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高敏C反应蛋白增加男性血脂异常患者颈动脉斑块不稳定的风险。

High Sensitivity C-Reactive Protein Increases the Risk of Carotid Plaque Instability in Male Dyslipidemic Patients.

作者信息

Scimeca Manuel, Montanaro Manuela, Cardellini Marina, Bonfiglio Rita, Anemona Lucia, Urbano Nicoletta, Bonanno Elena, Menghini Rossella, Casagrande Viviana, Martelli Eugenio, Servadei Francesca, Giacobbi Erica, Ippoliti Arnaldo, Bei Roberto, Manzari Vittorio, Federici Massimo, Schillaci Orazio, Mauriello Alessandro

机构信息

Department of Experimental Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.

San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy.

出版信息

Diagnostics (Basel). 2021 Nov 15;11(11):2117. doi: 10.3390/diagnostics11112117.

Abstract

BACKGROUND

The aim of this study was to evaluate how the high sensitivity C-reactive protein (hs-CRP) values influence the risk of carotid plaque instability in association with other cardiovascular risk factors.

METHODS

One hundred and fifty-six carotid plaques from both symptomatic and asymptomatic patients requiring surgical carotid endarterectomy were retrospectively collected. According to the modified American Heart Association, atherosclerosis plaques have been histologically distinguished into unstable and stable. The following anamnestic and hematochemical data were also considered: age, gender, hypertension, diabetes mellitus, smoking habit, therapy, low-density lipoprotein (LDL)-C, kidney failure and hs-CRP.

RESULTS

The results of our study clearly show that high levels of hs-CRP significantly increase the carotid plaque instability in dyslipidemic patients. Specifically, a 67% increase of the risk of carotid plaque instability was observed in patients with high LDL-C. Therefore, the highest risk was observed in male dyslipidemic patients 2333 (95% CI 0.73-7.48) and in aged female patients 2713 (95% CI 0.14-53.27).

DISCUSSION

These data strongly suggest a biological relationship between the hs-CRP values and the alteration of lipidic metabolism mostly in male patients affected by carotid atherosclerosis. The measurement of hs-CRP might be useful as a potential screening tool in the prevention of atheroscletotic disease.

摘要

背景

本研究旨在评估高敏C反应蛋白(hs-CRP)值与其他心血管危险因素相关时如何影响颈动脉斑块不稳定性风险。

方法

回顾性收集了156例有症状和无症状患者的颈动脉斑块,这些患者均需接受颈动脉内膜切除术。根据改良的美国心脏协会标准,动脉粥样硬化斑块在组织学上被区分为不稳定型和稳定型。还考虑了以下既往史和血液化学数据:年龄、性别、高血压、糖尿病、吸烟习惯、治疗情况、低密度脂蛋白(LDL)-C、肾功能衰竭和hs-CRP。

结果

我们的研究结果清楚地表明,在血脂异常患者中,高水平的hs-CRP会显著增加颈动脉斑块不稳定性。具体而言,在LDL-C水平高的患者中,观察到颈动脉斑块不稳定性风险增加了67%。因此,在男性血脂异常患者(2.333,95%置信区间0.73 - 7.48)和老年女性患者(2.713,95%置信区间0.14 - 53.27)中观察到最高风险。

讨论

这些数据有力地表明,hs-CRP值与脂质代谢改变之间存在生物学关系,这主要发生在受颈动脉粥样硬化影响的男性患者中。hs-CRP的测量可能作为预防动脉粥样硬化疾病的潜在筛查工具。

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Circulatory markers of immunity and carotid atherosclerotic plaque.循环免疫标志物与颈动脉粥样硬化斑块。
Atherosclerosis. 2021 May;325:69-74. doi: 10.1016/j.atherosclerosis.2021.03.040. Epub 2021 Apr 7.
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Vulnerable plaques and patients: state-of-the-art.易损斑块与患者:现状分析。
Eur Heart J. 2020 Aug 14;41(31):2997-3004. doi: 10.1093/eurheartj/ehaa227.

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