Low Levels of Antibodies Against Phosphorylcholine Predict Development of Stroke in a Population-Based Study From Northern Sweden
Low Levels of Antibodies Against Phosphorylcholine Predict Development of Stroke in a Population-Based Study From Northern Sweden
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DOI：
10.1161/strokeaha.109.558742
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发表时间：
2010-04-01
期刊：
影响因子：
8.3
通讯作者：
Frostegard, Johan
中科院分区：
文献类型：
--
作者：
Fiskesund, Roland;Stegmayr, Birgitta;Frostegard, Johan
背景和目的-针对磷脂酰胆碱(抗PC)的天然免疫球蛋白M抗体与动脉粥样硬化有关。我们以前已经证明，高水平的抗PC预示着人类动脉粥样硬化进展缓慢，而低水平的抗PC与心血管疾病的高风险相关。方法：采用嵌套式病例对照研究设计，在瑞典北部的Vasterbotten干预项目(VIP)和世界卫生组织心血管疾病监测趋势和决定因素(WHO Monica)项目的基于人群的队列中，我们检查了227例首次中风病例(125名男性和102名女性)和455名年龄和性别匹配的对照，时间跨度为13年(1985-1999)。在调整了年龄、性别、吸烟、血清胆固醇、糖尿病、体重指数和血压后，确定了95%顺应性的卒中的优势比。使用ELISA检测抗PC水平。结果：在整个抗PC水平低于第30百分位数的人群中，基线水平低的抗PC与发生卒中之间存在显著关联(多变量调整后的优势比为1.62；CI为1.11至2.35)。对性别相关性的分析表明，女性的相关性相当强，特别是在最低的30%(多变量调整后的优势比，2.65；CI，1.41至4.95)。结论：低抗-PC抗体是中风发生的一种新的独立危险标志物。抗-PC的测量可以用来识别中风风险增加的免疫缺陷受试者。这些受试者可能成为免疫疗法等新治疗模式的目标的可能性值得进一步调查。(笔划。2010；41：607-612。)
Background and Purpose-Natural immunoglobulin M antibodies specific for phosphorylcholine (anti-PC) have been implicated in atherosclerosis. We have shown previously that high levels of anti- PC predict a slower progression of atherosclerosis in humans and that low levels of anti- PC are associated with higher risk for cardiovascular disease. Here we determine the association between anti-PC and the incidence of stroke.Methods-Using a nested case control study design, we examined 227 incident cases (125 men and 102 women) of first-time stroke and 455 age-and sex-matched controls identified during a 13-year time period (1985 to 1999) within the population-based cohorts of the Vasterbotten Intervention Project (VIP) and the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease (WHO MONICA) project in Northern Sweden. Odds ratios of stroke with 95% CIs with adjustments for age, gender, smoking, serum cholesterol, diabetes, body mass index, and blood pressure were determined. Anti-PC levels were measured using ELISA.Results-A significant association between low levels of anti-PC at baseline and incident stroke was seen for the whole group of anti-PC levels below the 30th percentile (multivariately adjusted odds ratio, 1.62; CI, 1.11 to 2.35). Analyses of gender-specific associations indicated fairly strong associations for females, especially at the lowest 30th percentile (multivariately adjusted odds ratio, 2.65; CI, 1.41 to 4.95). No associations were noted for men.Conclusion-Low anti-PC is a novel independent risk marker for development of stroke. Measurements of anti- PC could be used to identify immunodeficient subjects at an increased risk for stroke. The possibility that such subjects might be targets for novel modes of treatment such as immunotherapies deserves further investigation. (Stroke. 2010;41:607-612.)