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【文摘发布】本期AJRCCM：COPD中的动脉硬化及骨质
Author:Ramsey Sabit, Charlotte E. Bolton, Peter H
Abstract:
Rationale: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular events and osteoporosis. Increased arterial stiffness is an independent predictor of cardiovascular disease.
Objectives: We tested the hypothesis that patients with COPD would have increased arterial stiffness, which would be associated with osteoporosis and systemic inflammation.
Methods: We studied 75 clinically stable patients with a range of severity of airway obstruction and 42 healthy smoker or ex-smoker control subjects, free of cardiovascular disease. All subjects underwent spirometry, measurement of aortic pulse wave velocity (PWV) and augmentation index, dual-energy X-ray absorptiometry, and blood sampling for inflammatory mediators.
Measurements and Main Results: Mean (SD) aortic PWV was greater in patients, 11.4 (2.7) m/s, than in control subjects, 8.95 (1.7) m/s, p < 0.0001. Inflammatory mediators and augmentation index were also greater in patients. Patients with osteoporosis at the hip had a greater aortic PWV, 13.1 (1.8) m/s, than those without, 11.2 (2.7) m/s, p < 0.05. In patients, aortic PWV was related to age (r = 0.63, p < 0.0001) and log10 IL-6 (r = 0.31, p < 0.01), and inversely to FEV1 (r = –0.34, p < 0.01). The strongest predictors of aortic PWV in all subjects were age (p < 0.0001), percent predicted FEV1 (p < 0.05), mean arterial pressure (p < 0.05), and log10 IL-6 (p < 0.05).
Conclusions: Increased arterial stiffness was related to the severity of airflow obstruction and may be a factor in the excess risk for cardiovascular disease in COPD. The increased aortic PWV in patients with osteoporosis and the association with systemic inflammation suggest that age-related bone and vascular changes occur prematurely in COPD.
Key Words: chronic obstructive pulmonary disease • cardiovascular disease • arterial stiffness • osteoporosis • systemic inflammation
AT A GLANCE COMMENTARY
Scientific Knowledge on the Subject
Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease and osteoporosis even when confounding factors are taken into account. The mechanisms linking COPD and cardiovascular disease are not known.
What This Study Adds to the Field
The excess cardiovascular risk in COPD may be due to increased arterial stiffness, which is related to airflow obstruction, systemic inflammation, and the presence of osteoporosis.
Am. J. Respir. Crit. Care Med. 2007; 175: 1259-1265. 心肺一家，互相影响。是否还应该考虑低氧对血管壁的影响呢 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title:Arterial Stiffness and Osteoporosis in Chronic Obstructive Pulmonary Disease
题目：慢性阻塞性肺部疾患中的动脉硬化和骨质疏松
Author:Ramsey Sabit, Charlotte E. Bolton, Peter H
Abstract:
摘要：
Rationale: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular events and osteoporosis. Increased arterial stiffness is an independent predictor of cardiovascular disease.
原理：慢性阻塞性肺部疾患（COPD）是和心血管疾病及骨质疏松升高的危险联系在一起的。进行性动脉硬化是心血管疾病的一个独立先兆。
Objectives: We tested the hypothesis that patients with COPD would have increased arterial stiffness, which would be associated with osteoporosis and systemic inflammation.
目的：我们检验这样一个假设，即患有COPD的病人患动脉硬化的危险会升高，动脉硬化和骨质疏松、全身性感染有关联。
Methods: We studied 75 clinically stable patients with a range of severity of airway obstruction and 42 healthy smoker or ex-smoker control subjects, free of cardiovascular disease. All subjects underwent spirometry, measurement of aortic pulse wave velocity (PWV) and augmentation index, dual-energy X-ray absorptiometry, and blood sampling for inflammatory mediators.
方法：我们研究了75例具有一定严重性的临床稳定期气道阻塞病人，42例吸烟或已经戒烟且没有心血管疾病的健康人作为对照。所有的研究对象接受肺量测定法，测量主动脉脉冲速度和增强指数，双能X线吸收仪和采集血样分析炎性介质。
Measurements and Main Results: Mean (SD) aortic PWV was greater in patients, 11.4 (2.7) m/s, than in control subjects, 8.95 (1.7) m/s, p < 0.0001. Inflammatory mediators and augmentation index were also greater in patients. Patients with osteoporosis at the hip had a greater aortic PWV, 13.1 (1.8) m/s, than those without, 11.2 (2.7) m/s, p < 0.05. In patients, aortic PWV was related to age (r = 0.63, p < 0.0001) and log10 IL-6 (r = 0.31, p < 0.01), and inversely to FEV1 (r = –0.34, p < 0.01). The strongest predictors of aortic PWV in all subjects were age (p < 0.0001), percent predicted FEV1 (p < 0.05), mean arterial pressure (p < 0.05), and log10 IL-6 (p < 0.05).
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作者:admin@医学,生命科学 2011-03-28 17:11
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