{"title":"免疫球蛋白和补体水平与冠心病发病的相关性和预测价值:一项针对中国成年人的巢式病例对照研究。","authors":"Qin Jiang, Rundong Niu, Jing Jiang, Hanyu Hu, Shiqi He, Hao Wang, Yu Yuan, Handong Yang, Chengwei Xu, Xiaomin Zhang, Meian He, Huan Guo, Xiang Cheng, Chaolong Wang, Tangchun Wu, Pinpin Long","doi":"10.1093/eurjpc/zwaf091","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To investigate the associations of serum immunoglobulin (Ig) and complement levels with incident coronary heart disease (CHD), and to explore the potential mediating role of C-reactive protein (CRP).</p><p><strong>Methods and results: </strong>We measured serum levels of IgA, IgE, IgG, IgM, complement 3 (C3), complement 4 (C4), and CRP in a nested case-control study within the Dongfeng-Tongji cohort, consisting of 1605 CHD cases and 1605 age- and sex-matched controls. We quantified the associations of serum Ig and complement levels with incident CHD using conditional logistic regression and restricted cubic spline models. Mediation analysis was conducted to explore the role of CRP in these associations. The additional predictive ability of an immune indicator score beyond traditional risk factors was also evaluated. Higher IgA and C3 levels were associated with an increased risk of CHD in a linear manner [odds ratio (OR) (95% confidence interval, CI): 1.35 (1.11-1.62), P = 0.002; OR (95% CI): 2.01 (1.17-3.44), P = 0.01, respectively]. Conversely, higher IgG exhibited a significant linear decrease in CHD risk [OR (95% CI): 0.55 (0.36-0.83), P = 0.005]. C-reactive protein mediated 5.70% and 12.51% in the associations of IgA and C3 with incident CHD, respectively. Adding an immune indicator score to the traditional risk model improved CHD prediction more effectively than adding CRP [area under receiver operating characteristic curve (AUC): 0.85% vs. 0.21%; net reclassification improvement (NRI): 15.33% vs. 7.85%; integrated discrimination improvement (IDI): 0.80% vs. 0.17%].</p><p><strong>Conclusion: </strong>Our study identified IgA and C3 as independent risk factors and IgG as a protective factor for CHD. These immune markers may improve CHD risk prediction beyond traditional and CRP models, highlighting their potential for better risk assessment.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association and predictive value of immunoglobulin and complement levels for incident coronary heart disease: a nested case-control study in Chinese adults.\",\"authors\":\"Qin Jiang, Rundong Niu, Jing Jiang, Hanyu Hu, Shiqi He, Hao Wang, Yu Yuan, Handong Yang, Chengwei Xu, Xiaomin Zhang, Meian He, Huan Guo, Xiang Cheng, Chaolong Wang, Tangchun Wu, Pinpin Long\",\"doi\":\"10.1093/eurjpc/zwaf091\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>To investigate the associations of serum immunoglobulin (Ig) and complement levels with incident coronary heart disease (CHD), and to explore the potential mediating role of C-reactive protein (CRP).</p><p><strong>Methods and results: </strong>We measured serum levels of IgA, IgE, IgG, IgM, complement 3 (C3), complement 4 (C4), and CRP in a nested case-control study within the Dongfeng-Tongji cohort, consisting of 1605 CHD cases and 1605 age- and sex-matched controls. We quantified the associations of serum Ig and complement levels with incident CHD using conditional logistic regression and restricted cubic spline models. Mediation analysis was conducted to explore the role of CRP in these associations. The additional predictive ability of an immune indicator score beyond traditional risk factors was also evaluated. Higher IgA and C3 levels were associated with an increased risk of CHD in a linear manner [odds ratio (OR) (95% confidence interval, CI): 1.35 (1.11-1.62), P = 0.002; OR (95% CI): 2.01 (1.17-3.44), P = 0.01, respectively]. Conversely, higher IgG exhibited a significant linear decrease in CHD risk [OR (95% CI): 0.55 (0.36-0.83), P = 0.005]. C-reactive protein mediated 5.70% and 12.51% in the associations of IgA and C3 with incident CHD, respectively. Adding an immune indicator score to the traditional risk model improved CHD prediction more effectively than adding CRP [area under receiver operating characteristic curve (AUC): 0.85% vs. 0.21%; net reclassification improvement (NRI): 15.33% vs. 7.85%; integrated discrimination improvement (IDI): 0.80% vs. 0.17%].