尿异前列腺素与亚临床动脉粥样硬化的关系:动脉粥样硬化的多民族研究(MESA)

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE Atherosclerosis plus Pub Date : 2023-03-01 DOI:10.1016/j.athplu.2022.12.002

Ryan L. Wallace , Oluseye Ogunmoroti , Di Zhao , Dhananjay Vaidya , Amir Heravi , Eliseo Guallar , Chiadi E. Ndumele , Joao A.C. Lima , Pamela Ouyang , Matthew J. Budoff , Matthew Allison , Isac Thomas , Oluwaseun E. Fashanu , Ron Hoogeveen , Wendy S. Post , Erin D. Michos

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引用次数: 0

摘要

背景尿异丙肾上腺素是全身氧化应激的标志物，与动脉粥样硬化性心血管疾病（ASCVD）的发病机制有关。冠状动脉钙（CAC）、胸主动脉钙（TAC）和颈动脉斑块是亚临床动脉粥样硬化和预测ASCVD风险的指标。我们在动脉粥样硬化多民族研究的一个队列中，研究了尿异丙肾上腺素水平与三个血管床上斑块患病率、负荷、发病率和进展指标之间的关系。方法在基线时测量1089名参与者（平均值±SD 62±8岁，48%为女性）的尿8-异丙酮和2,3-二Nor-8-F2-异丙酮水平。参与者接受了CAC和TAC的计算机断层扫描，以及颈动脉斑块的双重超声检查。TAC和CAC分别在2.4年和10年时重新评估。对CVD危险因素的回归模型进行了调整。结果在调整后的模型中，异丙肾上腺素水平与CAC患病率或进展之间没有显著相关性。8-异丙肾上腺素的最高和最低三分位数与基线时TAC下降的患病率降低28%相关[患病率（PR）0.72 95%CI（0.56、0.94）]，而1-SD较高的2,3-二nor-8-F2-异丙酮与随访时TAC上升事件增加96%有关[相对风险1.96（1.24，3.09）]。异丙酮测量的最高和最低三分位数与颈动脉斑块发生率增加22%有关[（PR 1.22（1.04，1.45）]，与基线时颈动脉斑块扩大程度的14%差异[3，26]。结论高尿异丙肾上腺素与某些亚临床动脉粥样硬化的影像学指标不一致。这表明尿异丙肾上腺素水平作为ASCVD发展的预后标志物的作用有限。试验注册MESA队列设计在clinicaltrials.gov上注册如下：https://clinicaltrials.gov/ct2/show/NCT00005487.

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Associations of urinary isoprostanes with measures of subclinical atherosclerosis: The Multi-Ethnic Study of Atherosclerosis (MESA)

Background

Urinary isoprostanes are markers of systemic oxidative stress, which is implicated in the pathogenesis of atherosclerotic cardiovascular disease (ASCVD). Coronary artery calcium (CAC), thoracic aortic calcium (TAC) and carotid plaque are measure subclinical atherosclerosis and prognosticate ASCVD risk. We examined the associations between urinary isoprostane levels and measures of plaque prevalence, burden, incidence and progression across three vascular beds in a cohort from the Multi-Ethnic Study of Atherosclerosis.

Methods

Urinary levels of 8-isoprostane and 2,3-dinor-8-F₂-isoprostane were measured in 1089 participants (mean ± SD 62 ± 8 years, 48% women) at baseline. Participants underwent computed tomography for CAC and TAC, and duplex ultrasound for carotid plaque. TAC and CAC were reassessed at 2.4 and 10 years, respectively. Regression models were adjusted for CVD risk factors.

Results

In adjusted models, there were no significant associations between isoprostane levels with CAC prevalence or progression. Highest versus lowest tertile of 8-isoprostane was associated with 28% lower prevalence of descending TAC at baseline [prevalence ratio (PR) 0.72 95% CI (0.56, 0.94)], while 1-SD higher 2,3-dinor-8-F₂-isoprostane was associated with 96% higher incident ascending TAC at follow-up [Relative Risk 1.96 (1.24, 3.09)]. Highest versus lowest tertile of isoprostane measures were associated with 22% higher prevalence of carotid plaque [(PR 1.22 (1.04, 1.45)] and 14% difference [3,26] in greater extent of carotid plaque at baseline.

Conclusions

Higher urinary isoprostanes were inconsistently associated with some measures of subclinical atherosclerosis by imaging. This suggests a limited role of urinary isoprostane levels as a prognostic marker for the development of ASCVD.