刚地弓形虫感染与心血管死亡率：基于美国人群队列研究的性别特异性差异。

Toxoplasma Gondii infection and cardiovascular mortality: sex-specific differences in a United States population-based cohort study.

机构信息

Department of Clinical Laboratory, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China.

Department of Critical Care, The eighth Affiliated Hospital of Sun Yat sen University, Shenzhen, China.

出版信息

BMC Infect Dis. 2024 Sep 27;24(1):1029. doi: 10.1186/s12879-024-09934-5.

DOI:10.1186/s12879-024-09934-5

PMID:39333926

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11428453/

Abstract

BACKGROUND

Although Toxoplasma gondii (T. gondii) infection has been linked to cardiac injury, the extent to which it increases the risk of cardiovascular disease (CVD) mortality remains unclear. We aimed to assess the association between T. gondii infection and CVD mortality in the United States population.

METHODS

This study used data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014 to investigate the association between T. gondii infection and CVD mortality. The T. gondii infection status was determined by measuring serum T. gondii IgG antibody levels. CVD mortality outcomes were ascertained through linkage with the national mortality index records. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) of T. gondii infection on CVD mortality.

RESULTS

A total of 10,237 (Male, n = 5010; Female, n = 5227) individuals aged ≥ 20 years were included in the analysis, of which 1,632 were positive for T. gondii serum IgG antibodies. After a median follow-up of eight years, there were 312 deaths due to CVD. In multivariable-adjusted analyses, the risk of death from CVD was 40% higher in T. gondii-seropositive men compared with seronegative men (HR: 1.40; 95%CI: 1.02-1.93), but not in women (HR: 0.87; 95% CI: 0.57-1.34). These results remained consistent in further stratified and sensitivity analyses.

CONCLUSION

In this large population-based cohort study, T. gondii infection was associated with an increased risk of CVD mortality in men, but not in women. Further studies are required to elucidate the underlying mechanisms and potential sex-specific differences in the effects of T. gondii infection on CVD mortality. Future investigations should focus on validating these results and exploring the potential implications for cardiovascular risk assessment and management.

摘要

背景

虽然刚地弓形虫（T. gondii）感染与心脏损伤有关，但它增加心血管疾病（CVD）死亡率的程度尚不清楚。我们旨在评估美国人群中 T. gondii 感染与 CVD 死亡率之间的关系。

方法

本研究使用了 2009 年至 2014 年期间进行的国家健康和营养检查调查（NHANES）的数据，以调查 T. gondii 感染与 CVD 死亡率之间的关系。T. gondii 感染状况通过测量血清 T. gondii IgG 抗体水平来确定。CVD 死亡率结果通过与国家死亡率指数记录的链接来确定。使用 Cox 比例风险模型估计 T. gondii 感染对 CVD 死亡率的风险比（HR）和相应的 95％置信区间（CI）。

结果

共有 10237 名（男性，n=5010；女性，n=5227）年龄≥20 岁的个体纳入分析，其中 1632 名血清 T. gondii IgG 抗体呈阳性。在中位随访 8 年后，有 312 人死于 CVD。在多变量调整分析中，与血清 IgG 抗体阴性的男性相比，T. gondii 血清 IgG 抗体阳性的男性 CVD 死亡风险增加了 40％（HR：1.40；95％CI：1.02-1.93），但在女性中则没有（HR：0.87；95％CI：0.57-1.34）。这些结果在进一步分层和敏感性分析中仍然一致。