Small artery dilation and endothelial markers in cardiovascular risk patients
Small artery dilation and endothelial markers in cardiovascular risk patients
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DOI：
10.1111/j.1365-2362.2011.02553.x
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发表时间：
2012-01-01
影响因子：
5.5
通讯作者：
Masana, Lluis
中科院分区：
文献类型：
--
作者：
Aragones, Gemma;Ferre, Raimon;Masana, Lluis
背景越来越多地使用基于远端小动脉反应性充血的方法来评估内皮功能（EF）。然而，大动脉和小动脉调节血管功能的机制可能不同。我们研究了通过外周动脉张力测定 (PAT) 测定的小外周动脉充血反应性与心血管 (CV) 危险因素患者的 EF、炎症和氧化的血清生物标志物水平之间的相关性。方法 招募了 407 名具有中等 CV 风险的患者进行横断面研究，以检查可溶性内皮、炎症和脂质氧化生物标志物是否与小动脉反应性充血指数 (saRHI) 值相关，saRHI 值通过以下方法测量： PAT.结果发现saRHI值与可溶性E-选择素(sE-选择素)和可溶性血管细胞粘附分子1(sVCAM-1)的浓度之间存在显着相关性。当仅分析非代谢综合征患者 (46%) 时，这些相关性更强（分别为 r = -0.310，P < 0.0001；r = -0.264，P < 0.0001）。在该亚组中，氧化低密度脂蛋白/LDL (oxLDL/LDL) 也与 saRHI 相关 (r = -0.193，P = 0.009)。逐步回归研究表明，sE-选择素是唯一与 saRHI 值显着相关的生物标志物 (P < 0.0001)。在多变量线性回归分析中，当考虑到主要混杂协变量时，这种关系仍然很强。 结论 sE-选择素水平升高，以及较小程度的 sVCAM-1 和 oxLDL/LDL 水平升高与远端小动脉缺血后反应性降低相关。通过回归分析评估，sE-选择素是 saRHI 的主要决定性生物标志物。多种风险因素的存在削弱了这种关联。
Background The use of methods based on reactive hyperaemia of small distal arteries to assess endothelial function (EF) is increasing; however, the mechanisms regulating vascular function in large and small arteries are probably different. We studied the correlations between the hyperaemia reactivity of small peripheral arteries determined by peripheral artery tonometry (PAT) and the levels of serum biomarkers of EF, inflammation and oxidation in patients with cardiovascular (CV) risk factors.Methods Four hundred and seven patients with intermediate CV risk were recruited into a cross-sectional study to examine whether soluble endothelial, inflammatory and lipid oxidative biomarkers correlate with small artery reactive hyperaemia index (saRHI) values, which were measured by PAT.Results A significant correlation was found between saRHI values and the concentrations of soluble E-selectin (sE-selectin) and soluble vascular cell adhesion molecule 1 (sVCAM-1). These correlations were stronger when only non-metabolic syndrome patients (46%) were analysed (r = -0.310, P < 0.0001; r = -0.264, P < 0.0001, respectively). In this subgroup, the oxidised low-density lipoprotein/LDL (oxLDL/LDL) was also correlated with saRHI (r = -0.193, P = 0.009). A stepwise regression study showed that sE-selectin was the only biomarker significantly correlated with saRHI values (P < 0.0001). In multivariate linear regression analysis, this relationship was still strong when the main confounding covariates were taken into consideration.Conclusions Elevated levels of sE-selectin and, to a smaller degree, sVCAM-1 and oxLDL/LDL are associated with lower postischemic reactivity in the small distal arteries. sE-selectin is the main determinant biomarker of saRHI as assessed by regression analysis. The presence of multiple risk factors weakens this association.