Plasma osteoprotegerin levels in the general population - Relation to indices of left ventricular structure and function
Plasma osteoprotegerin levels in the general population - Relation to indices of left ventricular structure and function
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DOI：
10.1161/hypertensionaha.107.087742
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发表时间：
2007-06-01
期刊：
影响因子：
8.3
通讯作者：
de Lemos, James A.
中科院分区：
文献类型：
--
作者：
Omland, Torbjorn;Drazner, Mark H.;de Lemos, James A.
骨保护素是肿瘤坏死因子受体超家族的成员，对骨代谢、内分泌功能和免疫系统具有多效性作用。心力衰竭时心肌骨保护素表达和循环水平增加。普通人群中骨保护素水平与左心室结构和功能指标之间的关系尚不清楚。在达拉斯心脏研究中纳入的2715例受试者（中位年龄：44岁; 45%为男性）中，可获得血浆骨保护素水平和左心室结构和功能的心脏MRI指数。通过线性回归分析评估骨保护素浓度与左心室结构和功能指数之间的相关性，调整可能的混杂因素。通过性别特异性线性回归分析，较高的骨保护素水平与较高的左心室质量、左心室壁厚度、左心室同心度指数和较低的左心室射血分数显著相关（均P < 0.001）。在调整了年龄、种族、去脂体重、脂肪量、高血压、糖尿病、冠状动脉疾病、估计肾小球滤过率、高胆固醇血症、吸烟状况、激素替代治疗、冠状动脉钙评分> 10和主动脉斑块存在后，在男性受试者中，骨保护素仍然与这些左心室指数中的每一个显著相关（每个P < 0.05）。在女性受试者中，较高的骨保护素与较高的左心室收缩末期容积和较低的射血分数独立相关（P < 0.0001），但与左心室肥大指数无关。这些发现与骨保护素可能在左心室肥大和收缩功能障碍的发展中发挥病理生理作用的理论是一致的。
Osteoprotegerin, a member of the tumor necrosis factor receptor superfamily, has pleiotropic effects on bone metabolism, endocrine function, and the immune system. Myocardial expression and circulating levels of osteoprotegerin are increased in heart failure. The relationship between osteoprotegerin levels in the general population and indices of left ventricular structure and function is unknown. Plasma osteoprotegerin levels and cardiac MRI indices of left ventricular structure and function were available in 2715 subjects (median age: 44 years; 45% male) enrolled in the Dallas Heart Study. The associations between osteoprotegerin concentration and indices of left ventricular structure and function were assessed by linear regression analysis, adjusting for possible confounders. By gender-specific linear regression analysis, higher osteoprotegerin levels were significantly associated with higher left ventricular mass, left ventricular wall thickness, left ventricular concentricity index, and lower left ventricular ejection fraction (P < 0.001 for all). After adjustment for age, race, fat-free mass, fat mass, hypertension, diabetes, coronary artery disease, estimated glomerular filtration rate, hypercholesterolemia, smoking status, hormone replacement therapy, coronary artery calcium score > 10, and presence of aortic plaque, osteoprotegerin remained significantly associated with each of these left ventricular indices among male subjects (P < 0.05 for each). Among female subjects, higher osteoprotegerin was independently associated with higher left ventricular end-systolic volume and lower ejection fraction (P < 0.0001 for each) but not with indices of left ventricular hypertrophy. These findings are compatible with the theory that osteoprotegerin may play a pathophysiological role in the development of left ventricular hypertrophy and systolic dysfunction.