ABSTRACT
FUNDAMENTO: A síndrome metabólica (SM) é uma entidade pró-aterogênica. Autoanticorpos tais como β2-glicoproteína I (β2-gpI) podem influenciar o aparecimento de ateromas. Estudos anteriores confirmaram uma associação entre anticorpos IgA anti-β2-gpI e isquemia cerebral, infarto do miocárdio, doença arterial periférica e doença da carótida. OBJETIVO: O objetivo desse estudo de caso-controle foi avaliar uma possível associação entre anticorpos anti-β2-gpI e anticardiolipina (aCL) com SM não-complicada. MÉTODOS: Pacientes com SM sem histórico de eventos vasculares e indivíduos-controle, consistindo em pacientes da Enfermaria de Ortopedia admitidos devido a doenças musculoesqueléticas foram incluídos no estudo. Idade, sexo, etnia, histórico de hipertensão, tabagismo, hipercolesterolemia e diabetes mellitus foram avaliados como fatores de risco em ambos os grupos. Anticorpos IgG, IgM, e IgA anti-β2-gpI e aCL foram detectados através de imunoensaios enzimáticos. RESULTADOS: Um total de 68 pacientes com SM e 82 controles foram estudados. Os pacientes com SM tinham média de idade superior à dos controles (P = 0,001), enquanto homens (P = 0,003; OR 0,31; IC95 por cento: 0,15-0,16) e etnia caucasiana (P = 0,004; OR 0,25; IC95 por cento:0,10-0,60) eram predominantes nos controles. Histórico de hipertensão, hipercolesterolemia e diabetes mellitus foi mais prevalente nos pacientes com SM do que nos controles (P < 0.05). A frequência de anticorpos aCL (todos os isotipos) e do IgG e IgM anti-β2 gpI não diferiu de forma significante nos pacientes com SM e controles. Anticorpos IgA anti-β2-gpI foram significantemente mais frequentes nos pacientes com SM (42,2 por cento) do que nos controles (10,9 por cento) (P < 0,001). O OR ajustado para anticorpos IgA anti-β2-gpI foi 3,60 (IC95 por cento: 1,55-8,37; P = 0,003). CONCLUSÃO: O presente estudo mostra que níveis elevados de autoanticorpos IgA para β2-gpI podem estar independentemente associados com SM.
BACKGROUND: The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE: This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS: Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS: Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95 percentCI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95 percentCI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2 percent) than controls (10.9 percent) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95 percentCI 1.55-8.37; P = 0.003). CONCLUSION: The current study shows that elevated levels of IgA autoantibodies to β2-gpI might be independently associated to MetS.
FUNDAMENTO: El síndrome metabólico (SM) es una entidad pro-aterogénica. Autoanticuerpos tales como β2-glicoproteína I (β2-GPI) pueden influir en la aparición de ateromas. Estudios previos han confirmado una asociación entre anticuerpos IgA anti-β2-GPI y la isquemia cerebral, infarto de miocardio, enfermedad arterial periférica y enfermedad carotidea. OBJETIVO: El objetivo de este estudio de caso-control fue evaluar una posible asociación entre los anticuerpos anti-β2-GPI y anticardiolipina (aCL) con SM complicada. MÉTODOS: Se incluyeron en el estudio a los pacientes con SM sin antecedentes de eventos vasculares y los sujetos control, que consiste en pacientes de la Internación de Ortopedia ingresados debido a enfermedades musculoesqueléticas. Edad, sexo, origen étnico caucásico, antecedentes de hipertensión, tabaquismo, hipercolesterolemia y diabetes mellitus fueron evaluados como factores de riesgo en ambos grupos. Anticuerpos IgG, IgM, e IgA anti-β2-GPI y aCL se detectaron a través de inmunoensayos enzimáticos. RESULTADOS: Un total de 68 pacientes con SM y 82 controles se estudiaron. Los pacientes con SM tenían un promedio de edad superior de los controles (p = 0,001), mientras que los hombres (p = 0,003; OR 0,31; IC95 por ciento: 0,15-0,16) y origen étnico caucásica (p = 0,004; OR 0,25; IC95 por ciento:0,10-0,60) eran predominantes en los controles. Historia de hipertensión, hipercolesterolemia y diabetes mellitus fue más prevalente en los pacientes con SM que en los controles (p < 0,05). La frecuencia de anticuerpos aCL (todos los isotipos) y del IgG e IgM anti-β2 gpI no se distinguió de forma significante en los pacientes con SM y controles. Anticuerpos IgA anti-β2-gpI fueron significantemente más frecuentes en los pacientes con SM (42,2 por ciento) que en los controles (10,9 por ciento) (p < 0,001). El OR ajustado para anticuerpos IgA anti-β2-gpI fue 3,60 (IC95 por ciento: 1,55 a 8,37, p = 0,003). CONCLUSIÓN: El presente estudio muestra que los niveles elevados de autoanticuerpos IgA para β2-gpI pueden estar independientemente asociados con la SM.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antibodies, Anticardiolipin/analysis , Autoantibodies/analysis , Metabolic Syndrome/immunology , /immunology , Antibodies, Anticardiolipin/immunology , Atherosclerosis/immunology , Autoantibodies/immunology , Case-Control Studies , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Logistic Models , Odds Ratio , Risk Factors , Sex FactorsABSTRACT
BACKGROUND: The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE: This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS: Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS: Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95%CI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95%CI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2%) than controls (10.9%) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95%CI 1.55-8.37; P = 0.003). CONCLUSION: The current study shows that elevated levels of IgA autoantibodies to ß2-gpI might be independently associated to MetS.