脂蛋白粒子和心血管风险预测 (来自前性队列研究)
Xin Su1, Meiping Wang2, Yingting Zuo2
1Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; School of Public Health, Baotou Medical College, Baotou, China.
The American journal of cardiology
|June 23, 2023
概括
阿波蛋白B (Apo B) 显示出与中国成年人心血管疾病 (CVD) 风险的强烈关联. 然而,将Apo B添加到现有风险评分中并不能显著改善心血管疾病风险预测.
科学领域:
- 心血管医学 心血管医学
- 脂质代谢 脂质代谢是什么
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 仍然是全球主要的死亡原因.
- 脂质样本,包括低密度脂蛋白胆固醇 (LDL-C) 和高密度脂蛋白胆固醇 (HDL-C),是评估心脏病风险的关键指标.
- 脂蛋白B (Apo B) 是一个新兴的标记物,但它与传统的脂质标记物一起在不同人群中预测心血管疾病风险方面的作用需要进一步研究.
研究的目的:
- 调查中国人群中不一致的阿波蛋白B (Apo B) 水平和传统的脂质样本 (LDL-C,非HDL-C) 与心血管疾病 (CVD) 风险之间的关联.
- 评估将Apo B纳入现有心血管疾病风险预测模型的增量预测价值,特别是中国动脉样硬化心血管疾病 (ASCVD) 风险评分.
主要方法:
- 利用来自中国健康和营养调查 (2009-2015) 的数据,包括7117名参与者.
- 根据相对于LDL-C和非HDL-C的残余差异和中位数,定义了不一致的Apo B水平.
- 使用后勤回归用于关联分析和接收器运行特征 (ROC) 曲线与分类净重新分类改进 (NRI) 来评估预测值.
主要成果:
- 与LDL-C或非HDL-C不一致的高Apo B参与者表现出显著更高的心血管疾病风险 (OR 1.38-1.40).
- 尽管存在强烈的关联,但Apo B并没有显著提高中国ASCVD风险评分的预测能力 (AUC差异最小).
- 在这个队列中,Apo B与CVD风险的关联比LDL-C和非HDL-C更强.
结论:
- 阿波蛋白B (Apo B) 与中国人口的心血管疾病 (CVD) 风险密切相关,独立于LDL-C和非HDL-C水平.
- 虽然Apo B显示出与心血管疾病风险的强有力的联系,但它被添加到中国ASCVD风险评分中,为风险评估和歧视提供了最小的增量价值.
- 可能需要进一步的研究来澄清Apo B在心血管疾病风险分层中的确切作用和最佳利用.
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