cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2012-4-52-58cardiovascular-1865Research ArticleСАХАРНЫЙ ДИАБЕТDIABETESГендерные особенности взаимосвязи между фибринолитической активностью крови и наличием сердечно-сосудистых заболеваний и сахарного диабета 2 типа в когорте москвичей старше 55 летGender specifics of the association between blood fibrinolytic activity and cardiovascular disease or diabetes mellitus in a cohort of Muscovites aged 55 years or olderРатниковаЛ. А.RatnikovaL. A.

(контактное лицо) – в.н.с. отдела изучения биохимических маркеров риска ХНИЗ

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lratnikova@gnicpm.ruМетельскаяВ. А.MetelskayaV. A.

руководитель отдела

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lratnikova@gnicpm.ruПероваН. В.PerovaN. V.

в.н.с. отдела

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lratnikova@gnicpm.ruДеевА. Д.DeevA. D.

руководитель лаборатории биостатистики

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lratnikova@gnicpm.ruШальноваС. А.ShalnovaS. A.

руководитель отдела эпидемиологии ХНИЗ

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lratnikova@gnicpm.ruГосударственный научно-исследовательский центр профилактической медицины Минздравсоцразвития России, МоскваState Research Centre for Preventive Medicine, Moscow2012200820121145258Copyright © Ратникова Л.А., Метельская В.А., Перова Н.В., Деев А.Д., Шальнова С.А., 20122012Ратникова Л.А., Метельская В.А., Перова Н.В., Деев А.Д., Шальнова С.А.Ratnikova L.A., Metelskaya V.A., Perova N.V., Deev A.D., Shalnova S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1865

Цель. Определить, имеются ли гендерные различия во взаимосвязях между фибринолитической активностью (ФЛА) плазмы крови пожилых людей и наличием заболеваний, связанных с атеросклерозом. Материалы и методы. Представленный в работе анализ выполнен в рамках проспективного, популяционного, когортного исследования «Стресс и здоровье в России». В исследование включены проживающие в Москве, случайно отобранные из популяции лица обоего пола в возрасте ≥ 55 лет (n=1863). В зависимости от ФЛА системы крови, оцениваемой по времени спонтанного лизиса эуглобулиновой фракции крови (ВЛЭС), обследованных мужчин (n=889) и женщин (n=974) разделили на три группы: с нормофибринолизом (ВЛЭС 180-260 мин) с гипофибринолизом (ВЛЭС > 260 мин) и с гиперфибринолизом (ВЛЭС < 180 мин). Результаты. В когорте пожилых москвичей выявлены различия между мужчинами и женщинами по взаимосвязи ФЛА с наличием ССЗ и сахарного диабета типа 2 (СД-2). При гипофибринолизе, атерогенном сдвиге в липидном составе и высоком уровне инсулина в крови натощак шанс наличия таких заболеваний, как артериальная гипертония (АГ), инфаркт миокарда (ИМ) и СД-2 по сравнению с группой нормофибринолиза повышен только у мужчин. Ни снижение, ни повышение ФЛА относительно нормы не связано с наличием СД-2 у женщин. У мужчин с гиперфибринолизом снижен шанс наличия АГ и СД-2, а у женщин – шанс наличия АГ, ИБС и стенокардии. Заключение. У пожилых людей высокая ФЛА выполняет защитную функцию по отношению к заболеваниям, связанным с атеротромбозом независимо от пола. Низкая ФЛА в исследовании была связана с ростом вероятности наличия ССЗ и СД-2 только у мужчин.

Aim. To investigate potential gender differences in the association between plasma fibrinolytic activity (FLA) and atherosclerotic pathology in elderly people. Material and methods. This analysis was performed as a part of the prospective population-based cohort study “Stress, Ageing, and Health in Russia”. The study included randomly selected Moscow residents of both genders and age of ≥55 years (n=1863; 889 men and 974 women). Based on the levels of blood FLA (time of spontaneous lysis of euglobin blood fraction, or euglobin lysis time, ELT), all participants were divided into three groups: with normofibrinolysis (ELT 180-260 minutes), hypofibrinolysis (ELT >260 minutes), and hyperfibrinolysis (ELT <180 minutes). Results. In this cohort of elderly Muscovites, the association between FLA and the presence of cardiovascular disease (CVD) or Type 2 diabetes mellitus (DM-2) differed in men and women. The link between hypofibrinolysis, atherogenic changes in lipid profile, or high fasting levels of insulin and arterial hypertension (AH), myocardial infarction (MI), or DM-2 was present only in men. In women, either reduced or increased FLA was not related to DM-2. Men with hyperfibrinolysis demonstrated lower odds of AH and DM-2, while women with hyperfibrinolysis had lower odds of AH, coronary heart disease, or angina. Conclusion. In elderly people, high FLA appears to provide protection against atherothrombotic pathology, regardless of gender. Low FLA was associated with higher odds of CVD and DM-2 in men only.

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The authors declare that there are no conflicts of interest present.