银屑病患者的胆固醇流出能力与冠状动脉粥样硬化的非钙化负荷呈负相关。
Cholesterol efflux capacity in humans with psoriasis is inversely related to non-calcified burden of coronary atherosclerosis.
作者信息
Salahuddin Taufiq, Natarajan Balaji, Playford Martin P, Joshi Aditya A, Teague Heather, Masmoudi Youssef, Selwaness Mariana, Chen Marcus Y, Bluemke David A, Mehta Nehal N
机构信息
Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, CRC, Room 5-5140, Bethesda, MD 20892, USA.
National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA.
出版信息
Eur Heart J. 2015 Oct 14;36(39):2662-5. doi: 10.1093/eurheartj/ehv339. Epub 2015 Jul 18.
AIMS
Cholesterol efflux capacity (CEC) was recently shown to predict future cardiovascular (CV) events. Psoriasis both increases CV risk and impairs CEC. However, whether having poor CEC is associated with coronary plaque burden is currently unknown. We aimed to assess the cross-sectional relationship between coronary plaque burden assessed by quantitative coronary computed tomography angiography (CCTA) with CEC in a well-phenotyped psoriasis cohort.
METHODS AND RESULTS
Total burden and non-calcified burden (NCB) plaque indices were assessed in 101 consecutive psoriasis patients using quantitative software. Cholesterol efflux capacity was quantified using a cell-based ex vivo assay measuring the ability of apoB-depleted plasma to mobilize cholesterol from lipid-loaded macrophages. Cholesterol efflux capacity was inversely correlated with NCB (unadjusted β-coefficient -0.33; P < 0.001), and this relationship persisted after adjustment for CV risk factors (β -0.24; P < 0.001), HDL-C levels (β -0.22; P < 0.001), and apoA1 levels (β -0.19; P < 0.001). Finally, we observed a significant gender interaction (P < 0.001) whereby women with low CEC had higher NCB compared to men with low CEC.
CONCLUSIONS
We show that CEC is inversely associated with prevalent coronary plaque burden measured by quantitative CCTA. Low CEC may therefore be an important biomarker for subclinical coronary atherosclerosis in psoriasis.
CLINICALTRIALSGOV
NCT01778569.
目的
胆固醇流出能力（CEC）最近被证明可预测未来心血管（CV）事件。银屑病既增加心血管风险，又损害CEC。然而，CEC较差是否与冠状动脉斑块负荷相关目前尚不清楚。我们旨在评估在一个特征明确的银屑病队列中，通过定量冠状动脉计算机断层扫描血管造影（CCTA）评估的冠状动脉斑块负荷与CEC之间的横断面关系。
方法和结果
使用定量软件对101例连续的银屑病患者评估总斑块负荷和非钙化斑块负荷（NCB）指数。使用基于细胞的体外试验量化胆固醇流出能力，该试验测量载脂蛋白B缺乏的血浆从脂质负载的巨噬细胞中动员胆固醇的能力。胆固醇流出能力与NCB呈负相关（未调整的β系数为-0.33；P<0.001），在调整心血管危险因素（β为-0.24；P<0.001）、高密度脂蛋白胆固醇（HDL-C）水平（β为-0.22；P<0.001）和载脂蛋白A1水平（β为-0.19；P<0.001）后，这种关系仍然存在。最后，我们观察到显著的性别交互作用（P<0.001），即CEC低的女性与CEC低的男性相比，NCB更高。
结论
我们表明，CEC与通过定量CCTA测量的冠状动脉斑块负荷呈负相关。因此，低CEC可能是银屑病亚临床冠状动脉粥样硬化的重要生物标志物。
临床试验注册
NCT01778569。
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