目的:评估原发性开角型青光眼(POAG)的内皮功能障碍和炎症过程的诊断前标志物。
方法:从1989年至1990年在护士健康研究(女性)和1993年至1995年在卫生专业人员随访研究(男性)中收集血液样本,并确定了医疗记录证实的事件poag病例(女性:229例和455例对照;男性:116例和228例对照)。对照组在队列中进行匹配,年龄,种族,种族,癌症状态,和采血日期。ICAM-1,E-选择素的血浆浓度,和可溶性TNF受体2(sTNF-R2),与TNF-α相关的标志物,用ELISA测定。对队列特异性多变量条件logistic回归模型结果进行荟萃分析。
结果:我们没有观察到与ICAM-1或E-选择素的关联。对于sTNF-R2,病例和对照组的平均(SD)血浆水平(pg/ml)分别为2888(997)和2993(913),分别,女性;2622(664)和2569(688),分别,在男人。汇总的多变量结果显示sTNF-R2水平与POAG之间没有关系.然而,与sTNF-R2的最低三位数相比,女性的最高三位数显示POAG风险显著降低(多变量比值比[OR]=0.58,95%置信区间[CI]=0.360.93;P(趋势)=0.03),而男性则没有(P(趋势)=0.21;按性别分类的异质性P=0.03).还,在女性中,正常眼压青光眼与sTNF-R2的负相关更强(ntg;诊断时的最大眼压21mmHg):最高和最低三位数比较OR=0.29(95%CI=0.12~0.71;Ptrend=0.007).
结论:在女性中,但不是男人,诊断前6至8年sTNF-R2水平升高与POAG呈负相关,但更强烈的NTG。
OBJECTIVE: To evaluate prediagnostic markers of endothelial dysfunction and inflammatory processes in primary open-angle glaucoma (POAG).
METHODS: Blood samples were collected from 1989 to 1990 in the nurses\' health study (women) and from 1993 to 1995 in the health professionals follow-up study (men), and medical-record confirmed incident poag cases were identified (women: 229 cases and 455 controls; men: 116 cases and 228 controls). Controls were matched on cohort, age, race, ethnicity, cancer status, and date of blood collection. Plasma concentrations of ICAM-1, E-selectin, and soluble TNF receptor 2 (sTNF-R2), a marker related to TNF-α, were measured with ELISA assays. Cohort-specific multivariable conditional logistic regression model results were meta-analyzed.
RESULTS: We observed no associations with ICAM-1 or E-selectin. for sTNF-R2, the mean (SD) plasma levels (pg/ml) in cases and controls were 2888 (997) and 2993 (913), respectively, in women; and 2622 (664) and 2569 (688), respectively, in men. pooled multivariable results showed no relation between sTNF-R2 levels and POAG. however, compared with the lowest tertile of sTNF-R2, the highest tertile showed a significant decreased risk of POAG in women (multivariable odds ratio [OR] = 0.58, 95% confidence interval [CI] = 0.360.93; P(trend) = 0.03) but not in men (P(trend) = 0.21; P for heterogeneity by sex = 0.03). also, among women, the inverse association with sTNF-R2 was stronger with normal-tension glaucoma (ntg; maximum intraocular pressure 21 mm Hg at diagnosis): highest versus lowest tertile comparison OR = 0.29 (95% CI = 0.12-0.71; Ptrend = 0.007).
CONCLUSIONS: In women, but not in men, higher sTNF-R2 levels at 6 to 8 years before diagnosis were inversely associated with POAG, but more strongly for NTG.