与脂蛋白相关的因素 (a) 多民族个体之间的测试
Sumeet Brar1, Qiwen Huang2, Xiaowei Yan2
1Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Journal of general internal medicine
|October 25, 2024
概括
建议对脂质蛋白 (Lp) 进行测试,但在实际使用中仍然很低. 在种族和族群之间存在Lp (a) 测试的显著差异,突出了改善访问的必要性.
科学领域:
- 心血管医学 心血管医学
- 临床流行病学 临床流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 脂蛋白 (Lp) 是一种已知的动脉样硬化心血管疾病 (ASCVD) 的因果风险因素.
- 临床指南主张将Lp (a) 检测纳入常规患者护理.
- 了解当前的Lp(a) 测试模式对于解决ASCVD风险至关重要.
研究的目的:
- 为了调查现实世界,当代的临床测试模式Lp(a).
- 检查Lp (a) 测试在多元多民族人群中的流行率.
- 确定与Lp (a) 测试利用率相关的因素.
主要方法:
- 在一个大型的北加利福尼亚州卫生系统 (2010-2021) 中进行了一项嵌套病例控制研究.
- 使用事件密度匹配来选择病例的对照 (高达1:5的比例).
- 条件后勤回归分析了Lp测试和患者特征之间的关联.
主要成果:
- 在1,484,410人中,只有1.0%接受了Lp (a) 测试;中位数为35mg/dL.
- 南亚人的测试概率更高 (OR=3.19),而黑人和西班牙裔人的测试率更低.
- 史上的ASCVD (OR=2.14) 和频繁的初级保健访问 (OR=1.99) 与测试增加有关.
结论:
- 现实世界Lp (a) 测试率较低,基于种族,种族和医疗保健利用情况存在显著差异.
- 为公平的ASCVD风险评估和治疗,扩大Lp (a) 测试的可用性至关重要.
- 解决测试差异将至关重要,因为新型Lp (a) 向疗法正在出现.
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