Remnant-like particles and coronary artery disease in familial hypercholesterolemia
Remnant-like particles and coronary artery disease in familial hypercholesterolemia
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DOI：
10.1016/j.cca.2018.04.007
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发表时间：
2018-07-01
影响因子：
5
通讯作者：
Hayashi, Kenshi
中科院分区：
文献类型：
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作者：
Tada, Hayato;Kawashiri, Masa-aki;Hayashi, Kenshi
背景尽管残余样颗粒胆固醇（RLP-C）与一般人群中的冠状动脉疾病（CAD）有关，但关于家族性高胆固醇血症（FH）患者中该问题的数据很少。我们的研究的目的是探讨RLP-C和存在的CAD在FH患者之间的关联。方法：我们检查了282例FI-I（144名男性，平均年龄，41 - 17岁），其RLP-C水平进行了测量。结果：血清RLP-C水平与血清甘油三酯（TG）水平显著相关（Pearson's r = 0.631，p < 0.001）。我们观察到，血清RLP-C水平较高三分位数的个体中，患病冠状动脉数量较多（多支血管病变趋势p < 0.001）。经年龄、性别、高血压、糖尿病、吸烟、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和脂蛋白（a）[Lp（a）]校正后的Logistic回归分析显示，RLP-C与CAD显著相关[比值比（OR）：1.08，95%可信区间（CI）：1.00-1.16，p = 0.046];然而，将血清TG水平加入逻辑回归模型中，（OR：1.07，95%CI：0.98-1.17，p = 0.141），而Lp（a）与CAD独立相关结论：FH患者血清RLP-C水平与冠心病的发生及严重程度显著相关。然而，测量RLP-C水平超出测量TG水平的临床有用性应进一步评估。
Background Although remnant-like particle cholesterol (RLP-C) has been associated with coronary artery disease (CAD) in the general population, few data exist regarding this issue in patients with familial hypercholesterolemia (FH). The aim of our study was to investigate the association between RLP-C and the presence of CAD in patients with FH.Methods: We examined 282 patients with FI-I (144 males, mean age, 41 17 years) whose RLP-C levels were measured. We assessed the baseline characteristics, including lipid levels, other conventional risk factors for cardiovascular events, the presence of CAD, and the serum RLP-C levels.Results: Serum RLP-C levels significantly correlated with serum triglyceride (TG) levels (Pearson's r = 0.631, p < 0.001). We observed that a larger proportion of individuals in the higher tertiles of serum RLP-C had a larger number of diseased coronary arteries (p < 0.001 for the trend of multi-vessel disease). Logistic regression analysis, after adjusting for age, sex, hypertension, diabetes, smoking, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, and lipoprotein (a) [Lp(a)], revealed that RLP-C was significantly associated with CAD [odds ratio (OR): 1.08, 95% confidence interval (CI): 1.00-1.16, p = 0.046]; however, adding serum TG levels into the logistic regression model nullified this association (OR: 1.07, 95% CI: 0.98-1.17, p = 0.141), whereas Lp(a) was independently associated with CAD (OR: 1.02, 95% CI: 1.00-1.03, p = 0.015).Conclusions: Serum RLP-C levels were significantly associated with the presence and severity of CAD in patients with FH. However, the clinical usefulness of measuring RLP-C levels beyond that of measuring TG levels should be further assessed.