Circulating inflammatory biomarkers are related to cerebrovascular disease in older adults
Circulating inflammatory biomarkers are related to cerebrovascular disease in older adults
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DOI：
10.1212/nxi.0000000000000521
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发表时间：
2019-01-01
影响因子：
8.8
通讯作者：
Mayeux, Richard
中科院分区：
文献类型：
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作者：
Gu, Yian;Gutierrez, Jose;Mayeux, Richard
本研究旨在检查循环炎症生物标志物C-反应蛋白（CRP）、白细胞介素-6（IL-6）和α 1-抗糜蛋白酶（ACT）是否与通过MRI评估的脑血管疾病（CVD）相关。ELISA法检测IL 6（N = 357）。无症状性脑梗死和白色高信号（WMH）来自基线时所有可用的MRI扫描，约4.4年后采集血液样本用于炎症生物标志物。在大约4.5年后的随访MRI访视中进行了梗死和WMH的重复评估以及微出血评估。使用适当的逻辑回归模型、广义线性模型或考克斯模型分析炎性生物标志物和CVD之间的横截面和纵向关系。log（10）IL 6的1 SD增加与MRI上的梗死相关{比值比[OR]（95%置信区间[CI]）= 1.28 [1.02-1.60]，p = 0.033}，log（10）CRP和log（10）ACT增加1 SD与微出血相关（OR [95% CI] = 1.46 [1.02-2.09]，p = 0.041;和1.65 [1.11-2.46]，p = 0.013;分别）。log（10）ACT增加一个SD也与随访MRI时较大的WMH（B = 0.103，p = 0.012）和随访期间WMH体积累积增加（B = 0.062，p = 0.041）相关。在额外调整血管危险因素并排除临床stroke.ConclusionsAmong老年人，增加循环炎症生物标志物与梗死和微出血，WMH负担和WMH进展的存在相关。
ObjectiveThis investigation aimed at examining whether circulating inflammatory biomarkers C-reactive protein (CRP), interleukin-6 (IL6), and alpha 1-antichymotrypsin (ACT) were related to cerebrovascular disease (CVD) assessed by MRI.MethodsThe study included nondemented elderly participants of a community-based, multiethnic cohort, who received baseline MRI scans and had CRP (n = 508), ACT (435), and IL6 (N = 357) measured by ELISA. Silent brain infarcts and white matter hyperintensities (WMH) were derived from all available MRI scans at baseline, approximately 4.4 years after blood sample collection for inflammatory biomarkers. Repeated assessments of infarcts and WMH, as well as microbleeds assessment, were performed at follow-up MRI visits around 4.5 years later. Cross-sectional and longitudinal relationship between inflammatory biomarkers and CVD were analyzed using appropriate logistic regression models, generalized linear models, or COX models.ResultsAfter adjusting for age, sex, ethnicity, education, APOE genotype, and intracranial volume, 1 SD increase in log(10) IL6 was associated with infarcts on MRI {odds ratio [OR] (95% confidence interval [CI]) = 1.28 [1.02-1.60],p = 0.033}, and 1 SD increase in log(10) CRP and log io ACT was associated with microbleeds (OR [95% CI] = 1.46 [1.02-2.09], p = 0.041; and 1.65 [1.11-2.46], p = 0.013; respectively). One SD increase in log(10) ACT was also associated with larger WMH at the follow-up MRI (b = 0.103,p = 0.012) and increased accumulation of WMH volume (b = 0.062, p = 0.041) during follow-up. The associations remained significant after additional adjustment of vascular risk factors and excluding participants with clinical stroke.ConclusionsAmong older adults, increased circulating inflammatory biomarkers were associated with the presence of infarcts and microbleeds, WMH burden, and progression of WMH.