Epidemiologic study on new risk factors for progression of atherosclerosis

为了研究日本人动脉粥样硬化的新危险因素，对四个社区的1648名年龄在60-74岁的男性和女性进行了超声心动图检查和候选危险因素。颈动脉粥样硬化超声和读数参照美国心血管健康研究（Cardiovascular Health Study）的方法进行标准化，该研究是一项检查动脉粥样硬化危险因素的大型队列研究。颈动脉粥样硬化的传统危险因素包括年龄、高血压、高总胆固醇、低高密度脂蛋白胆固醇、糖尿病和吸烟（颈总动脉内膜-中膜厚度>=1.1 mm，球动脉和颈内动脉>=1.5 mm）。年龄和高血压是颈总动脉和球/颈内动脉粥样硬化的常见危险因素。高总胆固醇、低高密度脂蛋白胆固醇是普通动脉粥样硬化的危险因素，而球囊/颈内动脉无危险因素。血浆纤维蛋白原或血小板聚集与颈动脉粥样硬化无关，无论是普通动脉还是球/颈动脉。作为颈动脉粥样硬化的新因素，血浆E选择（黏附分子之一）与颈总动脉粥样硬化相关。单核细胞和淋巴细胞计数，特别是记忆T细胞计数与颈总动脉粥样硬化有关。血浆同型半胱氨酸与正常血压男性颈动脉粥样硬化有关。综上所述，本研究显示高浓度的E选择素和同型半胱氨酸，以及高计数的单核细胞和记忆T细胞是动脉粥样硬化的新危险因素。

To investigate new risk factors for atherosclerosis among Japanese, the examination of echocardiograms and candidate risk factors were conducted for a total of 1,648 men and women aged 60-74 years in four communities. Sonography and reading of carotid atherosclerosis were standardized according to the methods of Cardiovascular Health Study in the United States, a large cohort study of examining of atherosclerosis risk factors.Conventional risk factors for carotid athrosclerosis (intima-media thickness >=1.1 mm for common carotid and/or >=1.5 mm for bulb and internal carotid) included age, hypertension, high total cholesterol, low HDL-cholesterol, diabetes, and smoking. Age and hypertension were common risk factors for atheorsclerosis in both common and bulb/internal carotid arteries. High total cholesterol, low HDL-cholesterol were risk factors for atherosclerosis in common arteries, but no in bulb/internal carotid arteries. Plasma fibrinogen or platelet aggregation were not associated with carotid ahthersclerosis in either common or bulb/carotid arteries. As new factors for carotid for carotid atherosclerosis, plasma E selection (one of the adhesion molecules) was associated with common carotid atherosclerosis. Counts of monocytes and lymphocyte, more specifically memory T cell lymphocytes were associated with common carotid atherosclerosis. Plasma homocysteine was associated with carotid atherosisclerosis in normotensive men.In conclusion, the present study showed high concentraions of E selectin and homocysteine, and high counts of monocytes and memory T cell as new risk factors for atherosclerosis.