Low-density lipoprotein particle number predicts coronary artery calcification in asymptomatic adults at intermediate risk of cardiovascular disease
Low-density lipoprotein particle number predicts coronary artery calcification in asymptomatic adults at intermediate risk of cardiovascular disease
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DOI：
10.1016/j.jacl.2011.07.001
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发表时间：
2011-10-01
影响因子：
4.4
通讯作者：
Backstrand, Jeffrey R.
中科院分区：
文献类型：
--
作者：
Prado, Kimberly Buff;Shugg, Suzanne;Backstrand, Jeffrey R.
背景：与目前大多数临床环境中使用的方法相比，临床医生需要更具辨别力的心血管风险测量方法。低密度脂蛋白 (LDL) 亚组分与亚临床动脉粥样硬化的关系是一个有前景的研究途径。 目的：评估 LDL 胆固醇亚组分与冠状动脉钙化 (CAC) 之间的横断面关联。 方法：研究样本包括 284 名无症状的临床患者，他们患有心血管疾病的中等风险，年龄 40-69 岁，未服用他汀类药物或烟酸。通过使用质子核磁共振波谱法获得脂蛋白亚类测量值。通过计算机断层扫描血管造影 (CTA) 评估 CAC。分析模拟了 CAC 存在或不存在的情况。结果：与传统脂蛋白测量相比，总 LDL 颗粒数 (LDL-P) 与 CAC 的相关性更强。总 LDL-P 最高三分位数 (1935-3560 nmol/L) 的患者出现冠状动脉钙化的可能性是最低三分位数 (620-1530 nmol/L) 的患者的 3.7 倍。在调整 LDL 胆固醇、高密度脂蛋白 (HDL)、甘油三酯、非 HDL 和大 LDL-P 后，小 LDL-P 的独立影响仍然显着。 HDL 和非 HDL 并不是 CAC 的显着独立预测因子。结论：小 LDL-P 是 CAC 存在的强有力的独立预测因子。需要进行大型前瞻性研究来检验 LDL 颗粒数量和大小对冠状动脉钙化的影响。 (C) 2011 年国家脂质协会。版权所有。
BACKGROUND: Clinicians require more discriminating measures of cardiovascular risk than those currently used in most clinical settings. A promising avenue of research concerns the relationship of low-density lipoprotein (LDL) subfractions to subclinical atherosclerosis.OBJECTIVE: To assess cross-sectional associations between subfractions of LDL cholesterol and coronary artery calcification (CAC).METHODS: The study sample comprised 284 asymptomatic clinic patients who were at intermediate risk of cardiovascular disease, aged 40-69 years, who were not taking a statin or niacin. Lipoprotein subclass measures were obtained by the use of proton nuclear magnetic resonance spectroscopy. CAC was assessed with computed tomography angiography (CTA). The analyses modeled the presence or absence of CAC.RESULTS: Total LDL particle number (LDL-P) had a stronger association with CAC than the traditional lipoprotein measures. Patients in the highest tercile of total LDL-P (1935-3560 nmol/L) were 3.7 times more likely to exhibit coronary artery calcification as those in the lowest tercile (620-1530 nmol/L). The independent effects of small LDL-P remained significant after adjustment for LDL-cholesterol, high-density lipoprotein (HDL), triglycerides, non-HDL, and large LDL-P. HDL and non-HDL were not significant, independent predictors of CAC.CONCLUSION: Small LDL-P was a strong, independent predictor of the presence of CAC. Large prospective studies are needed to examine the effect of LDL particle number and size on coronary artery calcification. (C) 2011 National Lipid Association. All rights reserved.