Novel Size-Based High-Density Lipoprotein Subspecies and Incident Vascular Events.
Novel Size-Based High-Density Lipoprotein Subspecies and Incident Vascular Events.
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DOI：
10.1161/jaha.123.031160
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发表时间：
2023-11-07
影响因子：
5.4
通讯作者：
Rohatgi, Anand
中科院分区：
文献类型：
--
作者：
Deets, Austin;Joshi, Parag H.;Chandra, Alvin;Singh, Kavisha;Khera, Amit;Virani, Salim S.;Ballantyne, Christie M.;Otvos, James D.;Dullaart, Robin P. F.;Gruppen, Eke G.;Connelly, Margery A.;Ayers, Colby;Navar, Ann Marie;Pandey, Ambarish;Wilkins, John T.;Rohatgi, Anand
高密度脂蛋白（HDL）颗粒浓度在预测动脉粥样硬化性心血管事件方面可能优于HDL胆固醇。基于大小的HDL亚种是否解释HDL颗粒浓度的动脉粥样硬化保护相关性仍然未知。我们的目的是在多种族汇总队列中评估特定大小的HDL亚种水平是否与动脉粥样硬化性心血管疾病相关，并改善传统动脉粥样硬化性心血管疾病风险因素以外的风险预测。在ARIC（社区动脉粥样硬化风险）、梅萨（多种族动脉粥样硬化研究）、PREVEND（肾脏和血管终末期疾病预防）和DHS（达拉斯心脏研究）队列（n=15 371人）中，通过核磁共振（LP 4算法; H1=最小; H7=最大）对既往无动脉粥样硬化性心血管疾病的参与者中7种基于HDL大小的亚种进行定量。多变量考克斯比例风险模型用于评价HDL亚类与随访（平均8-10年）时发生心肌梗死（MI）或缺血性卒中之间的相关性，调整HDL胆固醇和风险因素。风险预测的改善通过判别和重新分类分析进行评估。在汇总队列中（中位年龄57岁;女性54%;黑人22%），较高的H1（小）和H4（中）浓度与MI事件呈负相关（风险比[HR]/SD，H1 0.88 [95% CI，0.81-0.94]; H4 0.89 [95% CI，0.82-0.97]）。H4而不是H1改善了事件MI的风险预测指数。增加H2和H4与卒中、MI和心血管死亡复合终点的风险预测指数改善呈负相关（HR/SD，H2 0.94 [95%CI，0.88-0.99]; H4 0.91 [95%CI，0.85-0.98]）。大亚种（H6和H7）的水平与任何血管终点无关。在一个大型多种族汇总队列中，7个基于HDL大小的亚种中有2个适度改善了MI和复合血管终点的风险预测。这些发现支持对精确的HDL亚种进行评估，以用于未来关于临床效用的研究。
High‐density lipoprotein (HDL) particle concentration likely outperforms HDL cholesterol in predicting atherosclerotic cardiovascular events. Whether size‐based HDL subspecies explain the atheroprotective associations of HDL particle concentration remains unknown. Our objective was to assess whether levels of specific size‐based HDL subspecies associate with atherosclerotic cardiovascular disease in a multiethnic pooled cohort and improve risk prediction beyond traditional atherosclerotic cardiovascular disease risk factors. Seven HDL size‐based subspecies were quantified by nuclear magnetic resonance (LP4 algorithm; H1=smallest; H7=largest) among participants without prior atherosclerotic cardiovascular disease in ARIC (Atherosclerosis Risk in Communities), MESA (Multi‐Ethnic Study of Atherosclerosis), PREVEND (Prevention of Renal and Vascular Endstage Disease), and DHS (Dallas Heart Study) cohorts (n=15 371 people). Multivariable Cox proportional hazards models were used to evaluate the association between HDL subspecies and incident myocardial infarction (MI) or ischemic stroke at follow‐up (average 8–10 years) adjusting for HDL cholesterol and risk factors. Improvement in risk prediction was assessed via discrimination and reclassification analysis. Within the pooled cohort (median age 57 years; female 54%; Black 22%) higher H1 (small) and H4 (medium) concentrations were inversely associated with incident MI (hazard ratio [HR]/SD, H1 0.88 [95% CI, 0.81–0.94]; H4 0.89 [95% CI, 0.82–0.97]). H4 but not H1 improved risk prediction indices for incident MI. Increasing H2 and H4 were inversely associated with improved risk prediction indices for composite end point of stroke, MI, and cardiovascular death (HR/SD, H2 0.94 [95% CI, 0.88–0.99]; H4 0.91 [95% CI, 0.85–0.98]). Levels of the large subspecies (H6 and H7) were not associated with any vascular end point. Two of 7 HDL size‐based subspecies modestly improved risk prediction for MI and composite vascular end points in a large multiethnic pooled cohort. These findings support assessment of precise HDL subspecies for future studies regarding clinical utility.
影响因子：
4.4
作者：
Josefs T;Wouters K;Tietge UJF;Annema W;Dullaart RPF;Vaisar T;Arts ICW;van der Kallen CJH;Stehouwer CDA;Schalkwijk CG;Goldberg IJ;Fisher EA;van Greevenbroek MMJ
通讯作者：
van Greevenbroek MMJ
影响因子：
39.3
作者：
Giang KW;Björck L;Novak M;Lappas G;Wilhelmsen L;Torén K;Rosengren A
通讯作者：
Rosengren A
影响因子：
3.7
作者：
Parra ES;Panzoldo NB;Zago VH;Scherrer DZ;Alexandre F;Bakkarat J;Nunes VS;Nakandakare ER;Quintão EC;Nadruz W Jr;de Faria EC;Sposito AC
通讯作者：
Sposito AC