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升高的残留和LDL胆固醇和周围动脉疾病的风险:孟德尔的随机化研究
Benjamin Nilsson Wadström1, Maria Carolina Borges2, Anders Berg Wulff3
1Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
升高的残留胆固醇,而不仅仅是LDL胆固醇,因果性地增加了周围动脉疾病 (PAD) 的风险. 剩余胆固醇似乎是主要的驱动因素,这表明PAD预防和治疗的新治疗点.
科学领域:
- 心血管遗传学 心血管遗传学
- 脂质代谢 脂质代谢是什么
- 流行病学 流行病学
背景情况:
- 升高的残留胆固醇和低密度脂蛋白 (LDL) 胆固醇都是冠状动脉疾病 (CAD) 的确定的危险因素.
- 剩余胆固醇,LDL胆固醇和外围动脉疾病 (PAD) 风险之间的独立因果关系尚不清楚.
研究的目的:
- 研究残留胆固醇和LDL胆固醇对患PAD风险的独立因果关系.
- 为了确定残留胆固醇或LDL胆固醇是否是PAD的主要脂质相关风险因素.
主要方法:
- 利用孟德尔的随机化分析,使用来自英国生物库数据的遗传分数.
- 使用单变量和多变量模型评估残留和LDL胆固醇对PAD和CAD风险的因果关系.
- 包括PAD (n=38,414例) 和CAD (n=221,445例) 的大型病例对照队列.
主要成果:
- 较高的残留胆固醇对PAD风险具有显著的因果关系,独立于LDL胆固醇.
- LDL胆固醇对PAD风险的因果作用在很大程度上是由升高的残留胆固醇介导的.
- 这两种脂质分数都对CAD风险表现出因果关系,残留胆固醇也显示出显著的独立贡献.
结论:
- 剩余胆固醇是PAD风险的一个重要,独立的因果因素.
- 剩余胆固醇,而不是LDL胆固醇,可能是PAD的主要脂质相关风险因素.
- 对这些发现背后的生物机制进行进一步的研究是有必要的,以便开发新的PAD疗法.
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