The Associations of Lipid Profiles With Cardiovascular Diseases and Death in a 10-Year Prospective Cohort Study.
The Associations of Lipid Profiles With Cardiovascular Diseases and Death in a 10-Year Prospective Cohort Study.
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十年前瞻性队列研究中脂质谱与心血管疾病和死亡的关联
DOI：
10.3389/fcvm.2021.745539
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发表时间：
2021
影响因子：
3.6
通讯作者：
Shen C
中科院分区：
文献类型：
--
作者：
Dong J;Yang S;Zhuang Q;Sun J;Wei P;Zhao X;Chen Y;Chen X;Li M;Wei L;Chen C;Fan Y;Shen C
背景：血脂异常是心血管疾病（CVD）的可改变危险因素之一。识别血脂异常的受试者有助于预防性干预。目的：评估血脂指标对缺血性卒中（IS）、冠心病（CHD）、CVD、全因死亡和CVD死亡风险的影响。方法：4，128名受试者的队列研究于2009年5月开始，随访至2020年7月。采用限制性三次样条（RCS）回归分析探讨血脂指标与结局之间的剂量反应关系。采用考克斯比例风险回归分析估计与风险比（HR）和95% CI的相关性。结果如下：RCS分析显示TG与IS、非高密度脂蛋白胆固醇（HDL-C）、载脂蛋白B（ApoB）和总胆固醇（TC）/HDL-C比值与全因死亡呈显著线性相关，非HDL-C和RC与CVD死亡呈显著线性相关，ApoB与IS和CVD、TC、LDL-C、ApoAI和TC/HDL-C比值与CHD呈显著非线性相关，TC组与全因死亡组比较，差异均有统计学意义（P均<0.1）。考克斯回归分析显示，TC <155 mg/dl的受试者（相对于155 - 184 mg/dl），> 185 mg/dl（相对于155 - 184 mg/dl），ApoB <0.7 g/l与≥ 0.7 g/l相比，冠心病的危险性增加（P <0.05），校正的HR（95% CI）分别为1.933（1.248-2.993）、1.561（1.077-2.261）和1.502（1.01-2.234）。ApoAI> 2.1 g/l（vs.1.6 - 2.1 g/l）和TG <80 mg/dl（vs.80 - 177 mg/dl）的受试者发生CVD和全因死亡的风险较高（P <0.05），校正的HR（95%CI）分别为1.476（1.031 - 2.115）和1.234（1.002 - 1.519）。结论：低或高水平的TC、高水平的ApoAI和低水平的ApoB与CVD风险增加相关，低水平的TG与全因死亡增加相关。保持最佳的脂质水平将有助于预防CVD和降低死亡率。
Background: Dyslipidemia is one of the modifiable risk factors for cardiovascular diseases (CVD). Identifying subjects with lipid abnormality facilitates preventative interventions. Objectives: To evaluate the effects of lipid indices on the risks of ischemic stroke (IS), coronary heart disease (CHD), CVD, all-cause death, and CVD death. Methods: The cohort study of 4,128 subjects started in May 2009 and followed up to July 2020. Restricted cubic spline (RCS) regression analysis was used to explore the dose-response relationship between lipid indices with outcomes. Cox proportional hazard regression analysis was used to estimate the association with a hazard ratio (HR) and 95% CI. Results: RCS analysis showed that there were significant linear associations of TG with IS, non-high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (ApoB), and total cholesterol (TC)/HDL-C ratio with all-cause death, non-HDL-C and RC with CVD death, and significant non-linear associations of ApoB with IS and CVD, TC, LDL-C, ApoAI, and TC/HDL-C ratio with CHD, and TC with all-cause death (all P <0.1). Cox regression analysis revealed that subjects with TC <155 mg/dl (vs. 155–184 mg/dl), > 185 mg/dl (vs. 155–184 mg/dl), and ApoB <0.7 g/l (vs. ≥0.7 g/l) had higher risks of CHD (P < 0.05), the adjusted HRs (95% CIs) were 1.933 (1.248–2.993), 1.561 (1.077–2.261), and 1.502 (1.01–2.234), respectively. Subjects with ApoAI > 2.1 g/l (vs. 1.6–2.1 g/l) and TG <80 mg/dl (vs. 80–177 mg/dl) had higher risks of CVD and all-cause death (P < 0.05), the adjusted HRs (95% CIs) were 1.476 (1.031–2.115) and 1.234 (1.002–1.519), respectively. Conclusions: Lower or higher levels of TC, higher level of ApoAI, and lower level of ApoB were associated with increased risks of CVD, and lower level of TG was associated with increased all-cause death. Maintaining optimal lipid levels would help to prevent CVD and reduce mortality.