Lung function and cardiovascular risk -: Relationship with inflammation-sensitive plasma proteins

被引：221

作者：

Engström, G ^{[1
]}

Lind, P

Hedblad, B

Wollmer, P

Stavenow, L

Janzon, L

Lindgärde, F

机构：

[1] Malmo Univ Hosp, Dept Community Med, S-20502 Malmo, Sweden

[2] Malmo Univ Hosp, Dept Internal Med, S-20502 Malmo, Sweden

[3] Malmo Univ Hosp, Dept Vasc Dis, S-20502 Malmo, Sweden

[4] Malmo Univ Hosp, Dept Clin Physiol, S-20502 Malmo, Sweden

来源：

CIRCULATION | 2002年 / 106卷 / 20期

关键词：

forced vital capacity; epidemiology; inflammation;

D O I：

10.1161/01.CIR.0000037220.00065.0D

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background-The inverse relationship between pulmonary function and incidence of cardiovascular disease remains largely unexplained. This prospective study explored the hypothesis of a relationship with inflammation-sensitive plasma proteins. Methods and Results-Forced vital capacity (FVC) and plasma levels of fibrinogen, alpha(1)-antitrypsin, haptoglobin, ceruloplasmin, and orosomucoid were determined in 5064 healthy men aged 28 to 61 years. All-cause mortality, cardiovascular mortality, and incidence of myocardial infarction were monitored over a mean follow-up period of 18.4 years. Low FVC (fourth quartile) was associated with higher protein levels and with increased incidences of myocardial infarction and cardiovascular death. Adjustments for protein levels reduced the age-adjusted relative risks (RRs) for myocardial infarction (from 1.99, 95% CI 1.5 to 2.6, to 1.70, 95% CI 1.3 to 2.2) and cardiovascular death (from 2.71, 95% CI 1.9 to 3.9, to 2.28, 95% CI 1.6 to 3.3) among men with low FVC, corresponding to approximate to25% of the excess risk. The risk factor-adjusted RRs were reduced from 1.45 (95% CI 1.1 to 1.9) to 1.38 (95% CI 1.1 to 1.8) and from 1.96 (95% CI 1.4 to 2.8) to 1.85 (95% CI 1.3 to 2.7) for myocardial infarction and cardiovascular death, respectively, corresponding to approximate to10% to 15% of the excess risk. Among men with low FVC, the risk factor-adjusted RR for myocardial infarction was 2.5 (95% CI 1.7 to 3.6) for those with high protein levels (greater than or equal to2 proteins in top quartile) and 1.7 (95% CI 1.1 to 2.4) for those with low protein levels (less than or equal to1 protein in top quartile; reference, top quartile of FVC and low protein levels). Conclusions-FVC is significantly and inversely associated with plasma levels of inflammation-sensitive plasma proteins. This relationship contributes to but cannot fully explain the increased cardiovascular risk among men with low FVC.

引用

页码：2555 / 2560

页数：6

共 32 条

[11] Engstrom G., Lind P., Hedblad B., Et al., The effects of cholesterol and inflammation-sensitive plasma proteins on incidence of myocardial infarction and stroke in men, Circulation, 105, pp. 2632-2637, (2002)
[12] Ridker P.M., Cushman M., Stampfer M.J., Et al., Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men, N Engl J Med, 336, pp. 973-979, (1997)
[13] Mendall M.A., Strachan D.P., Butland B.K., Et al., C-reactive protein: Relation to total mortality, cardiovascular mortality and cardiovascular risk factors in men, Eur Heart J, 21, pp. 1584-1590, (2000)
[14] Dahl M., Tybjaerg-Hansen A., Vestbo J., Et al., Elevated plasma fibrinogen associated with reduced pulmonary function and increased risk of chronic obstructive pulmonary disease, Am J Respir Crit Care Med, 164, pp. 1008-1011, (2001)
[15] James A.L., Knuiman M.W., Divitini M.L., Et al., Associations between white blood cell count, lung function, respiratory illness and mortality: The Busselton Health Study, Eur Respir J, 13, pp. 1115-1119, (1999)
[16] Berglund G., Nilsson P., Eriksson K.F., Et al., Long-term outcome of the Malmö preventive project: Mortality and cardiovascular morbidity, J Intern Med, 247, pp. 19-29, (2000)
[17] Standardised lung function testing: Official statement of the European Respiratory Society, Eur Respir J, 6, SUPPL. 16, pp. 25-30, (1993)
[18] Laurell C.B., Electroimmunoassay, Scand J Clin Lab Invest Suppl, 124, pp. 21-37, (1972)
[19] Professional Statistics 7.5, (1997)
[20] Engstrom G., Berglund G., Goransson M., Et al., Distribution and determinants of ischaemic heart disease in an urban population: A study from the myocardial infarction register in Malmö, Sweden, J Intern Med, 247, pp. 588-596, (2000)

← 1 2 3 4 →