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高密度脂蛋白亚种由四个队列中的Apolipoprotein C-III的存在和冠心病的发生定义
Majken K Jensen1,2, Sarah A Aroner3, Kenneth J Mukamal4
1Departments of Nutrition (M.K.J., S.A.A., E.B.R., J.D.F., F.M.S.) mkjensen@hsph.harvard.edu.
Circulation
|November 23, 2017
概括
含有C-III的高密度脂蛋白 (HDL) 与冠状动脉疾病 (CHD) 的风险增加有关. 相反,缺乏ApoC-III的HDL与心血管疾病风险降低有关,提供了新的心血管风险见解.
科学领域:
- 心血管疾病研究
- 脂肪蛋白代谢
- 生物标志物发现
背景情况:
- 高密度脂蛋白 (HDL) 胆固醇的心脏保护作用越来越受到争议.
- 新的HDL功能测量可以改善心血管风险预测.
- 脂蛋白C-III (apoC-III) 是脂蛋白代谢的一个关键调节剂.
研究的目的:
- 研究由apoC-III定义的HDL亚种与冠心病 (CHD) 之间的关联.
- 为了确定APOC-III在HDL中的存在是否会影响心血管风险预测.
主要方法:
- 使用免疫 afinity 染色法测量具有或没有 apoC- III 的 HDL 中的 apoA- I 度.
- 进行了两项前性研究 (MESA和DCH) 和四项队列研究的元分析.
- 参与者是没有心血管疾病的成年人,并对发生心血管疾病事件进行了跟踪.
主要成果:
- 含有apoC- III的HDL与心脏病的风险较高有关 (每次SD的RR总值为1. 09;95% CI为1. 01-1. 18).
- 缺乏apoC- III的HDL与心脏病的风险较低有关 (合并RR,0. 76;95%CI,0. 70- 0. 83).
- 这些对立的关联在个人群体和元分析中一致.
结论:
- ApoC-III可能会识别与心脏病风险增加相关的HDL分数.
- 高密度胆固醇亚种分析提供了超越传统高密度胆固醇水平的新型心血管风险见解.
- 测量HDL结构和功能可以提高心血管风险评估.
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