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JAHA:高水平的脂质标记物或和心脏病患者的死亡风险升高相关

  1. JAHA
  2. 心脏病
  3. 患者
  4. 死亡风险
  5. 脂质标记物

来源:生物谷 2014-03-13 23:54

来自贝勒医学院研究者的最新研究表明,一种名为Gb3的新型标志物和心脏病患者的存活直接相关。

2014年3月14日 讯 /生物谷BIOON/ --近日,来自贝勒医学院研究者的最新研究表明,一种名为Gb3的新型标志物和心脏病患者的存活直接相关,相关研究刊登于国际杂志Journal of the American Heart Association上,该研究或为改变影响某些国家的头号杀手疾病的监控策略提供一定帮助。

文章中研究者发现,尿脂球形三脂酰基鞘鞍醇(Gb3)水平较高的患者其因为心脏病导致的短期内死亡风险较高;因此尿液中Gb3的升高就可以指示心脏疾病和机体器官中脂质异常之间的关系。

研究者Schiffmann表示,奇怪的是,我们发现某些心脏病患者,其虽然未患法布瑞氏症,但在其尿液中也存在较高水平的Gb3,与此同时我们也发现在前不久刚经过筛查的患者出现了部分死亡的现象。经过深入研究我们揭示了,相比正常个体而言,尿液中高水平Gb3的心脏病患者或许面临较高的死亡风险。

到目前为止,Gb3被认为是检测法布瑞氏症的标志,而本文的研究则发现Gb3或许也可以作为指示心脏病患者的死亡风险;研究者表示后期还会进行更为深入的研究来解释Gb3和其它脂质作为个体心脏病生物标记中的作用。(生物谷Bioon.com)

Risk of Death in Heart Disease is Associated With Elevated Urinary Globotriaosylceramide

Raphael Schiffmann, MD; Sabrina Forni, MS; Caren Swift, RN; Nastry Brignol, PhD; Xiaoyang Wu, PhD; David J. Lockhart, PhD; Derek Blankenship, PhD; Xuan Wang, PhD; Paul A. Grayburn, MD; Matthew R. G. Taylor, MD, PhD; Brian D. Lowes, MD, PhD; Maria Fuller, PhD; Elfrida R. Benjamin, PhD; Lawrence Sweetman, PhD

Background Elevated urinary globotriaosylceramide (Gb3) has been considered a hallmark of Fabry disease, an X‐linked lysosomal disorder that is a risk factor for most types of heart disease. Methods and Results We screened 1421 consecutive patients with common forms of heart disease for Fabry disease by measuring urinary Gb3 in whole urine using tandem mass spectrometry, α‐galactosidase A activity in dried blood spots, and we looked for GLA mutations by parallel sequencing of the whole gene (exons and introns) in pooled genomic DNA samples followed by Sanger sequencing verification. GLA variants were found in 13 patients. In the 1408 patients without GLA mutations, urinary Gb3 levels were significantly higher in heart disease patients compared to 116 apparently healthy controls (median difference=10.0 ng/mL and P<0.001). Urinary lipid profiling showed that levels of 5 other lipids significantly distinguished between urine of patients with Fabry disease (n=7) and heart disease patients with elevated urinary Gb3 (n=6). Sphingomyelin and Gb3 levels were abnormal in the left ventricular wall of patients with ischemic heart failure. Elevated levels of urinary Gb3 were independently associated with increased risk of death in the average follow‐up of 17 months (hazard ratio=1.59 for increase in Gb3 of 200, 95% CI=1.36 and 1.87, and P<0.0001). Conclusions In heart disease patients who do not have Fabry disease or GLA gene mutations, a higher level of urinary Gb3 is positively associated with near‐term mortality. The elevation of urinary Gb3 and that of other lipids suggests that heart disease is associated with multiorgan lipid abnormalities. Clinical Trial Registration URL: clinicaltrials.gov. Unique Identifier: NCT01019629.

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