title: Asymptomatic carotid atherosclerosis is associated with circulating chlamydia pneumoniae DNA in younger normotensive subjects in a general population survey.
abstract: OBJECTIVE
  Chlamydia pneumoniae infection has been associated with atherosclerosis, but serodiagnosis is unreliable in predicting vascular infection. Direct detection of circulating chlamydial DNA in peripheral blood mononuclear cells (PBMCs) was thus evaluated as a marker for cardiovascular risk in a general population survey using the common carotid intima-media thickness (IMT) as surrogate marker of asymptomatic atherosclerosis.
  
  
  RESULTS
  C pneumoniae DNA in PBMCs was determined by nested polymerase chain reaction and associated with IMT for 1032 healthy participants of a general population survey who were within the highest or lowest IMT distribution quartile. C pneumoniae DNA was more prevalent in those with increased IMT (13.4% versus 10.7%), but this was not significant in univariate and of borderline significance in multivariate analysis. Testing for potential effect modifications by known strong determinants of an increased IMT in group interaction analysis revealed an independent association between C pneumoniae DNA and IMT in normotensive subjects (odds ratio [OR], 2.06; 95% CI, 1.05 to 4.03; P=0.04) and in those <70 years old (OR, 1.84; 95% CI, 1.06 to 3.19; P=0.03).
  
  
  CONCLUSIONS
  Asymptomatic atherosclerosis is associated with circulating C pneumoniae DNA independently of classical cardiovascular risk factors in normotensive subjects and those <70 years old. C pneumoniae has been implicated in atherogenesis. We determined the association of chlamydial DNA in peripheral blood mononuclear cells with the carotid intima-media thickness from 1032 healthy subjects from a general population survey. A stratified group interaction analysis revealed an independent association in normotensive subjects and those <70 years old.
authors.affiliation: Medical Department, Hanse-Hospital Stralsund, Teaching Hospital of the Ernst-Moritz-Arndt-University of Greifswald, Post Box 2341, D-18410 Stralsund, Germany. mitusch@uni-greifswald.de
authors.forename: Rolf
authors.initials: R
authors.lastname: Mitusch
authors.forename: Jan
authors.initials: J
authors.lastname: Luedemann
authors.forename: William G
authors.initials: WG
authors.lastname: Wood
authors.forename: Klaus
authors.initials: K
authors.lastname: Berger
authors.forename: Ulf
authors.initials: U
authors.lastname: Schminke
authors.forename: Matthias
authors.initials: M
authors.lastname: Suter
authors.forename: Christof
authors.initials: C
authors.lastname: Kessler
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.forename: Jan
authors.initials: J
authors.lastname: Rupp
authors.forename: Michael
authors.initials: M
authors.lastname: Kentsch
authors.forename: Matthias
authors.initials: M
authors.lastname: Maass
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology; D002097:C-Reactive Protein / Q000032:analysis; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000648:ultrastructure; D023521:Chlamydophila Infections / Q000097:blood / Q000453:epidemiology*; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000097:blood*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005293:Ferritins / Q000097:blood; D005340:Fibrinogen / Q000032:analysis; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000648:ultrastructure; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000648:ultrastructure; D014463:Ultrasonography
chemical_list: D004269:DNA, Bacterial; D005340:Fibrinogen; D002097:C-Reactive Protein; D005293:Ferritins