睡眠时间与冠心病发病及死亡风险前瞻性研究的Meta分析

目的:通过常规Meta分析和量效Meta分析评估睡眠时间与冠心病发病及死亡风险的相关性.方法:计算机检索EMBASE、PubMed、Cochrane、Web of Science、万方、维普、中国生物医学文献数据库及中国知网数据库,筛选关于睡眠时间与冠心病相关性的前瞻性队列研究文献,并将长睡眠时间和短睡眠时间分别定义为...     

脂联素与冠心病及其危险因素的研究进展

脂联素是脂肪组织特异性分泌的一种激素蛋白。研究表明,脂联素在冠心病发生和发展中起调控和保护作用并且在控制冠心病危险因素方面也起重要作用。现主要论述脂联素与冠心病及其危险因素方面的研究进展。     

Periodontal Disease and Coronary Heart Disease Incidence: A Systematic Review and Meta-analysis

BACKGROUND  Periodontal disease is common among adults in the US and is a potential source of chronic inflammation. Recent data have suggested an important role for chronic inflammation in the development of coronary heart disease (CHD). OBJECTIVE  To aid the United States Preventive Services Task Force (USPSTF) in evaluating whether periodontal disease is an independent novel risk factor for incident CHD. METHODS  Studies were identified by searching Medline (1966 through March 2008) and reviewing prior systematic reviews, reference lists, and consulting experts. Prospective cohort studies that assessed periodontal disease, Framingham risk factors, and coronary heart disease incidence in the general adult population without known CHD were reviewed and quality rated using criteria developed by the USPSTF. Meta-analysis of good and fair quality studies was conducted to determine summary estimates of the risk of CHD events associated with various categories of periodontal disease. RESULTS  We identified seven articles of good or fair quality from seven cohorts. Several studies found periodontal disease to be independently associated with increased risk of CHD. Summary relative risk estimates for different categories of periodontal disease (including periodontitis, tooth loss, gingivitis, and bone loss) ranged from 1.24 (95% CI 1.01–1.51) to 1.34 (95% CI 1.10–1.63). Risk estimates were similar in subgroup analyses by gender, outcome, study quality, and method of periodontal disease assessment. CONCLUSION  Periodontal disease is a risk factor or marker for CHD that is independent of traditional CHD risk factors, including socioeconomic status. Further research in this important area of public health is warranted.     

冠心病与妊娠相关血浆蛋白A的Meta分析

目的探讨冠心病与妊娠相关血浆蛋白A(PAPP-A)的关系,指导临床工作。方法从中国期刊网全文数据库和Pubmed等外文专业数据库中收录的2001～2012年有关妊娠相关血浆蛋白A与冠心病相关分析文献中,纳入符合条件的文献,应用RevMan 5.0软件进行分析。结果本研究共纳入10项研究,包括1 091例研究对象。结果显示,稳定型心绞痛和PAPP-A水平的关系:95%CI为0.02、0.34(P=0.03);不稳定型心绞痛和PAPP-A水平的关系:95%CI为1.32、1.74(P<0.01);急性心肌梗死和PAPP-A水平的关系:95%CI为1.83、2.38(P<0.01);冠状动脉1支病变和PAPP-A水平的关系:95%CI为1.78、2.50(P<0.01);冠状动脉2支病变和PAPP-A水平的关系:95%CI为1.83、7.72(P<0.01);冠状动脉3支病变和PAPP-A水平的关系:95%CI为2.39、3.26(P<0.01)。结果表明冠心病及冠状动脉病变的支数与妊娠相关血浆蛋白A高度相关,均有统计学意义。结论冠心病及冠状动脉病变的支数均与妊娠相关血浆蛋白A有密切的关系。     

Prediagnostic Plasma Antibody Levels to Periodontopathic Bacteria and Risk of Coronary Heart Disease

Many epidemiological studies have indicated that periodontitis is an important risk factor for coronary heart disease (CHD). We examined whether plasma antibody levels to 3 major periodontal pathogens, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia predicted the risk of CHD events. A nested case-control research design (case: n = 191, control: n = 382), by matching gender, age, study area, date of blood collection, and time since last meal at blood collection, was employed in a large cohort of Japanese community residents.Antibody levels of periodontopathic bacteria were associated with risk of CHD after adjusting for BMI, smoking status, alcohol intake, history of hypertension, history of diabetes mellitus, exercise during leisure time, and perceived mental stress. The association was different by age subgroup. For subjects aged 40-55 years, the medium (31.7-184.9 U/mL) or high tertile plasma antibody level (> 184.9 U/mL) of A. actinomycetemcomitans showed higher risk of CHD (medium: OR = 3.72; 95% CI = 1.20-11.56, high: OR = 4.64; 95% CI = 1.52-14.18) than the low tertile level (< 31.7 U/mL). The ORs of CHD incidence became higher with an increase in IgG level of A. actinomycetemcomitans (P for trend = 0.007). For subjects aged 56-69 years, the high tertile level (> 414.1 U/mL) of P. intermedia was associated with higher risk of CHD (OR = 2.65; 95% CI = 1.18-5.94) in a dose-response fashion (P for trend = 0.007). The possible role of periodontopathic bacteria as a risk factor for CHD incidence was suggested by the results of this study by the elevated antibody level to these bacteria with the increased risk of CHD.     

血浆氧化三甲胺水平对冠心病患者预后的预测作用:剂量-反应Meta分析

目的:探讨冠心病患者的血浆氧化三甲胺(TMAO)水平与主要不良心血管事件(MACE)以及全因死亡风险之间的关系.方法:计算机检索2020年7月前发表并收录在PubMed、EMBASE、中国知网、万方等数据库中评估冠心病患者血浆TMAO水平与MACE(心血管死亡、心肌梗死、脑卒中、血管重建、再入院)及全因死亡风险相关性的...     

