背景:关于外周动脉疾病(PAD)的免疫表型的研究缺乏。本研究旨在描述基线特征,免疫表型,项目基线健康研究(PBHS)中PAD参与者的生活质量(QoL)。
方法:PBHS研究是一项前瞻性的,多中心,纵向队列研究收集了临床,分子,以及2017年至2018年招募的参与者的生物特征数据。在这个分析中,基线人口统计,临床,移动性,QoL,和流式细胞术数据根据是否存在PAD(踝臂指数[ABI]≤0.90)进行分层。
结果:在2,209名参与者中,58(2.6%)患有下肢PAD,只有2例(3.4%)在纳入前已诊断出PAD.吸烟合并症(29.3%与14%,p<0.001),高血压(54%vs.30%,p<0.001),糖尿病(25%vs.14%,p=0.031),和至少中度冠状动脉钙化(Agatston评分>100:32%vs.17%,p=0.01)在PAD患者中明显高于ABI正常患者,高敏C反应蛋白水平(5.86vs.2.83,p<0.001)。在调整了人口和风险因素后,PAD患者的循环CD56高自然杀伤细胞明显减少,IgM+记忆B细胞,和CD10/CD27双阳性B细胞(均p<0.05)。
结论:这项研究加强了现有证据,即大部分无跛行的PAD可能被诊断不足,特别是女性和黑人或非裔美国人参与者。我们描述了PAD参与者的一种新的免疫表型谱,它可以代表一种潜在的未来筛查或诊断工具,以促进PAD的早期诊断。
结果:
■NCT03154346,https://clinicaltrials.gov/ct2/show/NCT03154346。
BACKGROUND: There is a dearth of research on
immunophenotyping in peripheral artery disease (PAD). This
study aimed to describe the baseline characteristics, immunophenotypic profile, and quality of life (QoL) of participants with PAD in the Project Baseline Health
Study (PBHS).
METHODS: The PBHS
study is a prospective, multicenter, longitudinal cohort
study that collected clinical, molecular, and biometric data from participants recruited between 2017 and 2018. In this analysis, baseline demographic, clinical, mobility, QoL, and flow cytometry data were stratified by the presence of PAD (ankle brachial index [ABI] ≤0.90).
RESULTS: Of 2,209 participants, 58 (2.6%) had lower-extremity PAD, and only 2 (3.4%) had pre-existing PAD diagnosed prior to enrollment. Comorbid smoking (29.3% vs 14%, P < .001), hypertension (54% vs 30%, P < .001), diabetes (25% vs 14%, P = .031), and at least moderate coronary calcifications (Agatston score >100: 32% vs 17%, P = .01) were significantly higher in participants with PAD than in those with normal ABIs, as were high-sensitivity C-reactive protein levels (5.86 vs 2.83, P < .001). After adjusting for demographic and risk factors, participants with PAD had significantly fewer circulating CD56-high natural killer cells, IgM+ memory B cells, and CD10/CD27 double-positive B cells (P < .05 for all).
CONCLUSIONS: This
study reinforces existing evidence that a large proportion of PAD without claudication may be underdiagnosed, particularly in female and Black or African American participants. We describe a novel immunophenotypic profile of participants with PAD that could represent a potential future screening or diagnostic tool to facilitate earlier diagnosis of PAD.
RESULTS: UNASSIGNED: NCT03154346, https://clinicaltrials.gov/ct2/show/NCT03154346.