超出LDL-C:不和的小密度LDL胆固醇在中国纵向队列中分层了高血压风险
Xiaofei Wu1, Chunfang Ma2, Weihai Chen3
1Department of Emergency Medicine, Suzhou Ninth People's Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China.
Lipids in health and disease
|June 23, 2025
概括
小密度低密度脂蛋白胆固醇 (sdLDL-C) 和其与LDL-C的不一致性预测了中国成年人高血压 (HTN) 的风险. 高的sdLDL-C,特别是低的LDL-C,表明HTN发病率升高.
科学领域:
- 心血管疾病流行病学
- 脂质新陈代谢和高血压
背景情况:
- 研究了小密度低密度脂蛋白胆固醇 (sdLDL-C) 和其与低密度脂蛋白胆固醇 (LDL-C) 的不一致性,作为高血压 (HTN) 发病率的预测因素.
- 专注于中国健康与退休长度研究 (CHARLS) 中的中国成年人群.
研究的目的:
- 确定sdLDL-C及其与LDL-C的不一致性是否预测高血压 (HTN) 的发生率.
- 评估不同sdLDL-C/LDL-C比率与HTN风险之间的关联.
- 用Sampson方程计算的LDL-C值与同质测试测量进行比较.
主要方法:
- 利用桑普森方程,从4574名中国成年人 (≥45岁) 的数据中计算sdLDL-C.
- 根据sdLDL-C/LDL-C百分位差异 (≥10%):不一致的低,一致的和不一致的高.
- 采用考克斯回归分析来检查sdLDL-C和HTN发病率之间的关系,调整为混因素.
主要成果:
- 在9年的时间里,39.9%的患者出现了HTN. 基线sdLDL-C独立预测了HTN风险 (HR=1.36).
- 不一致高的sdLDL-C组与不一致低的组 (HR=1.28) 相比,HTN风险高出24%.
- 低LDL-C但高sdLDL-C的个体表现出最高的HTN风险. 他们注意到桑普森方程和直接LDL-C测量之间的潜在偏差.
结论:
- sdLDL-C,特别是其与LDL-C的不一致性,是中国成年人发生HTN的独立预测因素.
- 这些发现表明sdLDL-C可以完善心血管风险分层.
- sdLDL-C可以提高高血压的精确预防策略.
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