患有糖尿病和没有糖尿病的个体之间与HDL相关的冠心病风险的差异
Jun-Xiang Chen1, Qi Lu2, Tingting Geng3
1Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Public Health and Medical Technology, Xiamen Medical College, Xiamen, China.
Atherosclerosis
|August 26, 2024
概括
高密度脂蛋白 (HDL) 胆固醇和颗粒水平对糖尿病人和非糖尿病人的冠心病 (CHD) 风险的影响不同. 非常高的HDL胆固醇会增加糖尿病人的心脏病风险,而较小的HDL颗粒也与更高的风险有关.
科学领域:
- 心血管疾病研究研究
- 代谢综合征研究 代谢综合征研究
- 脂蛋白代谢 脂蛋白的代谢
背景情况:
- 高密度脂蛋白 (HDL) 在糖尿病患者中可能会失去对动脉样硬化的保护功能.
- 了解HDL胆固醇 (HDL-C) 和HDL粒子 (HDL-P) 亚类在冠状动脉疾病 (CHD) 风险中的作用至关重要,特别是当它们被糖尿病状态分层时.
研究的目的:
- 研究HDL-C和HDL-P亚类与患心血管疾病的风险之间的关联.
- 根据糖尿病的存在或不存在来分层这些关联.
主要方法:
- 利用了英国生物库的393516名参与者的数据,包括20691名糖尿病患者和372825名没有糖尿病患者.
- 使用Cox比例危险模型的受限立方线,分析HDL测量和事件CHD之间的关联,平均随访时间为13.0年.
主要成果:
- 在非糖尿病患者中,HDL-C显示与心脏病的反向关联,但在糖尿病患者中呈U形关联. 非常高的HDL-C与非糖尿病人的心脏病风险降低有关,但糖尿病人的风险更高.
- 高密度胆固醇-P的关联有所不同:非常大的和大的高密度胆固醇-P在非糖尿病患者中分别显示了与心脏病的反转U形和负相关性. 相比之下,糖尿病患者与非常大的HDL-P呈现出积极的关联,与很大的HDL-P呈现出无关联.
- 在糖尿病和非糖尿病组中,中小的HDL-P显示了与心脏病的L形关联.
结论:
- 非常高的HDL-C水平在非糖尿病人中降低了心脏病风险,但在糖尿病人中增加了风险.
- 在糖尿病患者中,较小的HDL颗粒与心脏病风险有负面关联,而非常大的HDL颗粒与心脏病风险有积极关联.
- 这些发现提高了对HDL功能和糖尿病在心血管疾病背景下的复杂相互作用的理解.
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