Joint Effects of Antibody to Heat Shock Protein 60, Hypertension, And Diabetes on Risk of Coronary Heart Disease in Chinese (Lipids, Lipoproteins, And Cardiovascular Risk Factors‪)‬

Coronary heart disease (CHD) [5] is a multifactorial disease, and autoimmunity is considered to be one of its most important mechanisms (1). Heat shock protein (Hsp) is a possible autoantigenic determinant that mayplayasignificantroleinthedevelopmentofatherosclerosis. High concentrations of antibody to human Hsp60 (anti-Hsp60) have been shown to be associated with CHD in small case-control studies (276 cases/129 controls and 424 cases/321 controls, respectively) (2, 3). In a cross-sectional study, a strong association was detected between concentrations of anti-Hsp60 and both the presence and the severity of CHD in 391 patients (4). However, no association between IgG anti-Hsp60 and levels of coronary calcification was found in201 healthy, asymptomatic subjects (5). Huittinen et al. (6) found no association between coronary risk and IgG anti-Hsp60 in dyslipidemic middle-aged males (239 case-control pairs). Kocsis et al. (7) reported that anti-Hsp60 concentration did not predict the development of new cardiovascular events. These inconsistent results may be due to differences in study populations and small sample sizes. A recent study (8) indicated that there may be ethnic differences in the circulating concentrations of Hsps. Our previous studies (9) found a significant association between anti-Hsp60 and increased risk of electrocardiographic abnormalities characteristic of chronic myocardial ischemia, sinus arrhythmia, and ectopic rhythm. Therefore, we further tested whether there was a dose-response relationship between anti-Hsp60 and the risk of CHD in a Chinese Han population. In addition, we examined joint effects of anti-Hsp60, hypertension, and diabetes on risk of CHD because previous studies have suggested that anti-Hsp60 may also be involved in hypertension (10) and diabetes (11-13). Materials and Methods