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血浆黏度、免疫球蛋白与心血管疾病及死亡率风险:新数据和荟萃分析。

Plasma viscosity, immunoglobulins and risk of cardiovascular disease and mortality: new data and meta-analyses.

机构信息

Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.

The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia

出版信息

J Clin Pathol. 2024 May 17;77(6):394-401. doi: 10.1136/jcp-2022-208223.

Abstract

AIMS

Associations of plasma viscosity and plasma Ig levels (a determinant of viscosity) with incident coronary heart disease (CHD) events; and with CHD, cardiovascular disease (CVD: CHD and stroke) and all-cause mortalities.

METHODS

Meta-analysis of plasma viscosity levels from the MONitoring of trends and determinants of CArdiovascular (MONICA)/Cooperative Health Research in the Region of Augsburg, MONICA Glasgow and Speedwell Studies; and five other published studies. Meta-analysis of IgA, IgG and IgM levels from the Augsburg, Glasgow and Speedwell studies; and one other published study.

RESULTS

Over median follow-up periods of 14-26 years, there were 2270 CHD events, and 4220 all cause deaths in 28 605 participants with baseline plasma viscosity measurements. After adjustment for major risk factors, (HRs; 95% CIs) for a 1 SD increase in viscosity were 1.14 (1.09 to 1.20) for CHD events; and 1.21 (1.17 to 1.25) for all-cause mortality. 821 CHD events and 2085 all-cause deaths occurred in 8218 participants with baseline Ig levels. For CHD events, adjusted HRs for 1 SD increases in IgA, IgG and IgM were, respectively, 0.97 (0.89 to 1.05); 0.95(0.76 to 1.17) and 0.90 (0.79 to 1.03). Corresponding adjusted HRs for all-cause mortality were 1.08 (95% CI 1.02 to 1.13), 1.03 (95% CI 0.94 to 1.14) and 1.01 (95% CI 0.96 to 1.06).

CONCLUSIONS

After risk factor adjustment, plasma viscosity was significantly associated with risks of CHD events; and with CHD, CVD and all-cause mortalities. We found no significant association of IgA, IgG or IgM levels with incident CHD events or mortality, except for a borderline association of IgA with all-cause mortality.

摘要

目的

研究血浆黏度和血浆免疫球蛋白水平(黏度的决定因素)与冠心病(CHD)事件的关系;以及与 CHD、心血管疾病(CVD:CHD 和中风)和全因死亡率的关系。

方法

对 MONitoring of trends and determinants of CArdiovascular(MONICA)/Cooperative Health Research in the Region of Augsburg、MONICA Glasgow 和 Speedwell 研究中的血浆黏度水平,以及另外 5 项已发表研究进行荟萃分析;对 Augsburg、Glasgow 和 Speedwell 研究中的 IgA、IgG 和 IgM 水平,以及另外 1 项已发表研究进行荟萃分析。

结果

在 28605 名基线有血浆黏度测量值的参与者中,中位随访期为 14-26 年,共发生 2270 例 CHD 事件和 4220 例全因死亡。在校正主要危险因素后,黏度每增加 1 SD,CHD 事件的风险比(HR)为 1.14(1.09-1.20);全因死亡率的 HR 为 1.21(1.17-1.25)。在基线 Ig 水平的 8218 名参与者中,发生了 821 例 CHD 事件和 2085 例全因死亡。对于 CHD 事件,IgA、IgG 和 IgM 每增加 1 SD 的校正 HR 分别为 0.97(0.89-1.05)、0.95(0.76-1.17)和 0.90(0.79-1.03)。全因死亡率的相应校正 HR 分别为 1.08(95%CI 1.02-1.13)、1.03(95%CI 0.94-1.14)和 1.01(95%CI 0.96-1.06)。

结论

在校正危险因素后,血浆黏度与 CHD 事件的风险显著相关;与 CHD、CVD 和全因死亡率相关。我们发现 IgA、IgG 或 IgM 水平与 CHD 事件或死亡率无显著相关性,但 IgA 与全因死亡率呈边缘相关性。

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