预测在早期成年期累积暴露于异质脂质的预测
John T Wilkins1, Hongyan Ning2, Norrina B Allen2
1Department of Medicine (Cardiology), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Preventive Medicine (Epidemiology), Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Journal of the American College of Cardiology
|September 4, 2024
概括
年轻成年人的单次胆固醇测量准确地预测了长期的脂质暴露和未来的动脉样硬化心血管疾病 (ASCVD) 风险. 这一发现有助于在18-40岁的个人中早期评估ASCVD风险.
科学领域:
- 心血管健康 心血管健康
- 脂质代谢 脂质代谢是什么
- 预防性心脏病学 预防性心脏病学
背景情况:
- 早期成年期单次非高密度脂蛋白胆固醇 (非HDL-C) 或低密度脂蛋白胆固醇 (LDL-C) 测量对累积脂质暴露和随后的动脉样硬化心血管疾病 (ASCVD) 风险的预测价值尚未得到充分确立.
- 了解这种关系对于早期识别和预防ASCVD至关重要.
研究的目的:
- 为了确定在年轻成年人中一次性非HDL-C或LDL-C测量是否可以预测他们从18-40岁的累积脂质暴露.
- 量化早期成年期累积脂质暴露与40岁以后的ASCVD风险之间的联系.
主要方法:
- 利用了冠状动脉风险发展在年轻成年人 (心脏) 研究的数据.
- 评估单个非HDL-C或LDL-C测量 (18-30岁) 的能力,以预测累积脂质暴露的四分位数 (18-40岁).
- 研究了累积脂质暴露四分位数与40岁以后发生的ASCVD事件之间的关联.
主要成果:
- 单个非HDL-C或LDL-C测量显示出对累积脂质暴露四分位数的优异预测能力 (AUC:0.93).
- 确定了特定门:非高血压-C>135 mg/dL和LDL-C>118 mg/dL预测的上四分位数;<107 mg/dL和<96 mg/dL预测的下四分位数.
- 与最低四分位数相比,40岁后,累积非高密度胆固醇和低密度胆固醇暴露的最高四分位数的人具有显著更高的ASCVD风险 (HR分别为4.6和4.0).
结论:
- 在年轻成人 (18-30岁) 中单次测量非HDL-C和LDL-C,是40岁时累积脂质暴露的高度有效预测指标.
- 这种早期的脂质暴露与ASCVD晚年发展的风险有很强的相关性,并预测了这种风险.
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