高密度脂蛋白胆固醇在动脉样硬化心血管疾病风险评估:探索和解释"U"形曲线
Alexander C Razavi1, Anurag Mehta2, Vardhmaan Jain1
1Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA.
Current cardiology reports
|November 16, 2023
概括
高密度脂蛋白胆固醇 (HDL-C) 显示了与动脉样硬化心血管疾病 (ASCVD) 风险的U形关联. 低和非常高的HDL-C水平独立地增加死亡风险,影响ASCVD风险评估.
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
- 动脉样硬化研究 动脉样硬化研究
背景情况:
- 高密度脂蛋白胆固醇 (HDL-C) 在心血管健康中起着复杂的作用.
- 传统的风险因素并不能完全解释所有ASCVD事件.
- 人们一直在讨论HDL-C的独立预后价值.
研究的目的:
- 审查目前对HDL-C与动脉样硬化心血管疾病 (ASCVD) 的关联的理解.
- 讨论将HDL-C纳入心血管风险评估策略中的问题.
主要方法:
- 审查有关HDL-C和ASCVD的现有文献.
- 流行病学数据和遗传研究的分析 (门德尔的随机化).
- 评估HDL-C在初级和二级预防中的作用.
主要成果:
- 在HDL-C水平和ASCVD风险之间存在U形关系.
- 低的HDL-C (男性<40毫克/dL,女性<50毫克/dL) 和非常高的HDL-C (男性≥80毫克/dL) 与所有原因和ASCVD死亡率的增加有关.
- 非常高的HDL-C与死亡率相关的因果关系是不确定的,特别是在女性中.
结论:
- HDL-C是ASCVD的显著风险因素或增强剂,特别是在两性低水平和男性非常高水平.
- 风险评估模型应纳入HDL-C与死亡率相关的U形性质.
- 需要进一步的研究来澄清非常高的HDL-C的因果作用.
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