LDL particle size and composition and incident cardiovascular disease in a South-European population: The Hortega-Liposcale Follow-up Study
LDL particle size and composition and incident cardiovascular disease in a South-European population: The Hortega-Liposcale Follow-up Study
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DOI：
10.1016/j.ijcard.2018.03.128
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发表时间：
2018-08-01
影响因子：
3.5
通讯作者：
Redon, J.
中科院分区：
文献类型：
--
作者：
Pichler, G.;Amigo, N.;Redon, J.
背景：低密度脂蛋白（LDL）颗粒组成与心血管风险的关系以前尚未探讨。目的是评估基线LDL颗粒大小和组成（大、中、小LDL颗粒占其总和的比例，表示为小LDL %、中LDL %和大LDL %）与基于人群的研究中的心血管疾病事件之间的关系。结果：研究样本中总LDL颗粒浓度的几何平均值为827.2 mg/dL（95%CI 814.7，839.8）。在平均12.4 +/- 3.3年的随访期间，共发生159起事件。在调整传统危险因素和治疗后，中等LDL颗粒与所有心血管疾病、冠心病（CHD）和中风呈正相关。对于LDL颗粒组成，中等和小LDL %增加5%，大LDL %相应减少，冠心病的多变量校正危险比分别为1.93（1.55，2.39）和1.41（1.14，1.74）。LDL颗粒表现出最强的关联与心血管事件时，颗粒组成，而不是总浓度，进行了研究。LDL颗粒的基线组成从大到中和小LDL颗粒的变化与心血管风险增加相关，尤其是CHD。(C)2018 Elsevier B. V.版权所有。
Background: The association of low-density lipoprotein (LDL) particle composition with cardiovascular risk has not been explored before. The aim was to evaluate the relationship between baseline LDL particle size and composition (proportions of large, medium and small LDL particles over their sum expressed as small-LDL %, medium-LDL % and large-LDL %) and incident cardiovascular disease in a population-based study.Methods: Direct measurement of LDL particles was performed using a two-dimensional NMR-technique (Liposcale (R)). LDL cholesterol was assessed using both standard photometrical methods and the Liposcale (R) technique in a representative sample of 1162 adult men and women from Spain.Results: The geometric mean of total LDL particle concentration in the study sample was 827.2 mg/dL (95% CI 814.7, 839.8). During a mean follow-up of 12.4 +/- 3.3 years, a total of 159 events occurred. Medium LDL particles were positively associated with all cardiovascular disease, coronary heart disease (CHD) and stroke after adjustment for traditional risk factors and treatment. Regarding LDL particle composition, the multivariable adjusted hazard ratios for CHD for a 5% increase in medium and small LDL % by a corresponding decrease of large LDL % were 1.93 (1.55, 2.39) and 1.41 (1.14, 1.74), respectively.Conclusions: Medium LDL particles were associated with incident cardiovascular disease. LDL particles showed the strongest association with cardiovascular events when the particle composition, rather than the total concentration, was investigated. A change in baseline composition of LDL particles from large to medium and small LDL particles was associated with an increased cardiovascular risk, especially for CHD. (C) 2018 Elsevier B.V. All rights reserved.