在糖尿病中升高的残留胆固醇和动脉样性心血管疾病:基于人口的前性队列研究
Benjamin N Wadström1,2,3, Kasper M Pedersen1,2,3, Anders B Wulff1,2,3
1Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.
Diabetologia
|September 30, 2023
概括
升高的残留胆固醇显著增加了糖尿病患者的动脉样硬化心血管疾病 (ASCVD) 风险. 剩余的胆固醇和炎症解释了这一过度风险的很大一部分.
科学领域:
- 心脏病学 心脏病学
- 代谢障碍 代谢障碍 代谢障碍
- 流行病学 流行病学
背景情况:
- 升高的残留胆固醇是一般人群中动脉样硬化心血管疾病 (ASCVD) 的已知危险因素.
- 糖尿病患者残留胆固醇与ASCVD风险之间的关联尚未得到充分证实.
- 糖尿病是ASCVD的重要危险因素,了解有助于脂肪因子至关重要.
研究的目的:
- 调查糖尿病患者中高残留胆固醇和ASCVD风险之间的关联.
- 量化糖尿病所造成的ASCVD风险过多的比例,由残留胆固醇解释.
- 探索低度炎症和LDL胆固醇在这种关联中的作用.
主要方法:
- 分析了4569名患有糖尿病的丹麦白人的队列.
- 数据是从哥本哈根总人口研究 (2003-2015) 中收集的.
- 通过国家卫生登记处确定ASCVD事件 (外周动脉疾病,心肌梗塞,缺血性中风). 剩余胆固醇是根据标准脂质样本计算的.
主要成果:
- 剩余胆固醇的翻倍与外周动脉疾病 (HR1.6),心肌梗塞 (HR1.8),缺血性中风 (HR1.5) 和任何ASCVD (HR1.6) 的风险增加有关.
- 剩余的胆固醇和低级炎症解释了与糖尿病相关的ASCVD风险的14-34%.
- LDL胆固醇并不能解释这种过度风险,因为它在糖尿病患者中没有升高.
结论:
- 升高的残留胆固醇是糖尿病患者ASCVD的重要危险因素.
- 剩余的胆固醇和低级炎症在很大程度上导致了糖尿病中观察到的过度ASCVD风险.
- 需要进一步的随机对照试验来确定残留胆固醇是否应该成为治疗点.
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