Lung function and cardiovascular risk -: Relationship with inflammation-sensitive plasma proteins
Lung function and cardiovascular risk -: Relationship with inflammation-sensitive plasma proteins
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DOI：
10.1161/01.cir.0000037220.00065.0d
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发表时间：
2002-11-12
期刊：
影响因子：
37.8
通讯作者：
Lindgärde, F
中科院分区：
文献类型：
--
作者：
Engström, G;Lind, P;Lindgärde, F
背景--肺功能与心血管疾病发病率之间的负相关关系在很大程度上仍未得到解释。方法和结果：对5064名年龄在28-61岁的健康男性进行了用力肺活量(FVC)和血浆纤维蛋白原、α(1)抗胰蛋白酶、结合珠蛋白、铜蓝蛋白和类粘蛋白的测定。对全因死亡率、心血管死亡率和心肌梗塞发生率进行了监测，平均随访时间为18.4年。低FVC(第四四分位数)与较高的蛋白质水平以及心肌梗死和心血管死亡的发生率增加相关。对蛋白质水平的调整降低了低FVC男性的心肌梗死(从1.99，95%可信区间1.5至2.6，至1.70，95%可信区间1.3至2.2)和心血管死亡(从2.71，95%可信区间1.9至3.9，至2.28，95%可信区间1.6至3.3)的年龄调整后相对危险度(RR)，相当于额外风险的约25%。心肌梗死和心血管死亡的危险因素调整RR值分别从1.45(95%CI 1.1~1.9)降至1.38(95%CI 1.1~1.8)，从1.96(95%CI 1.4~2.8)降至1.85(95%CI 1.3~2.7)，相当于超额危险度的10%~15%。在低FVC男性中，高蛋白水平(大于或等于上四分位2个蛋白)和低蛋白水平(参考FVC上四分位中小于或等于1个蛋白；参考，FVC上四分位数和低蛋白水平)心肌梗死的危险因素调整RR分别为2.5(95%CI 1.7~3.6)和1.7(95%CI 1.1~2.4)。这种关系有助于但不能完全解释低FVC男性心血管风险增加的原因。
Background-The inverse relationship between pulmonary function and incidence of cardiovascular disease remains largely unexplained. This prospective study explored the hypothesis of a relationship with inflammation-sensitive plasma proteins.Methods and Results-Forced vital capacity (FVC) and plasma levels of fibrinogen, alpha(1)-antitrypsin, haptoglobin, ceruloplasmin, and orosomucoid were determined in 5064 healthy men aged 28 to 61 years. All-cause mortality, cardiovascular mortality, and incidence of myocardial infarction were monitored over a mean follow-up period of 18.4 years. Low FVC (fourth quartile) was associated with higher protein levels and with increased incidences of myocardial infarction and cardiovascular death. Adjustments for protein levels reduced the age-adjusted relative risks (RRs) for myocardial infarction (from 1.99, 95% CI 1.5 to 2.6, to 1.70, 95% CI 1.3 to 2.2) and cardiovascular death (from 2.71, 95% CI 1.9 to 3.9, to 2.28, 95% CI 1.6 to 3.3) among men with low FVC, corresponding to approximate to25% of the excess risk. The risk factor-adjusted RRs were reduced from 1.45 (95% CI 1.1 to 1.9) to 1.38 (95% CI 1.1 to 1.8) and from 1.96 (95% CI 1.4 to 2.8) to 1.85 (95% CI 1.3 to 2.7) for myocardial infarction and cardiovascular death, respectively, corresponding to approximate to10% to 15% of the excess risk. Among men with low FVC, the risk factor-adjusted RR for myocardial infarction was 2.5 (95% CI 1.7 to 3.6) for those with high protein levels (greater than or equal to2 proteins in top quartile) and 1.7 (95% CI 1.1 to 2.4) for those with low protein levels (less than or equal to1 protein in top quartile; reference, top quartile of FVC and low protein levels).Conclusions-FVC is significantly and inversely associated with plasma levels of inflammation-sensitive plasma proteins. This relationship contributes to but cannot fully explain the increased cardiovascular risk among men with low FVC.