Lipoprotein-associated phospholipase A2 activity is associated with risk of coronary heart disease and ischemic stroke - The Rotterdam Study
Lipoprotein-associated phospholipase A2 activity is associated with risk of coronary heart disease and ischemic stroke - The Rotterdam Study
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DOI：
10.1161/01.cir.0000154553.12214.cd
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发表时间：
2005-02-08
期刊：
影响因子：
37.8
通讯作者：
Witteman, JCM
中科院分区：
文献类型：
--
作者：
Oei, HHS;van der Meer, IM;Witteman, JCM
背景-脂蛋白相关磷脂酶A2 （Lp- PLA2）已被认为是心血管疾病的炎症标志物。在本研究中，我们研究了Lp- PLA2是否是冠心病和缺血性卒中的独立预测因子。方法和结果：鹿特丹研究是一项以人群为基础的随访研究，研究对象为7983名大于或等于55岁的受试者。我们进行了一项病例队列研究，包括308例冠心病病例、110例缺血性中风病例和1820名随机样本。我们使用Cox比例风险模型，在稳健方差估计的基础上对标准误差进行修正，计算年龄、性别、体重指数、收缩压、非高密度脂蛋白胆固醇、高密度脂蛋白胆固醇、糖尿病、吸烟、饮酒、降胆固醇药物、白细胞计数和C反应蛋白校正后的风险比。与Lp- PLA2活性的第一个四分位数相比，第二、第三和第四个四分位数的冠心病多变量校正危险比分别为1.39 （95% CI， 0.92至2.10）、1.99 （95% CI， 1.32至3.00）和1.97 (95% CI， 1.28至3.02)（趋势P = 0.01）。缺血性卒中相应的多因素校正危险比分别为1.08 （95% CI, 0.55 ~ 2.11）、1.58 （95% CI, 0.82 ~ 3.04）和1.97 (95% CI, 1.03 ~ 3.79)（趋势P = 0.03）。Lp- PLA2与冠心病的关系存在于非高密度脂蛋白胆固醇水平低于中位数和非高密度脂蛋白胆固醇水平高于中位数的受试者中。结论：本研究表明，Lp- PLA2活性是普通人群中冠心病和缺血性中风的独立预测因子。
Background - Lipoprotein- associated phospholipase A2 ( Lp- PLA2) has been proposed as an inflammatory marker of cardiovascular disease. In the present study, we investigated whether Lp- PLA2 is an independent predictor of coronary heart disease and ischemic stroke.Methods and Results - The Rotterdam Study is a population- based follow- up study in 7983 subjects greater than or equal to 55 years of age. We performed a case- cohort study, including 308 coronary heart disease cases, 110 ischemic stroke cases, and a random sample of 1820 subjects. We used Cox proportional- hazard models with modification of the standard errors based on robust variance estimates to compute hazard ratios adjusted for age, sex, body mass index, systolic blood pressure, non- HDL cholesterol, HDL cholesterol, diabetes, smoking, alcohol consumption, cholesterol- lowering medication, white blood cell count, and C- reactive protein. Compared with the first quartile of Lp- PLA2 activity, multivariate-adjusted hazard ratios for coronary heart disease for the second, third, and fourth quartiles were 1.39 ( 95% CI, 0.92 to 2.10), 1.99 ( 95% CI, 1.32 to 3.00), and 1.97 ( 95% CI, 1.28 to 3.02), respectively ( P for trend = 0.01). Corresponding multivariate- adjusted hazard ratios for ischemic stroke were 1.08 ( 95% CI, 0.55 to 2.11), 1.58 ( 95% CI, 0.82 to 3.04), and 1.97 ( 95% CI, 1.03 to 3.79) ( P for trend = 0.03). The relation between Lp- PLA2 and coronary heart disease was present in both subjects with non- HDL cholesterol levels below the median and those with non- HDL cholesterol levels above the median.Conclusions - This study shows that Lp- PLA2 activity is an independent predictor of coronary heart disease and ischemic stroke in the general population.