低密度脂蛋白胆固醇与所有原因和心血管死亡率之间的关联及其人口异质性:基于人口的队列研究
Jiapeng Lu1, Haibo Zhang1, Bowang Chen1
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 100037, China.
Chinese medical journal
|July 30, 2024
概括
非常低的和非常高的低密度脂蛋白胆固醇 (LDL-C) 水平都与增加的死亡风险有关. 综合健康评估对于个性化的心血管风险管理和降脂疗法至关重要,特别是对于LDL-C非常低的人来说.
科学领域:
- 心血管流行病学心血管流行病学
- 脂质代谢 脂质代谢是什么
- 公共卫生 公共卫生
背景情况:
- 低密度脂蛋白胆固醇 (LDL-C) 与死亡率之间的关系,包括人口异质性,需要进一步研究.
- 了解这些关联对于完善心血管疾病 (CVD) 预防策略至关重要.
研究的目的:
- 检查LDL-C水平与所有原因和心血管疾病死亡率之间的剂量依赖关系.
- 调查各种子组之间的这些协会中的人口异质性.
主要方法:
- 在中国HEART研究 (2014-2019) 中利用了2,968,462名参与者 (年龄在35-75岁) 的数据.
- 采用Cox比例危险和细灰分区危险模型来分析LDL-C类别和死亡结果.
主要成果:
- 观察到LDL-C与所有原因,心血管疾病,冠心病 (CHD) 和缺血性中风死亡率之间的J形关联.
- 在LDL-C和出血性中风 (HS) 死亡率之间发现了L型关联.
- 非常低的LDL-C (<70.0 mg/dL) 增加了CVD和HS死亡风险;非常高的LDL-C (≥190.0 mg/dL) 增加了CVD和CHD死亡风险.
- 亚组分析显示,在老年人和心血管疾病风险较低的人中,非常低的LDL-C具有更强的关联,而非常高的LDL-C在年轻人中显示出更强的关联.
结论:
- 非常低和非常高的LDL-C水平都与所有原因,心血管疾病和特定死亡风险的增加有关.
- 强调需要进行全面的健康评估,以量身定制降脂疗法,特别是在LDL-C非常低的人群中.
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