Synergistic role of inflammation and insulin resistance as coronary artery disease risk factors in African Americans and Caucasians.
Synergistic role of inflammation and insulin resistance as coronary artery disease risk factors in African Americans and Caucasians.
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DOI：
10.1016/j.atherosclerosis.2008.11.028
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发表时间：
2009-07
期刊：
影响因子：
5.3
通讯作者：
Berglund, Lars
中科院分区：
文献类型：
--
作者：
Anuurad, Erdembileg;Tracy, Russell P.;Pearson, Thomas A.;Kim, Kyoungmi;Berglund, Lars
炎症和胰岛素抵抗（IR）在心血管疾病（CVD）发病机制中的独立作用已得到广泛认可。我们调查是否存在炎症会改变冠状动脉疾病（CAD）的风险预测在受试者或没有IR。胰岛素，葡萄糖，CRP和纤维蛋白原水平测定在317名白人和222名非洲裔美国人进行诊断冠状动脉造影。CAD程度由综合评分（0-75）定义。白人和非裔美国人胰岛素抵抗（HOMA-IR≥3.0）的总患病率分别为32.5%和22.9%（P<0.05）。IR受试者的CAD程度（综合评分）更高（白人和非裔美国人分别为20.7 vs. 14.5，P=0.014和20.1 vs. 13.1，P=0.031），在多元回归模型中，IR是两组CAD的独立预测因子。在两个种族组中，与无IR和低CRP（<3 mg/L）的受试者相比，IR和高CRP（≥3 mg/L）的受试者的综合评分显著更高（白人和非裔美国人分别为21.2 vs. 13.9，P<0.05和20.9 vs. 10.2，P<0.05）。同样，与无IR和低纤维蛋白原的受试者相比，IR和高纤维蛋白原（≥340 mg/dl）受试者的复合评分显著更高。总之，炎症标志物水平升高与IR呈正相关。此外，IR和炎症的结合导致高加索人和非裔美国人的CAD程度更高。结果表明，炎症可能会加强IR的心血管危险因素的作用。
The separate roles of inflammation and insulin resistance (IR) in the pathogenesis of cardiovascular disease (CVD) are well recognized. We investigated whether presence of inflammation would modify coronary artery disease (CAD) risk prediction in subjects with or without IR. Insulin, glucose, CRP and fibrinogen levels were determined in 317 Caucasians and 222 African Americans undergoing diagnostic coronary angiography. Extent of CAD was defined by a composite score (0–75). The overall prevalence of IR (HOMA-IR≥3.0) in Caucasians and African Americans was 32.5% and 22.9%, respectively (P<0.05). The degree of CAD (composite score) was higher in subjects with IR (20.7 vs. 14.5, P=0.014 and 20.1 vs. 13.1, P=0.031 for Caucasians and African Americans, respectively), and in a multiple regression model IR was an independent predictor for CAD in both groups. In both ethnic groups, subjects with a combination of IR and high CRP (≥3 mg/L) had significantly higher composite score compared to those with no IR and low CRP (<3 mg/L) (21.2 vs. 13.9, P<0.05 and 20.9 vs. 10.2, P<0.05 for Caucasians and African Americans respectively). Similarly, the composite score was significantly higher in subjects with IR and high fibrinogen (≥340 mg/dl) compared to those with no IR and low fibrinogen. In conclusion, elevated levels of inflammatory markers were positively associated with IR. Further, a combination of IR and inflammation resulted in a higher degree of CAD in both Caucasians and African Americans. The results suggest that inflammation may potentiate the cardiovascular risk factor role of IR.
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影响因子：
120.7
作者：
KANNEL, WB;WOLF, PA;DAGOSTINO, RB
通讯作者：
DAGOSTINO, RB
影响因子：
37.8
作者：
Festa, A;Hanley, AJG;Haffner, SM
通讯作者：
Haffner, SM
DOI：
10.1161/01.atv.20.12.2619
发表时间：
2000-12-01
影响因子：
8.7
作者：
Paultre, F;Pearson, TA;Berglund, L
通讯作者：
Berglund, L
影响因子：
15.9
作者：
Ginsberg, HN
通讯作者：
Ginsberg, HN
影响因子：
1.2
作者：
Nakanishi, N;Shiraishi, T;Wada, M
通讯作者：
Wada, M