Miettinen H, Lehto S, Saikku P, Haffner S M, Rönnemaa T, Pyörälä K, Laakso M
Department of Medicine, University of Kuopio, Finland.
Eur Heart J. 1996 May;17(5):682-8. doi: 10.1093/oxfordjournals.eurheartj.a014934.
It has been suggested that Chlamydia pneumoniae, a Gram-negative intracellular bacterium, is a risk factor for both myocardial infarction and chronic coronary heart disease. Previous studies have been done predominantly in non-diabetic subjects and thus the effect of diabetes on the association between C. pneumoniae antibodies and coronary heart disease has not been analysed. The aim of our study was to investigate the association between prior chlamydial infection and the risk of serious coronary heart disease events (myocardial infarction or coronary death) in a 7-year prospective study of cohorts of diabetic and non-diabetic subjects in two areas of Finland.
It was found that the prevalence of elevated chlamydial antibodies at baseline was higher in nondiabetic subjects who had serious coronary heart disease events during the follow-up than in subjects without coronary heart disease events (32 vs 15%, relative risk 2.56, P = 0.013) in East Finland. In non-diabetic subjects living in West Finland we did not find this association. The association between the C. pneumoniae antibodies and coronary heart disease events did not markedly change after controlling for other risk factors for coronary heart disease (OR 2.44, P = 0.055) in non-diabetic subjects living in eastern Finland. In diabetic patients we did not find any association between chlamydial antibodies and coronary heart disease events.
We found an association between C. pneumoniae antibodies and coronary heart disease events in non-diabetics living in eastern Finland. This association remained strong even after controlling for the other risk factors for coronary heart disease. In diabetic patients with high risk for coronary heart disease, C. pneumoniae was not a risk factor for coronary heart disease.
有研究表明，革兰氏阴性细胞内细菌肺炎衣原体是心肌梗死和慢性冠心病的危险因素。先前的研究主要在非糖尿病患者中进行，因此尚未分析糖尿病对肺炎衣原体抗体与冠心病之间关联的影响。我们研究的目的是在芬兰两个地区对糖尿病和非糖尿病队列进行为期7年的前瞻性研究，以调查既往衣原体感染与严重冠心病事件（心肌梗死或冠心病死亡）风险之间的关联。
发现在东芬兰，随访期间发生严重冠心病事件的非糖尿病患者基线时衣原体抗体升高的患病率高于无冠心病事件的患者（32% 对15%，相对风险2.56，P = 0.013）。在西芬兰居住的非糖尿病患者中，我们未发现这种关联。在东芬兰居住的非糖尿病患者中，控制其他冠心病危险因素后，肺炎衣原体抗体与冠心病事件之间的关联没有明显变化（比值比2.44，P = 0.055）。在糖尿病患者中，我们未发现衣原体抗体与冠心病事件之间存在任何关联。
我们发现在东芬兰居住的非糖尿病患者中，肺炎衣原体抗体与冠心病事件之间存在关联。即使在控制了其他冠心病危险因素之后，这种关联仍然很强。在冠心病高危的糖尿病患者中，肺炎衣原体不是冠心病的危险因素。
