The Associations of Fetuin-A With Subclinical Cardiovascular Disease in Community-Dwelling Persons The Rancho Bernardo Study
The Associations of Fetuin-A With Subclinical Cardiovascular Disease in Community-Dwelling Persons The Rancho Bernardo Study
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DOI：
10.1016/j.jacc.2011.08.035
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发表时间：
2011-11-29
影响因子：
24
通讯作者：
Laughlin, Gail A.
中科院分区：
文献类型：
--
作者：
Ix, Joachim H.;Barrett-Connor, Elizabeth;Laughlin, Gail A.
目的 本研究的目的是确定社区生活个体中胎球蛋白-A 与亚临床心血管疾病 (CVD) 的关系。 背景 胎球蛋白-A 是一种肝分泌蛋白，可在体外抑制动脉钙沉积。较低的胎球蛋白-A 水平与终末期肾病人群的动脉钙化和死亡相关。一般人群中胎球蛋白-A 与亚临床 CVD 的关联尚不清楚。方法 在 1,375 名没有流行临床 CVD 的社区生活个体中，我们测量了血浆胎球蛋白-A 浓度。外周动脉疾病（PAD）的定义是踝臂指数<0.90，冠状动脉钙化（CAC）是通过计算机断层扫描测量的，总内膜中层厚度（cIMT）是通过颈动脉超声测量的。 PAD 与胎球蛋白-A 同时测量，CAC 和 cIMT 在 4.6 年（平均）后测量。结果 平均年龄为 70 +/- 11 岁，其中 64% 为女性。胎球蛋白-A 水平与 CAC 严重程度呈负相关。当使用序数 Logistic 回归评估 CAC 类别（0、1 至 100、101 至 300、> 300）时，在针对人口数据、生活方式因素、传统 CVD 进行调整的模型中，每个 SD 较高的胎球蛋白-A 与 CAC 严重程度的几率降低 31% 相关（比例优势比：0.69；95% 置信区间：0.46 至 0.92；p = 0.008）危险因素和肾功能。相比之下，在调整后的模型中，未观察到胎球蛋白-A 与 PAD 或高普通或内部 cIMT 相关。结论 较低的胎球蛋白-A 水平与较高的 CAC 严重程度独立相关，但与 PAD 或 cIMT 无关。如果得到证实，胎球蛋白-A 可能会标记脉管系统内的钙沉积，但不会标记动脉粥样硬化本身。 （J Am Coll Cardiol 2011；58：2372-9）(C) 2011 年，美国心脏病学会基金会
Objectives The aim of this study was to determine the association of fetuin-A with subclinical cardiovascular disease (CVD) in community-living individuals.Background Fetuin-A is a hepatic secretory protein that inhibits arterial calcium deposition in vitro. Lower fetuin-A levels are associated with arterial calcification and death in end-stage renal disease populations. The association of fetuin-A with subclinical CVD in the general population is unknown.Methods Among 1,375 community-living individuals without prevalent clinical CVD, we measured plasma fetuin-A concentrations. Peripheral arterial disease (PAD) was defined by ankle brachial index < 0.90, coronary artery calcification (CAC) was measured by computed tomography, and common and internal intima-media thickness (cIMT) were measured by carotid ultrasound. PAD was measured concurrent with fetuin-A, and CAC and cIMT were measured 4.6 years (mean) later.Results Mean age was 70 +/- 11 years, and 64% were women. Fetuin-A levels were inversely associated with CAC severity. When evaluated as CAC categories (0, 1 to 100, 101 to 300, > 300) with ordinal logistic regression, each SD higher fetuin-A was associated with 31% lower odds of CAC severity (proportional odds ratio: 0.69; 95% confidence interval: 0.46 to 0.92; p = 0.008) in models adjusted for demographic data, lifestyle factors, traditional CVD risk factors, and kidney function. In contrast, no association of fetuin-A was observed with PAD or high common or internal cIMT in adjusted models.Conclusions Lower fetuin-A levels are independently associated with greater CAC severity but not PAD or cIMT. If confirmed, fetuin-A might mark calcium deposition within the vasculature but not atherosclerosis per se. (J Am Coll Cardiol 2011; 58: 2372-9) (C) 2011 by the American College of Cardiology Foundation