</p><p><strong>Conclusion: </strong>Our study identified IgA and C3 as independent risk factors and IgG as a protective factor for CHD. These immune markers may improve CHD risk prediction beyond traditional and CRP models, highlighting their potential for better risk assessment.</p>\",\"PeriodicalId\":12051,\"journal\":{\"name\":\"European journal of preventive cardiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":8.4000,\"publicationDate\":\"2025-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of preventive cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/eurjpc/zwaf091\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of preventive cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/eurjpc/zwaf091","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨血清免疫球蛋白(Ig)和补体水平与冠心病(CHD)发生的关系,并探讨c反应蛋白(CRP)在冠心病发生中的潜在介导作用。方法和结果:在一项巢式病例对照研究中,我们测量了血清中IgA、IgE、IgG、IgM、补体3 (C3)、补体4 (C4)和CRP的水平,该研究包括1605例冠心病患者和1605例年龄和性别匹配的对照组。我们使用条件逻辑回归和限制三次样条模型量化血清Ig和补体水平与冠心病的关系。进行中介分析以探讨CRP在这些关联中的作用。还评估了免疫指标评分超出传统危险因素的额外预测能力。IgA和C3水平升高与冠心病风险增加呈线性相关[比值比(OR)(95%置信区间,CI): 1.35 (1.11-1.62), P = 0.002;OR (95% CI): 2.01 (1.17-3.44), P = 0.01。相反,较高的IgG表现出冠心病风险的显著线性降低[OR (95% CI): 0.55 (0.36-0.83), P = 0.005]。c反应蛋白介导的IgA和C3与冠心病发生的相关性分别为5.70%和12.51%。在传统风险模型中加入免疫指标评分比加入CRP[受试者工作特征曲线下面积(AUC)]更有效地改善了冠心病的预测:0.85% vs 0.21%;净重分类改善(NRI): 15.33% vs. 7.85%;综合歧视改善(IDI): 0.80% vs. 0.17%]。结论:本研究确定IgA和C3为冠心病的独立危险因素,IgG为冠心病的保护因素。这些免疫标记物可能比传统模型和CRP模型更好地预测冠心病风险,突出了它们更好的风险评估潜力。
Association and predictive value of immunoglobulin and complement levels for incident coronary heart disease: a nested case-control study in Chinese adults.
Aims: To investigate the associations of serum immunoglobulin (Ig) and complement levels with incident coronary heart disease (CHD), and to explore the potential mediating role of C-reactive protein (CRP).
Methods and results: We measured serum levels of IgA, IgE, IgG, IgM, complement 3 (C3), complement 4 (C4), and CRP in a nested case-control study within the Dongfeng-Tongji cohort, consisting of 1605 CHD cases and 1605 age- and sex-matched controls. We quantified the associations of serum Ig and complement levels with incident CHD using conditional logistic regression and restricted cubic spline models. Mediation analysis was conducted to explore the role of CRP in these associations. The additional predictive ability of an immune indicator score beyond traditional risk factors was also evaluated. Higher IgA and C3 levels were associated with an increased risk of CHD in a linear manner [odds ratio (OR) (95% confidence interval, CI): 1.35 (1.11-1.62), P = 0.002; OR (95% CI): 2.01 (1.17-3.44), P = 0.01, respectively]. Conversely, higher IgG exhibited a significant linear decrease in CHD risk [OR (95% CI): 0.55 (0.36-0.83), P = 0.005]. C-reactive protein mediated 5.70% and 12.51% in the associations of IgA and C3 with incident CHD, respectively. Adding an immune indicator score to the traditional risk model improved CHD prediction more effectively than adding CRP [area under receiver operating characteristic curve (AUC): 0.85% vs. 0.21%; net reclassification improvement (NRI): 15.33% vs. 7.85%; integrated discrimination improvement (IDI): 0.80% vs. 0.17%].
Conclusion: Our study identified IgA and C3 as independent risk factors and IgG as a protective factor for CHD. These immune markers may improve CHD risk prediction beyond traditional and CRP models, highlighting their potential for better risk assessment.
期刊介绍:
European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.