Plasma Levels of Fetuin-A and Risk of Coronary Heart Disease in US Women: The Nurses' Health Study

被引:19
|
作者
Sun, Qi [1 ,3 ]
Jimenez, Monik C. [2 ]
Townsend, Mary K. [1 ]
Rimm, Eric B. [1 ,3 ,4 ]
Manson, JoAnn E. [1 ,2 ,4 ]
Albert, Christine M. [2 ]
Rexrode, Kathryn M. [2 ]
机构
[1] Brigham & Womens Hosp, Dept Med, Channing Div Network Med, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Dept Med, Div Prevent Med, Boston, MA 02115 USA
[3] Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
[4] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA
来源
JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2014年 / 3卷 / 03期
基金
美国国家卫生研究院;
关键词
coronary heart disease; fetuin-A; inflammation; INCIDENT DIABETES-MELLITUS; LOW SERUM FETUIN; ARTERY CALCIFICATION; CARDIOVASCULAR CALCIFICATION; INFLAMMATORY MARKERS; ASSOCIATION; MORTALITY; DIALYSIS; ADULTS; ATHEROSCLEROSIS;
D O I
10.1161/JAHA.114.000939
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Fetuin-A may be involved in the etiology of coronary heart disease (CHD) through opposing pathways (ie, promoting insulin resistance and inhibiting ectopic calcification). We aimed to explicitly examine whether systemic inflammation, a factor leading to elevated vascular calcification, may modify the association between fetuin-A and CHD risk. Method and Results-During 16 years of follow-up (1990-2006), we prospectively identified and confirmed 466 incident fatal or nonfatal CHD case in the Nurses' Health Study. For each case, 1 healthy control was selected using risk-set sampling from 26 245 eligible participants. Cases and controls were matched for age, smoking status, fasting status, and date of blood draw. After multivariate adjustment for lifestyle factors, body mass index, diet, and blood lipids, fetuin-A levels were not associated with CHD risk in the whole population: odds ratio (OR) (95% CI) comparing extreme quintiles of fetuin-A was 0.79 (0.44 to 1.40). However, a significant inverse association was observed among participants with higher C-reactive protein levels (Pinteraction=0.04). The OR (95% CI) comparing highest versus lowest quintiles of fetuin-A was 0.50 (0.26 to 0.97; Ptrend=0.004) when C-reactive protein levels were above population median (0.20 mg/dL), whereas among the remainder of the participants, the corresponding OR (95% CI) was 1.09 (0.58 to 2.05; Ptrend=0.75). Conclusions-In this population of US women, fetuin-A levels were associated with lower CHD risk when C-reactive protein levels were high, but null association was observed among participants with lower C-reactive protein levels. This divergent pattern of association needs replication in future studies.
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页数:10
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