リポプロテイン (a) と冠動脈疾患. 展望研究のメタ分析
1Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Clinical Medicine, University of Oxford, Radcliffe Infirmary, Oxford, UK.
Circulation
|September 7, 2000
まとめ
増加したリポプロテイン (Lp) のレベルは,冠動脈疾患 (CHD) のリスクの増加と関連しています. この前向きな研究のメタ解析は,より高いLp(a) とCHDのイベントとの間に重要な関連があることを確認しています.
科学分野:
- 心血管医学 心血管医学
- リピドロジーは,脂質学です.
- エピデミオロジー エピデミオロジー
背景:
- プラズマリポプロテイン (Lp) と冠動脈疾患 (CHD) の関連性については,矛盾する結果がある.
- 2000年以前に発表された見通し研究を元分析し,少なくとも1年間の追跡調査を行った.
研究 の 目的:
- ベースラインの血Lp (a) 濃度と,その後のCHDのリスクとの関係を体系的に評価する.
- Lp(a) とCHDリスクに関する以前の研究における不一致を解決する.
主な方法:
- 対象となる27件の見通し研究に関するメタアナリシスが行われました.
- 抽象化されたデータには,研究の特徴,Lp (a) 測定方法,およびCHDのアウトカムが含まれていました.
- ベースラインLp (a) 測定の上位3分の1と下位3分の1の個人を比較した.
主要な成果:
- Lp (a) 濃度が最も高い個体と最も低い個体では,CHDの総合リスク比1.6 (95%CI1.4~1.8) が観察されました.
- 人口ベースの研究でも同様の結果が見られた (リスク比1.7,95%CI1.4~1.9).
- 研究全体で有意な異質性は検出されず,Lp (a) は従来の血管リスク因子との相関が弱いことを示した.
結論:
- 展望的研究では,Lp (a) とCHDとの関連が明確に示されています.
- CHD発症におけるLp (a) の因果的役割を確立するために,さらなる研究が必要である.
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