JAHA:小而密低密度脂蛋白胆固醇是容易引起动脉粥样硬化的脂蛋白指标

2021-02-17 MedSci原创 MedSci原创

在多变量分析中,sdLDL-C、LDL-C和脂蛋白(a)均对ASCVD风险具有显著影响,sdLDL-C是最容易引起动脉粥样硬化的脂蛋白指标。

血浆中低密度脂蛋白胆固醇(LDL-C)、小而密LDL-C(sdLDL-C)、低密度脂蛋白(LDL)甘油三酯、甘油三酯、富含甘油三酯的脂蛋白胆固醇、残余脂蛋白颗粒胆固醇和脂蛋白(a)水平升高都与动脉粥样硬化性血管疾病(ASCVD)相关。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在评估哪些指标与ASCVD风险最相关。

研究人员使用标准化的自动分析法(变异系数<5.0%)测量了3094名没有ASCVD的空腹受试者血浆样品中的总胆固醇、甘油三酯、高密度脂蛋白胆固醇、LDL-C、sdLDL-C、LDL甘油三酯、残留脂蛋白颗粒胆固醇、富含甘油三酯的脂蛋白胆固醇和脂蛋白(a)水平。

在这些受试者中,20.2%的受试者在16年内发生了ASCVD。在单变量分析中,所有ASCVD危险因素均与ASCVD相关,以下特定脂蛋白指标也与ASCVD显著相关:sdLDL-C、LDL甘油三酯、甘油三酯、富含甘油三酸酯的脂蛋白胆固醇、残留脂蛋白颗粒胆固醇和LDL-C。校正标准危险因素(年龄、性别、高血压、糖尿病、吸烟、总胆固醇和高密度脂蛋白胆固醇)后,只有sdLDL-C、LDL-C和脂蛋白(a)在多变量分析和净重分类中仍然显著。

研究人员使用合并的队列方程,分别添加了脂蛋白指标都获得了重要信息,但是模型中一旦加入了sdLDL-C(风险比为1.42;P<0.0001),就没有指标能获得重要信息。sdLDL-C的这些结果通过调整后的不一致分析中得到了证实,而与LDL甘油三酯相反。

由此可见,在多变量分析中,sdLDL-C、LDL-C和脂蛋白(a)均对ASCVD风险具有显著影响,但将sdLDL-C进入模型,则没有指标可以为合并队列方程添加显著的风险信息。该研究的数据表明,sdLDL-C是最容易引起动脉粥样硬化的脂蛋白指标

原始出处:

Hiroaki Ikezaki.et al.Small Dense Low‐Density Lipoprotein Cholesterol Is the Most Atherogenic Lipoprotein Parameter in the Prospective Framingham Offspring Study.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/10.1161/JAHA.120.019140

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    2021-06-19 ms7000001124466419

    非常实用有效

    0

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    2021-02-19 ms8000002011346329

    学习了,一直都在给病人强调这个!

    0

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    2021-02-19 zhaohui6731
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    2021-02-17 ms7000002141506965

    我的检查指标好像都没有这个

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