Plasma sphingomyelin and subclinical atherosclerosis: Findings from the multi-ethnic study of atherosclerosis
Plasma sphingomyelin and subclinical atherosclerosis: Findings from the multi-ethnic study of atherosclerosis
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DOI：
10.1093/aje/kwj140
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发表时间：
2006-05-15
影响因子：
5
通讯作者：
Shea, S
中科院分区：
文献类型：
--
作者：
Nelson, J;Jiang, XC;Shea, S
血浆鞘磷脂已被证明是冠心病的独立危险因素，但血浆鞘磷脂与早期亚临床动脉粥样硬化性疾病的关系尚未报道。作者在2000年开始的动脉粥样硬化多种族研究中，对6,814名中年无症状成年人的血浆鞘磷脂与亚临床心血管疾病的三项指标（颈动脉内膜-中壁厚度、踝臂血压指数和Agatston冠状动脉钙化评分）之间的关系进行了研究。鞘磷脂水平与血脂和脆性危险评分呈正相关（两者均P < 0.01），女性的平均水平高于男性（50（标准差（SD），16）vs. 45（SD，15）mg/dl）（p < 0.01），并且在从不吸烟者与当前吸烟者中更高（49（SD，16）对45（SD，17）mg/dl）（p < 0.01）。鞘磷脂水平≥ 60 mg/dl的女性比鞘磷脂水平≤ 39 mg/dl的对照组有更严重的亚临床疾病，尽管在标准心血管疾病危险因素的多变量校正后，相关性并不显著。鞘磷脂水平为60 mg/dl或更高的男性与鞘磷脂水平为39 mg/dl或更低的男性相比，钙评分更高（135 vs. 99 Agatston单位）（p = 0.01）。这些观察结果与以下假设一致：血浆鞘磷脂处于介导标准心血管疾病风险因素所致亚临床疾病风险的生物途径中。
Plasma sphingomyelin has been shown to be an independent risk factor for coronary heart disease, but the relation of plasma sphingomyelin to earlier, subclinical atherosclerotic disease has not been reported. The authors examined the association between plasma sphingomyelin and three measures of subclinical cardiovascular disease (carotid intimal-medial wall thickness, ankle-arm blood pressure index, and Agatston coronary artery calcium score) among 6,814 middle-aged, asymptomatic adults in the Multi-Ethnic Study of Atherosclerosis, which was initiated in 2000. The sphingomyelin level was positively correlated with lipids and the Framingham risk score (p < 0.01 for both), and the mean level was higher in women than men (50 (standard deviation (SD), 16) vs. 45 (SD, 15) mg/dl) (p < 0.01) and higher in never versus current smokers (49 (SD, 16) vs. 45 (SD, 17) mg/dl) (p < 0.01). Women with sphingomyelin levels of 60 or more mg/dl had more severe subclinical disease by all three measures than did the referent group with sphingomyelin levels of 39 or less mg/dl, although associations were not significant after multivariate adjustment for standard cardiovascular disease risk factors. Men with sphingomyelin levels of 60 or more mg/dl versus those with sphingomyelin levels of 39 or less mg/dl had higher calcium scores (135 vs. 99 Agatston units) (p = 0.01). These observations are consistent with the hypothesis that plasma sphingomyelin is in the biologic pathway that mediates the risk for subclinical disease attributable to standard cardiovascular disease risk factors.