脂蛋白 (a) 和长期心血管风险在多民族聚合前性队列中
Nathan D Wong1, Wenjun Fan1, Xingdi Hu2
1Division of Cardiology, University of California-Irvine, Irvine, California, USA; Department of Epidemiology and Biostatistics, University of California-Irvine, Irvine, California, USA.
Journal of the American College of Cardiology
|April 17, 2024
概括
较高的脂蛋白a (Lp[a]) 水平显著增加了动脉样硬化心血管疾病 (ASCVD) 事件的风险,特别是在糖尿病患者中. 这一发现突出了Lp[a]作为一个关键的遗传风险因素.
科学领域:
- 心血管医学 心血管医学
- 遗传学 是一个遗传学.
- 流行病学 流行病学
背景情况:
- 脂蛋白a (Lp[a]) 是已知的动脉样硬化心血管疾病 (ASCVD) 的遗传风险因素.
- 有限的长期随访数据存在Lp[a]在大规模的美国人口队列.
研究的目的:
- 调查Lp[a]水平与ASCVD结果之间的关联.
- 分析这些关联在美国不同的人口中以及根据糖尿病状况定义的子组内.
主要方法:
- 来自五项大型美国前性研究 (MESA,CARDIA,JHS,FHS-OS,ARIC) 的数据,包括27,756名参与者.
- 根据队列特定百分比分类的Lp[a]水平.
- 多变量考克斯回归模型用于评估Lp[a]与发生的ASCVD事件的关联,调整风险因素并分析与糖尿病的相互作用.
主要成果:
- 升高的Lp[a]水平 (≥75百分位) 与ASCVD风险增加有关 (HRs在1.18至1.46之间).
- 最高的Lp[a]水平 (≥90百分位) 与ASCVD事件 (aHR=1.46) 有显著的关联.
- 这种关联在患有糖尿病的患者中更为明显 (aHR=1.92为≥90百分位) 与没有糖尿病的患者相比 (aHR=1.41).
结论:
- 较高的Lp[a]水平独立地与大量的多民族美国人口中ASCVD风险增加有关.
- 对于ASCVD的Lp[a]的预测值在各种人口群体中是显著的,特别是在糖尿病患者中得到放大.
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