral artery disease [PAD]), with adjustments for age, sex, smoking (pack-years), BMI, hypertension, HbA1c, total cholesterol, and statin use.
in the fully adjusted models, higher Z-score hs-CRP was positively associated with CAD in Dutch [OR 1·63, (95% CI 1·21-2·18)] and PAD in South Asians [1·25(1·03-1·53)], respectively. Higher Z-score fibrinogen was positively associated with CAD in African Surinamese [1·28(1·03-1·59)] while higher Z-score d-dimer was positively associated with PAD in Moroccans [1·39(1·01-1·93)]. Higher Z-score hs-CRP [0·71(0·54-0·94)] and fibrinogen [0·75(0·58-0·97)] concentrations were negatively associated with PAD in African Surinamese.
our study shows that inflammatory biomarkers are unequally associated with vascular dysfunction in different ethnic groups. These observations provide opportunities for future studies aimed at assessing the predictive roles of inflammation on vascular disease in different ethnic groups.
有证据表明血管功能障碍发生率存在重要的种族差异；然而，导致这些差异的机制仍不清楚。一个潜在因素是炎症在血管损伤中的作用存在种族差异。我们检验了这样一个假设，即低度炎症与不同种族群体的血管功能障碍的关联并不相同。
我们纳入了2011年至2015年在荷兰进行的HELIUS研究中的5698名参与者（荷兰人、非洲裔苏里南人、南亚裔苏里南人、加纳人、土耳其人和摩洛哥人，每组人数相近）。采用逻辑回归分析炎症生物标志物浓度Z评分（高敏C反应蛋白[hs-CRP]、纤维蛋白原和D-二聚体）与血管功能障碍（主动脉僵硬度、冠状动脉疾病[CAD]和外周动脉疾病[PAD]）之间的关联，并对年龄、性别、吸烟（包年数）、体重指数、高血压、糖化血红蛋白、总胆固醇和他汀类药物使用情况进行了调整。
在完全调整模型中，较高的hs-CRP Z评分分别与荷兰人的CAD呈正相关[比值比1.63，（95%置信区间1.21-2.18）]和南亚人的PAD呈正相关[1.25（1.03-1.53）]。较高的纤维蛋白原Z评分与非洲裔苏里南人的CAD呈正相关[1.28（1.03-1.59）]，而较高的D-二聚体Z评分与摩洛哥人的PAD呈正相关[1.39（1.01-1.93）]。较高的hs-CRP Z评分[0.71（0.54-0.94）]和纤维蛋白原Z评分[0.75（0.58-0.97）]浓度与非洲裔苏里南人的PAD呈负相关。
我们的研究表明，炎症生物标志物与不同种族群体的血管功能障碍的关联并不相同。这些观察结果为未来旨在评估炎症在不同种族群体血管疾病中的预测作用研究提供了机会。