脂蛋白相关磷脂酶A2与冠心病风险的预测

脂蛋白相关磷脂酶A:主要由巨噬细胞和淋巴细胞产生,大部分与低密度脂蛋白结合,能水解低密度脂蛋白上的氧化磷脂,产生溶血卵磷脂和氧化游离脂肪酸,促进炎症和动脉粥样硬化的发生发展,可作为冠心病危险的独立预测因子.     

脂联素与冠心病研究进展

脂联素是近年来新发现的一种脂肪因子,血浆中脂联素含量丰富。在有冠心病危险因素,如糖尿病、代谢综合征的病人中,脂联素水平明显下降。因具有抗炎、抗动脉粥样硬化作用脂联素近来成为研究的热点,脂联素浓度与冠心病特别是急性冠脉综合征进程密切相关,脂联素浓度测定有可能成为冠心病危险性的评估因素。通过药物干预提高血浆脂联素浓度可能成为一种新的冠心病治疗方法。     

新的冠心病危险因素

传统冠心病危险因素如高血压、糖尿病、高胆固醇血症不能完全解释所有冠心病的病因。目前,对新的危险因素如炎症、促凝物质、氧化低密度脂蛋白、小而密的低密度脂蛋白、脂蛋白(a)、感染、高同型半胱氨酸血症、高尿酸血症等在冠心病发生发展中的深入研究,加深了对冠心病发病机制的认识,提示临床上治疗冠心病时,除了控制传统的冠心病危险因素外,应加强对新的冠心病危险因素的干预。     

Urinary Stones and Risk of Coronary Heart Disease and Stroke: the Japan Public Health Center-Based Prospective Study

Aim: Evidence is lacking about whether urinary stones are associated with the subsequent risk of cardiovascular diseases. Herein, we investigated the association between history of urinary stones and the risk of coronary heart disease (CHD) and stroke among middle-aged Japanese.Methods: This cohort study included 89,037 Japanese men and women (45–74 years) registered in the Japan Public Health Center-based prospective study. Cox proportional hazard models were used to calculate the hazard ratios (HRs) and their 95% confidence intervals (CIs) for incident CHD and stroke among Japanese adults with a self-reported history of urinary stones compared with those without it. The following covariates were included in the regression models: age, sex, area, body mass index, and histories of hypertension, diabetes, hyperlipidemia, smoking habit, alcohol intake, and physical activity.Results: In total, 1.31% of Japanese adults reported a positive history of urinary stones. Throughout a median follow-up period of 12 years, 1.16% of Japanese adults developed CHD, and 4.96% developed stroke. No associations were detected between history of urinary stones and the risk of CHD (HR 1.04; 95% CI: 0.64–1.67), stroke (HR 0.92; 95% CI: 0.71–1.20), or total CVD (HR 0.95; 95% CI: 0.75–1.19). Younger urinary stone formers (45–59 years) tended to have a higher, though statistically insignificant, risk of CHD than older urinary stone formers (60–74 years): [(HR 1.15; 95% CI: 0.61–2.15) versus (HR 0.83; 95% CI: 0.40–1.76)], respectively.Conclusion: The history of urinary stones was shown to be not associated with the risk of CVD among Japanese adults.     

脂联素水平及基因多态性与冠心病的关系

目的:探讨脂联素(APN)水平及其单核苷酸基因多态性(SNP)+45T/G和+276G/T 2个位点与冠心病(CHD)的关系.方法:将195例研究对象分为正常对照组和CHD组,采用实验-对照研究方法,应用酶联免疫吸附法(ELISA)及聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术,对血浆APN浓度及APN 2个位点基因多态性进行检测.结果:2组比较,CHD组APN降低(P<0.05);CHD组SNP+45 TG+GG基因型和G等位基因的分布频率明显低于正常对照组,差异具有统计学意义(P<0.05);基因SNP+276多态性位点各基因型频率与等位基因频率在2组之间差异均无统计学意义(P>0.05).结论:CHD患者APN水平下降,SNP+45 G等位基因可能为CHD的保护因素;SNP+276位点基因多态性可能与CHD的发生无明显相关性.     

冠心病患者血浆同型半胱氨酸水平变化的临床特点

目的研究冠心病患者血浆同型半胱氨酸(Hcy)水平变化的临床特点.方法采用高压液相色谱法测定209例冠心病患者(冠心病组)和101例正常人(正常对照组)血浆Hcy水平.结果冠心病组血浆Hcy水平(23.42±26.87μmol/L)明显高于正常对照组(14.98±13.05μmol/L),有非常显著差异(P＜0.001),高Hcy血症所占比例(47.5%)高于正常对照组(20.6%),有非常显著差异(P＜0.001).冠心病组男性血浆总Hcy水平(24.85±28.38μmol/L)高于正常对照组男性(15.54±12.85μmnol/L),有非常显著差异(P＜0.001),而在冠心病女性(13.33±4.88μmnol/L)和正常对照组女性(13.23±13.75μmol/L)之间没有差异.并且,急性心肌梗塞患者血浆总Hcy水平明显高于心绞痛患者,零支、单支、双支、三支血管有病变者血浆总Hcy水平呈逐级上升趋势.结论我国冠心病患者血浆总Hcy水平明显升高,高Hcy血症所占比例较大,而Hcy对冠心病患者的影响主要在男性可能更明显.