Distribution and correlates of lipoprotein-associated phospholipase A2 in an elderly cohort:: The Cardiovascular Health Study
Distribution and correlates of lipoprotein-associated phospholipase A2 in an elderly cohort:: The Cardiovascular Health Study
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DOI：
10.1111/j.1532-5415.2008.01667.x
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发表时间：
2008-05-01
影响因子：
6.3
通讯作者：
Psaty, Bruce M.
中科院分区：
文献类型：
--
作者：
Furberg, Curt D.;Nelson, Jeanenne J.;Psaty, Bruce M.
目的：确定高水平的脂蛋白相关磷脂酶 A(2) (Lp-PLA(2)) 是否与流行的心血管疾病 (CVD) 相关，并评估社区老年人队列中最影响 Lp-PLA(2) 水平的因素。设计：横断面。背景：心血管健康研究 (CHS)，一项针对 65 岁及以上男性和女性的人群队列研究。参与者：5000 人531 名 CHS 参与者。测量：使用基线检查中储存的血液样本测定 Lp-PLA(2) 活性水平。结果：心电图确定心室传导缺陷和主要 Q 波异常的参与者的平均 Lp-PLA(2) 较高，并且与左心室 (LV) 质量呈正相关。在超声心动图确定左心室射血分数异常的患者中，该值较高，且在调整后仍持续存在。患有轻度肾功能不全和肾脏疾病的参与者的平均 Lp-PLA(2) 也较高。多变量调整后，Lp-PLA(2) 每增加一个标准差，流行性 CHF 的风险就会适度但显着增加 27%，流行性心肌梗死的风险会适度但显着增加 12%。 Lp-PLA(2) 与胆固醇和脂蛋白的相关性较弱，但主要是最强的，但这些相关性并不是特别强。 Lp-PLA(2)与可溶性细胞间粘附分子1呈弱正相关，但与白细胞介素6无关。总的来说，所有考虑的因素只能解释 29% 的 Lp-PLA(2) 活性。 结论：该研究的新发现是，在 65 岁及以上的人群中，Lp-PLA(2) 活性与左室功能障碍、CHF 和肾脏疾病之间存在关联。 CVD 危险因素只能最低限度地解释 Lp-PLA 水平(2)。
OBJECTIVES: To determine whether high levels of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) are associated with prevalent cardiovascular disease (CVD) and to evaluate factors most influencing Lp-PLA(2) levels in a community-based cohort of older adults.DESIGN: Cross-sectional.SETTING: The Cardiovascular Health Study (CHS), a population-based cohort study of men and women aged 65 and older.PARTICIPANTS: Five thousand five hundred thirty-one CHS participants.MEASUREMENTS: Levels of Lp-PLA(2) activity were determined using stored blood samples from the baseline examination.RESULTS: Mean Lp-PLA(2) was higher in participants with electrocardiographically determined ventricular conduction defect and major Q-wave abnormality and was positively correlated with left ventricular (LV) mass. It was high in those with echocardiographically determined abnormal LV ejection fraction, which persisted after adjustment. Mean Lp-PLA(2) was also higher in participants with mild renal insufficiency and kidney disease. After multivariable adjustment, there was a modest but significant 27% greater risk of prevalent CHF per standard deviation increment of Lp-PLA(2) and a modest but significant 12% greater risk of prevalent myocardial infarction. Lp-PLA(2) was weakly but mainly most strongly correlated with cholesterol and lipoproteins, but those correlations were not especially strong. Lp-PLA(2) was weakly positively correlated with soluble intercellular adhesion molecule-1 but not interleukin-6. In total, all factors considered could explain only 29% of Lp-PLA(2) activity.CONCLUSION: Novel findings in the study are the associations, in those aged 65 and older, between Lp-PLA(2) activity and LV dysfunction, CHF, and renal disease. CVD risk factors only minimally explain levels of Lp-PLA(2).