遗传和测量的LDL-C:对心血管和中风亚型的差异性和相互作用影响
Yeun Soo Yang1,2, So Young Kim3, Hyungwoo Seo1,4
1Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health Yonsei University, Seoul, South Korea.
American journal of preventive cardiology
|November 5, 2025
概括
降低低密度脂蛋白胆固醇 (LDL-C) 会降低心血管疾病的风险,不会增加出血性中风的风险. 生活方式的改变可以有效地降低LDL-C,即使在具有高遗传倾向的个体中也是如此.
科学领域:
- 心血管遗传学 心血管遗传学
- 流行病学 流行病学
- 生物化学 生物化学
背景情况:
- 低密度脂蛋白胆固醇 (LDL-C) 是冠状动脉疾病 (CAD) 和死亡的主要风险因素.
- 人们担心,在非常低的LDL-C水平下,可能会增加出血性中风风险.
- 了解对LDL-C的遗传和环境影响对于管理心血管健康至关重要.
研究的目的:
- 研究LDL-C的遗传和环境决定因素.
- 分析基因决定的LDL-C (GLDL-C) 和环境决定的LDL-C (ELDL-C) 与心血管疾病 (CVD) 和出血性中风 (HS) 风险的关联.
- 为了确定非常低的LDL-C水平是否会增加HS的风险.
主要方法:
- 在15万多名来自韩国癌症预防研究II (KCPS-II) 参与者的全基因组关联研究 (GWAS) biobank.
- 通过从测量的LDL-C (MLDL-C) 中减去GLDL-C来计算ELDL-C.
- 分析MLDL-C,GLDL-C和ELDL-C五分位数与ASCVD,IHD和HS的关联,使用BBJ-GWAS总结统计数据进行外部验证.
主要成果:
- 与MLDL-C不同的是,GLDL-C独立于混因素.
- GLDL-C显示与动脉样硬化心血管疾病 (ASCVD) 和缺血性心脏病 (IHD) 风险有线关联.
- 在基于KCPS-II或BBJ的分析中,没有观察到较低GLDL-C水平增加HS风险;高遗传风险组受益于较低ELDL-C.
结论:
- 降低LDL-C与降低ASCVD风险线性相关.
- 非常低的LDL-C水平不会增加出血性中风的风险.
- 改变生活方式可以有效地降低基因高LDL-C的个体心血管风险.
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