Circulation丨低密度脂蛋白胆固

　　Long-TermAssociationofLow-DensityLipoproteinCholesterolWithCardiovascularMortalityinIndividualsatLow10-YearRiskofAtheroscleroticCardiovascularDiseaseCirculationresearch-articleNov20,:(21),–./CIRCULATIONAHA..点击文末“阅读原文”下载本文PDFBackground:Theassociationsoflow-densitylipoproteincholesterol(LDL-C)withcardiovasculardisease(CVD)andcoronaryheartdiseasemortalityinanexclusivelylowestimated10-yearriskgrouparenotwelldelineated.Wesoughttodeterminethelong-termassociationsofvariousLDL-Candnon–high-densitylipoproteincholesterol(HDL-C)thresholdsandCVDandcoronaryheartdiseasemortalityinalarge,low10-yearriskcohort.对于低风险人群，低密度脂蛋白胆固醇(LDL-C)与心血管疾病(CVD)和冠心病死亡率之间的关系，尚未有明确的研究。我们在一个大规模的低10年风险队列中，尝试明确各种LDL-C/非高密度脂蛋白胆固醇(HDL-C)阈值和心血管疾病以及冠心病死亡率的长期相关性。Methods:ThestudysampleincludedparticipantsoftheCCLS(CooperCenterLongitudinalStudy)withoutahistoryofCVDordiabetesmellitusanddefinedaslowrisk(7.5%)for10-yearatheroscleroticCVDeventsatbaselinebasedonPooledCohortRiskAssessmentEquations.TheassociationsoffastingLDL-Candnon–HDL-CwithCVDmortalityweretestedwithCoxproportionalhazardsmodels.研究纳入CCLS研究中无CVD或糖尿病病史的、10年动脉粥样硬化CVD事件风险低（7.5%）的受试者。用Cox比例风险模型检验空腹LDL-C和非HDL-C与CVD死亡率的关系。Results:In36?participants(72%men,medianage42)followedforamedianof26.8years,CVDandcoronaryheartdiseasedeathsoccurred.ComparedwithLDL-Cmg/dL,LDL-Ccategoriestomg/dL,tomg/dL,to.9mg/dL,and≥mg/dLwereassociatedwithasignificantlyhigherriskofCVDdeath,withhazardratiosof1.4(95%CI,1.1–1.7),1.3(95%CI,1.1–1.6),1.9(95%CI,1.5–2.4),and1.7(95%CI,1.3–2.3),andmeanreductionsinyearsfreeofCVDdeathof1.8,1.1,4.3,and3.9,respectively.AfteradjustmentforatheroscleroticCVDriskfactors,LDL-Ccategoriestomg/dLand≥mg/dLremainedindependentlyassociatedwithCVDmortality,withhazardratiosof1.7(95%CI,1.4–2.2)and1.5(95%CI,1.2–2.1),respectively.Inmultivariable-adjustedmodelsusingnon–HDL-Cmg/dLasthereference,non–HDL-Ctomg/dL,tomg/dL,and≥mg/dLweresignificantlyassociatedwithCVDdeath,withhazardratiosof1.3(95%CI,1.1–1.6),1.8(95%CI,1.4–2.2),and1.5(95%CI,1.2–2.0),respectively.Restrictingthecohorttothosewith10-yearrisk5%didnotdiminishtheassociationsofLDL-Candnon–HDL-CwithCVDmortality.共纳入36位受试者（72%为男性，平均42岁），中位随访26.8年。共发生例CVD死亡和例冠心病死亡。与LDL-C10mg/dL相比，LDL-C水平在-mg/dL、-mg/dL、-.9mg/dL和≥mg/dL时均与CVD死亡风险明显增高相关，风险比分别是1.4（95%CI1.1-1.7）、1.3（95%CI1.1-1.6）、1.9（95%CI1.5-2.4）和1.7（95%CI1.3-2.3），无CVD死亡的年龄分别平均减少1.8、1.1、4.3和3.9。经过动脉粥样硬化CVD风险因素校正后，LDL-C浓度为-mg/dL和≥mg/dL时，仍与CVD死亡率存在独立的相关性，风险比分别为1.7（95%CI1.4-2.2）和1.5（95%CI1.2-2.1）。在以非HDL-C＜mg/dL为参照的多变量校正模型中，非HDL-C水平-mg/dL、-mg/dL和≥mg/dL均与CVD死亡明显相关，风险比分别为1.3（95%CI1.1-1.6）、1.8（95%CI1.4-2.2）和1.5（95%CI1.2-2.0）。对于10年风险＜5%的队列人群，LDL-C/非HDL-C与CVD死亡率之间的关系不变。Conclusions:Inalow10-yearriskcohortwithlong-termfollow-up,LDL-Candnon–HDL-C≥mg/dLwereindependentlyassociatedwitha50%to80%increasedrelativeriskofCVDmortality.Thesefindingsmayhaveimplicationsforfuturecholesteroltreatmentparadigms.经对低10年风险队列进行长期随访发现，LDL-C和非HDL-C≥mg/dL与CVD死亡率的相对风险增加50%~80%独立相关。这些发现可能会进一步规范胆固醇的治疗模式。Long-TermAssociationofLow-DensityLipoproteinCholesterolWithCardiovascularMortalityinIndividualsatLow10-YearRiskofAtheroscleroticCardiovascularDiseaseCirculationresearch-articleNov20,:(21),–./CIRCULATIONAHA..预览时标签不可点收录于话题#个上一篇下一篇

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