Heparin cofactor II is a novel protective factor against carotid atherosclerosis in elderly individuals
Heparin cofactor II is a novel protective factor against carotid atherosclerosis in elderly individuals
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DOI：
10.1161/01.cir.0000129968.46095.f3
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发表时间：
2004-06-08
期刊：
影响因子：
37.8
通讯作者：
Matsumoto, T
中科院分区：
文献类型：
--
作者：
Aihara, K;Azuma, H;Matsumoto, T
背景-凝血酶在动脉粥样硬化血栓形成中起关键作用.由于肝素辅因子II（HCII）在与受损动脉壁处的硫酸皮肤素结合后抑制凝血酶作用，HCII可负调节血管壁中的凝血酶作用。我们假设血浆HCII活性是一个预防动脉粥样硬化变化的因素，特别是在已经有动脉粥样硬化血管损伤的老年人中，方法和结果--在306名日本老年人中，通过超声检查测量颈动脉最大斑块厚度（MPT（154例男性和152例女性;年龄：40 - 91岁; 68.9 +/- 11.1岁，平均值+/- SD）。对包括血浆HCII活性在内的心血管危险因素与MPT严重程度的相关性进行统计学评价。血浆HCII活性随年龄增长而降低。校正年龄和性别后的简单线性回归分析显示，脂蛋白（a）、糖化血红蛋白A1 c和糖尿病的存在显著有助于MPT值的增加（分别为r = 0.119，P < 0.05; r = 0.196，P < 0.001; r = 0.227，P < 0.0001）。高密度脂蛋白胆固醇（HDL）和HCII活性与MPT呈负相关（r =-0.117，P < 0.05; r =-0.202，P < 0.0005）。多元回归分析显示，血浆HCII活性和HDL胆固醇独立地抑制MPT值，HCII活性的抗动脉粥样硬化作用强于HDL胆固醇（分别为P < 0.001和P < 0.05）。此外，在老年人中，HCII是比HDL胆固醇更强的颈动脉粥样硬化预测因子。
Background - Thrombin plays a crucial role in atherothrombotic changes. Because heparin cofactor II (HCII) inhibits thrombin actions after binding to dermatan sulfate at injured arterial walls, HCII may negatively regulate thrombin actions in vascular walls. We hypothesized that plasma HCII activity is a preventive factor against atherosclerotic changes, especially in elderly ndividuals who already have atherosclerotic vascular injuries.Methods and Results - Maximum plaque thickness (MPT) in the carotid artery was measured by ultrasonography in 306 Japanese elderly individuals ( 154 men and 152 women; age, 40 to 91 years; 68.9 +/- 11.1 years, mean +/- SD). The relevance of cardiovascular risk factors including plasma HCII activity to the severity of MPT was statistically evaluated. Plasma HCII activity decreased with age. Simple linear regression analysis after adjustments for age and sex showed that lipoprotein( a), glycosylated hemoglobin A1c, and presence of diabetes mellitus significantly contributed to an increase in MPT values ( r = 0.119, P < 0.05; r = 0.196, P < 0.001; and r = 0.227, P < 0.0001, respectively). In contrast, high-density lipoprotein (HDL) cholesterol and HCII activity were negatively correlated with MPT values ( r = - 0.117, P < 0.05, and r = - 0.202, P < 0.0005, respectively). Multiple regression analysis revealed that plasma HCII activity and HDL cholesterol independently contributed to the suppression of MPT values and that the antiatherogenic contribution of HCII activity was stronger than that of HDL cholesterol ( P < 0.001 and P < 0.05, respectively).Conclusions - These results suggest that HCII can be a novel and independent antiatherogenic factor. Moreover, HCII is a stronger predictive factor than HDL cholesterol against carotid atherosclerosis in elderly individuals.