高密度脂蛋白参数与心力衰竭风险的关联:多队列分析
Ambarish Pandey1, Kershaw V Patel2, Matthew W Segar3
1Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
JACC. Heart failure
|May 16, 2024
概括
较高的高密度脂蛋白颗粒度 (HDL-P) 与心力衰竭 (HF) 风险的降低有关. 相反,更大的HDL颗粒大小与高血压风险增加有关,而HDL胆固醇 (HDL-C) 没有显著的关联.
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
- 心脏衰竭研究研究
背景情况:
- 高密度脂蛋白 (HDL) 传统上是通过胆固醇度 (HDL-C) 来评估的.
- HDL-C与动脉样硬化心血管疾病有相反的关系.
- 在心力衰竭 (HF) 风险中,HDL颗粒度 (HDL-P) 和大小 (HDL大小) 在心力衰竭 (HF) 风险中的作用不明.
研究的目的:
- 研究HDL颗粒度 (HDL-P),HDL颗粒大小 (HDL-size),HDL胆固醇 (HDL-C) 和每颗颗粒胆固醇含量 (HDL-C/HDL-P) 与整体心力衰竭 (HF) 风险之间的关联.
- 为了检查这些关联与特定的HF亚型相关:HF减少喷射分数 (HFrEF) 和HF保留喷射分数 (HFpEF).
主要方法:
- 分析了四项大型队列研究的数据:社区动脉样硬化风险,达拉斯心脏研究,动脉样硬化多民族研究以及预防脏和血管末期疾病.
- 包括没有HF病史的参与者.
- 使用调整后的考克斯比例危险模型来评估HDL-P,HDL-size,HDL-C和HDL-C/HDL-P与发生的HF事件的关联.
主要成果:
- 在16,925名参与者中,随访时间中位数为11.4年,发生了612次HF事件.
- 较高的HDL-P与整体HF风险较低显著相关 (HR:0.76).
- 较大的HDL大小与整体HF风险更高 (HR:1.27) 有关.
- 在HDL-C和HF风险之间没有发现显著的关联.
- 较高的HDL-C/HDL-P与整体高血压风险的增加显著相关 (HR:1.29).
结论:
- 增加的HDL颗粒度 (HDL-P) 与心力衰竭风险降低有关.
- 较大的HDL颗粒大小与心力衰竭的风险增加有关.
- 在对心血管风险因素进行调整后,HDL胆固醇 (HDL-C) 水平与HF风险没有显著的关联.
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