Cytomegalovirus infection, lipoprotein(a), and hypercoagulability: an atherogenic link?
Cytomegalovirus infection, lipoprotein(a), and hypercoagulability: an atherogenic link?
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巨细胞病毒感染、脂蛋白(a) 和高凝状态：致动脉粥样硬化的联系？
DOI：
10.1161/01.atv.17.9.1780
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Szklo,M
中科院分区：
文献类型：
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作者：
Nieto,FJ;Sorlie,P;Comstock,GW;Wu,K;Adam,E;Melnick,JL;Szklo,M
实验、临床和流行病学研究表明巨细胞病毒（CMV）感染与动脉粥样硬化之间存在联系。我们调查了1974年在马里兰州华盛顿县收集的300名成年居民血清中CMV抗体滴度与1987年至1989年收集的血浆中止血参数之间的相关性，当时这些人参加了社区动脉粥样硬化风险研究的基线检查。在另一组社区动脉粥样硬化风险病例和对照组中，还探讨了CMV血清抗体和止血参数的横断面相关性。在纵向分析中，1974年的CMV滴度与1987年至1989年的血浆血管性血友病因子、因子VIII和蛋白C水平直接相关，与活化部分凝血活酶时间呈负相关。在横断面分析中，CMV滴度与抗凝血酶III和纤维蛋白原水平直接相关。当分层分析CMV抗体和动脉粥样硬化之间的关联时，一个显著的关联仅限于脂蛋白（a）和纤维蛋白原水平高的个体。这些结果与先前的证据表明CMV病毒可能具有促凝血特性是一致的。CMV感染和由此导致的高凝状态与由于脂蛋白（a）水平升高导致的纤维蛋白溶解降低可能存在协同作用，值得进一步研究。
A link between cytomegalovirus (CMV) infection and atherosclerosis has been suggested by experimental, clinical, and epidemiologic studies. We investigated the association between CMV antibody titers in serum collected in 1974 in 300 adult residents in Washington County, Md, and hemostatic parameters in plasma collected in 1987 through 1989, when these individuals participated in the baseline examination of the Atherosclerosis Risk in Communities Study. The cross-sectional association of CMV serum antibodies and hemostatic parameters was also explored in another set of Atherosclerosis Risk in Communities cases and controls. In the longitudinal analyses, CMV titers in 1974 were directly associated with 1987 through 1989 plasma levels of von Willebrand factor, factor VIII, and protein C and negatively associated with activated partial thromboplastin time. In the cross-sectional analyses, CMV titers were directly related to antithrombin III and fibrinogen levels. When the association between CMV antibodies and atherosclerosis was examined in stratified analyses, a significant association was restricted to individuals with high levels of lipoprotein(a) and fibrinogen. These results are compatible with previous evidence suggesting that CMV virus might have procoagulant properties. The possible synergism of CMV infection and resulting hypercoagulability with reduced fibrinolysis due to increased lipoprotein(a) levels deserves further investigation.