Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
Department of Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
Clin Chim Acta. 2023 Nov 1;551:117606. doi: 10.1016/j.cca.2023.117606. Epub 2023 Oct 14.
We assessed the predictive values of neutrophil gelatinase-associated lipocalin (NGAL), fat distribution, and their interaction on the development of major adverse cardiovascular events (MACE) in a community-based cohort of middle-aged and older individuals.
This prospective study involved 1349 adults (43.2% men) aged 50-80 y, without baseline cardiovascular diseases, from communities in 2013-2014. All participants were followed up for a mean of 7.6 y via phone calls and medical records. Serum NGAL concentrations were analyzed at baseline. Fat distribution, including subcutaneous fat area and visceral fat area (VFA), was assessed by magnetic resonance imaging.
In fully-adjusted Cox regression models, baseline high NGAL concentrations were related to an increased risk of MACE in women [HR 1.75, 95% CI 1.03-2.99], compared with low NGAL concentrations. After stratification by VFA concentrations, the observed association was more predominant in women with baseline low VFA (HR 1.24, 95% CI 1.11-1.38). Moreover, the association between NGAL and MACE was interacted by VFA, strengthening the association at low VFA concentrations (P < 0.05).
Serum NGAL determined at baseline predicts the development of MACE, and the association is modified by VFA in women.
我们评估了中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、脂肪分布及其相互作用对中年和老年人群中主要不良心血管事件（MACE）发生的预测价值。
这项前瞻性研究纳入了 2013-2014 年来自社区的 1349 名年龄在 50-80 岁、无基线心血管疾病的成年人（43.2%为男性）。所有参与者通过电话和病历记录进行了平均 7.6 年的随访。在基线时分析了血清 NGAL 浓度。脂肪分布，包括皮下脂肪面积和内脏脂肪面积（VFA），通过磁共振成像进行评估。
在完全调整的 Cox 回归模型中，与低 NGAL 浓度相比，基线时高 NGAL 浓度与女性发生 MACE 的风险增加相关[风险比 1.75，95%置信区间 1.03-2.99]。在按 VFA 浓度分层后，在基线时 VFA 浓度低的女性中观察到的相关性更为显著[风险比 1.24，95%置信区间 1.11-1.38]。此外，NGAL 和 MACE 之间的关联受 VFA 调节，在 VFA 浓度低时增强了这种关联（P<0.05）。
基线时测定的血清 NGAL 可预测 MACE 的发生，且该关联在女性中受 VFA 影响。
