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入院血糖和炎症标志物在颈动脉及股腘动脉粥样硬化斑块组织病理学特征中的作用

The Role of Admission Glucose and Inflammatory Markers in Histopathological Features of Atherosclerotic Plaques in Carotid and Femoro-Popliteal Arteries.

作者信息

Coșarcă Mircea Cătălin, Șincaru Suzana Vasilica, Horváth Emőke, Sala Daniela Tatiana, Lazăr Nicolae Alexandru, Szanto Ludovic Alexandru, Harpa Marius Mihai, Carașcă Cosmin, Ráduly Gergő, Bândea Paula, Mureșan Vasile Adrian

机构信息

Department of Anatomy, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania.

Clinic of Vascular Surgery, Mures County Emergency Hospital (SCJU Târgu-Mureș), 540136 Targu Mures, Romania.

出版信息

Medicina (Kaunas). 2025 May 12;61(5):879. doi: 10.3390/medicina61050879.

Abstract

: Atherosclerosis is a chronic inflammatory disease significantly contributing to cardiovascular morbidity and mortality. This study primarily aims to evaluate the role of baseline blood glucose levels and inflammatory markers in the histopathological features of atherosclerotic plaques in the carotid and femoro-popliteal arteries. : In this retrospective, observational, and monocentric study, 165 patients diagnosed with infrainguinal peripheral arterial disease or carotid artery disease hospitalized in the Vascular Surgery Clinic, between January 2019 and December 2023, were included. From the electronic database of the hospital, we documented demographic data, cardiovascular comorbidities, including hypertension, atrial fibrillation, ischemic heart disease, and chronic heart failure, as well as chronic kidney disease, diabetes, and prevalent risk factors such as active smoking, dyslipidemia, and obesity. Additionally, we recorded the arterial site from which the atherosclerotic plaque was obtained, along with laboratory data obtained at the time of admission prior to the surgery. The patients were divided into "Carotid Artery" and "Femoro-Popliteal Axis" based on anatomical location. : A greater prevalence of male patients ( = 0.008) and dyslipidemia ( = 0.002) was found in the group with atherosclerotic plaques from the femoro-popliteal axis. Laboratory data also showed increased lymphocyte ( = 0.020) and PLT ( = 0.028) levels in this group. There was no significant difference in the types of atherosclerotic plaques between the two patient groups. However, those in the Carotid Artery group showed a higher rate of antiaggregant treatment and a reduced incidence of dual therapy ( < 0.001). The Spearman correlation analysis revealed a positive correlation between baseline glucose levels and NLR (r = 0.402, < 0.001), MLR (r = 0.217, = 0.005), PLR (r = 0.306, < 0.001), and LGI (r = 0.693, < 0.001). Furthermore, the predictive roles of glucose, NLR, MLR, and LGI were assessed through multivariate analysis. Consequently, elevated baseline values of the parameters above were associated with unstable atherosclerotic plaques, independent of demo-graphic data, standard cardiovascular risk factors, site of artery harvest, and chronic vascular treatments at the time of admission (for all < 0.05). : This study highlights the significant relationships between glucose levels and various inflammatory markers in patients with different histopathological diagnoses of atherosclerotic plaques. Additionally, elevated glycemic and systemic inflammation biomarkers were associated with unstable atherosclerotic plaque, independent of demographic data, comorbidities, cardiovascular risk factors, anatomical artery harvest, and vascular chronic medication at the time of admission.

摘要

动脉粥样硬化是一种慢性炎症性疾病,对心血管疾病的发病率和死亡率有显著影响。本研究主要旨在评估基线血糖水平和炎症标志物在颈动脉和股腘动脉粥样硬化斑块组织病理学特征中的作用。

在这项回顾性、观察性单中心研究中,纳入了2019年1月至2023年12月期间在血管外科诊所住院的165例诊断为腹股沟下外周动脉疾病或颈动脉疾病的患者。从医院的电子数据库中,我们记录了人口统计学数据、心血管合并症,包括高血压、心房颤动、缺血性心脏病和慢性心力衰竭,以及慢性肾病、糖尿病和常见危险因素,如主动吸烟、血脂异常和肥胖。此外,我们记录了获取动脉粥样硬化斑块的动脉部位,以及手术前入院时获得的实验室数据。根据解剖位置将患者分为“颈动脉组”和“股腘动脉组”。

在股腘动脉粥样硬化斑块组中,男性患者(P = 0.008)和血脂异常(P = 0.002)的患病率更高。实验室数据还显示该组淋巴细胞(P = )和血小板(P = 0.028)水平升高。两组患者的动脉粥样硬化斑块类型无显著差异。然而,颈动脉组的抗血小板治疗率更高,双联治疗的发生率更低(P < 0.001)。Spearman相关性分析显示基线血糖水平与中性粒细胞与淋巴细胞比值(NLR,r = 0.402,P < 0.001)、单核细胞与淋巴细胞比值(MLR,r = 0.217,P = 0.005)、血小板与淋巴细胞比值(PLR,r = 0.306,P < 0.001)和淋巴细胞生成指数(LGI,r = 0.693,P < 0.001)呈正相关。此外,通过多变量分析评估了血糖、NLR、MLR和LGI的预测作用。因此,上述参数的基线值升高与不稳定的动脉粥样硬化斑块相关,独立于人口统计学数据、标准心血管危险因素、动脉取材部位和入院时的慢性血管治疗(所有P < 0.05)。

本研究强调了血糖水平与不同组织病理学诊断的动脉粥样硬化斑块患者的各种炎症标志物之间的重要关系。此外,血糖和全身炎症生物标志物升高与不稳定的动脉粥样硬化斑块相关,独立于人口统计学数据、合并症、心血管危险因素、解剖动脉取材和入院时的血管慢性用药情况。

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