Combined use of apolipoprotein B/apolipoprotein A1 ratio and non-high-density lipoprotein cholesterol before routine clinical lipid measurement in predicting coronary heart disease
Combined use of apolipoprotein B/apolipoprotein A1 ratio and non-high-density lipoprotein cholesterol before routine clinical lipid measurement in predicting coronary heart disease
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DOI：
10.1097/mca.0000000000000100
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发表时间：
2014-08
影响因子：
1.8
通讯作者：
Liting Pan;Guoping Lu;Zhenyue Chen
中科院分区：
文献类型：
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作者：
Liting Pan;Guoping Lu;Zhenyue Chen
本研究旨在探讨在常规临床血脂测定前联合应用载脂蛋白B（apoB）/载脂蛋白A1（apoA 1）和非高密度脂蛋白胆固醇（non-HDL-C）对冠心病（CHD）的预测价值。研究对象与方法826例患者，根据冠状动脉造影结果分为冠心病组532例和正常组294例。实验室数据，包括空腹血脂后，获得了一夜的快速。计算血清apoB/apoA 1比值和非HDL-C。应用逻辑回归分析评估apoB/apoA 1比值、非HDL-C和CHD之间的横断面相关性。应用受试者工作特征曲线分析apoB/apoA 1比值和non-HDL-C对冠心病的诊断价值。结果apoB/apoA 1比值[OR =8.941，95% CI 4.363-18.323]与冠心病危险性的相关性明显高于非HDL-C（OR=1.373，95% CI 1.163-1.622）。apoB/apoA 1分布上四分位数的患者与下四分位数的患者相比，OR为7.321（95%CI 3.891-13.771）。apoB/apoA 1和non-HDL-C联合高水平（N=92，79.31%）的患者患冠心病的危险性最高。apoB/apoA 1比值和非HDL-C（0.762; 95%CI 0.677-0.847）的联合使用显示了比其单个组分或其他脂质谱更大的受试者工作特征面积。结论apoB/apoA 1和non-HDL-C联合检测对冠心病的预测价值比单独检测或其他血脂指标更高。
Background and aimsOur aim was to examine whether the combined use of apolipoprotein B (apoB)/apolipoprotein A1 (apoA1) and non-high-density lipoprotein cholesterol (non-HDL-C) was useful before routine clinical lipid measurement in predicting coronary heart disease (CHD). Patients and methodsIn total, 826 patients were enrolled and they were classified into a CHD group (532 cases) and a normal group (294 cases) according to the results of coronary angiography. Laboratory data including fasting lipid profile were obtained after an overnight fast. Serum apoB/apoA1 ratio and non-HDL-C were calculated. Logistic regression was applied to estimate the cross-sectional association between the apoB/apoA1 ratio, non-HDL-C, and CHD. Receiver operating characteristics curve analysis was used to determine the value of apoB/apoA1 ratio and non-HDL-C in the diagnosis of CHD. ResultsThe associations with an increased risk of CHD were much stronger for the apoB/apoA1 ratio [odds ratio (OR)=8.941, 95% confidence interval (CI) 4.363–18.323] than for non-HDL-C (OR=1.373, 95% CI 1.163–1.622). The patients in the top quartile of the apoB/apoA1 distribution had an OR of 7.321 (95% CI 3.891–13.771) compared with those in the bottom quartile. Patients with combined high levels of apoB/apoA1 and non-HDL-C (N=92, 79.31%) had the highest risk of CHD. The combined use of apoB/apoA1 ratio and non-HDL-C (0.762; 95% CI 0.677–0.847) showed greater receiver operating characteristics area than its individual components or other lipid profiles. ConclusionThe combination of apoB/apoA1 and non-HDL-C had even greater predictive value than its individual components or other lipid profiles.