低密度脂蛋白胆固醇,心血管疾病风险和中国的死亡率
Liang Chen1,2, Shi Chen1,2, Xueke Bai1
1National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
低密度脂蛋白胆固醇 (LDL-C) 与死亡率之间的关联在动脉样硬化心血管疾病 (ASCVD) 风险组之间有所不同. 对于最低死亡风险的最佳LDL-C水平因ASCVD风险和糖尿病状况而异.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 关于低密度脂蛋白胆固醇 (LDL-C) 与不同动脉样硬化心血管疾病 (ASCVD) 风险分层的死亡率之间的联系的证据有限.
- 了解这些关联对于定制预防策略至关重要.
研究的目的:
- 研究LDL-C水平与死亡率之间的关系.
- 确定最佳的LDL-C范围,以最大限度地降低ASCVD风险概况不同的人群的死亡风险.
主要方法:
- 前性队列研究 (ChinaHEART项目),包括超过370万参与者,年龄在35-75岁之间.
- 参与者被分为低风险,初级预防和二级预防队列.
- 考克斯比例危险回归模型用于评估LDL-C与所有原因/特定原因死亡率之间的关联.
主要成果:
- 在低风险和初级预防队列中观察到的LDL-C与死亡率之间的U形关联;在二级预防队列中,J形.
- 对于心血管疾病死亡率最低的最佳LDL-C:117.8 mg/dL (低风险),106.0 mg/dL (初级预防),55.8 mg/dL (二级预防).
- 与没有糖尿病的人相比,糖尿病患者的LDL-C较低,与较低的死亡率相关.
结论:
- LDL-C与死亡率之间的关系取决于ASCVD风险分层和糖尿病状况.
- 对于高ASCVD风险和糖尿病患者,可能需要更严格的LDL-C控制目标.
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