非常高的HDL-C水平与死亡率之间的关联:系统性审查和元分析
Isadora Mamede1, Marcelo Antonio Pinheiro Braga2, Otavio C Martins3
1Faculty of Medicine, Federal University of Sao Joao del-Rei, Centro Oeste Campus, Divinopolis, Brazil (Dr Mamede).
Journal of clinical lipidology
|September 15, 2024
概括
非常高密度脂蛋白胆固醇 (HDL-C) 水平不能防止心血管死亡,并且可能增加风险,特别是在男性中. 这次元分析没有发现所有原因或心血管死亡率的显著差异,但冠心病事件的减少.
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
- 公共卫生 公共卫生
背景情况:
- 最近的研究质疑高密度脂蛋白胆固醇 (HDL-C) 对心血管的益处.
- 有关与极高的HDL-C水平相关的不良结果存在担忧.
研究的目的:
- 调查非常高的HDL-C (≥80 mg/dL) 与没有冠状动脉疾病 (CAD) 的个体的死亡率之间的关联.
主要方法:
- 在PubMed,Embase和Cochrane数据库中的系统文献搜索.
- 对包括100多万个体在内的8项研究的元分析.
- 用于评估异质性的随机效应模型.
主要成果:
- 非常高的HDL-C并没有显著改变全因或癌症死亡率.
- 心血管死亡率没有显著变化 (HR 1.05;95% CI 0.94-1.17)
- 致命和非致命的冠心病事件在非常高的HDL-C组 (HR 0.79;95% CI 0.73-0.86) 较少发生.
- 亚组分析表明,女性高于116毫克/分升,男性高于94毫克/分升时,心血管死亡风险增加.
结论:
- 非常高的HDL-C水平并不能保护心血管死亡率.
- 升高的HDL-C可能会增加心血管死亡风险,特别是在男性中.
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