不一致性分析比较LDL胆固醇,非HDL胆固醇和阿波利波蛋白B,用于估计心血管风险
Camilla Ditlev Lindhardt Johannesen1, Martin Bødtker Mortensen2, Børge Grønne Nordestgaard1
1Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev Gentofte, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital - Herlev Gentofte, Denmark; The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg Frederiksberg, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark.
确定动脉样硬化心血管疾病 (ASCVD) 风险的最佳胆固醇标志物是复杂的. 不一致性分析显示,高的LDL,非HDL胆固醇或apoB表明风险,特别是在接受治疗的患者中.
科学领域:
- 心脏病学和动脉样硬化研究
- 生物标志物发现和验证
- 临床风险评估临床风险评估
背景情况:
- 确定动脉样硬化心血管疾病 (ASCVD) 风险的最佳胆固醇标志物一直是一个长期的挑战.
- 低密度脂蛋白 (LDL) 胆固醇,非高密度脂蛋白 (非HDL) 胆固醇和阿波利波蛋白B (apoB) 之间的高相关性使直接比较复杂化.
- 不一致性分析,检查这些标记者之间的分歧,已经成为一个关键的方法.
研究的目的:
- 审查和比较ASCVD风险评估中胆固醇标记物的不同不一致性分析方法.
- 讨论与不一致性分析相关的复杂性和解释挑战.
- 评估各种异调方法的临床适用性,特别是在治疗与未治疗的个体中.
主要方法:
- 审查使用基于切割点,百分位数或余数的不一致性分析的研究.
- 检查不一致的脂质水平与ASCVD风险之间的关联,使用一致的水平作为参考.
- 分析降脂药物如何影响胆固醇标志物之间的不一致.
主要成果:
- 一致的低脂水平与最低的ASCVD风险有关,而一致的高水平表明最高的风险,显示方法之间的异质性.
- 胆固醇标记物之间的不一致性在接受降脂药物治疗的患者中更为普遍.
- 切割点的不一致性是直观的;高的LDL,非HDL或apoB表明未接受治疗的个体的风险,而非HDL和apoB最好预测治疗患者的残留风险.
结论:
- 由于参考组的异质性,不同不一致性方法的结果的直接比较是有限的.
- 降脂药物显著影响胆固醇标志物异常和风险预测.
- 异调分析的切点方法具有临床适用性,特定的标志物在治疗和未治疗人群中显示风险不同.
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