Association of Combinations of Lipid Parameters With Carotid Intima-Media Thickness and Coronary Artery Calcium in the MESA (Multi-Ethnic Study of Atherosclerosis)
Association of Combinations of Lipid Parameters With Carotid Intima-Media Thickness and Coronary Artery Calcium in the MESA (Multi-Ethnic Study of Atherosclerosis)
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DOI：
10.1016/j.jacc.2010.01.073
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发表时间：
2010-09-21
影响因子：
24
通讯作者：
Heckbert, Susan R.
中科院分区：
文献类型：
--
作者：
Paramsothy, Pathmaja;Knopp, Robert H.;Heckbert, Susan R.
目的本研究的目的是确定脂质参数组合与亚临床动脉粥样硬化的关系。背景颈动脉内膜-中膜厚度（CIMT）和冠状动脉钙（CAC）与心血管疾病（CVD）的发生显著相关。与正常血脂相比，普通血脂异常（合并高脂血症、[单纯性]高胆固醇血症、代谢综合征血脂异常、孤立性低高密度脂蛋白胆固醇和孤立性高甘油三酯血症）与CIMT和CAC之间的关系尚未被研究过。MESA（多种族动脉粥样硬化研究）参与者为无临床心血管疾病的白人、华人、非裔美国人或西班牙裔成年人。排除患有糖尿病或正在接受降脂治疗的受试者。根据特定的低密度脂蛋白胆固醇、高密度脂蛋白胆固醇或甘油三酯切点，每个参与者被分为6组中的1组。在调整心血管疾病危险因素后，多变量线性和相对风险回归评估了CIMT和CAC的横断面相关性。对CIMT和CAC结果评估与种族、性别和高敏c反应蛋白的相互作用。结果：在4,792名参与者中，只有合并高脂血症和高胆固醇血症的患者显示出普通CIMT（合并高脂血症0.048 mm厚，95%可信区间[CI]: 0.016至0.080 mm；高胆固醇血症0.048 mm厚，95% CI: 0.029至0.067 mm）和内部CIMT(合并高脂血症0.120 mm厚，95% CI: 0.032至0.208 mm；和高胆固醇血症（厚0.161毫米，95% CI: 0.098至0.223毫米）以及与正常血脂相比，普遍CAC的风险增加（合并高脂血症相对风险：1.22,95% CI: 1.08至1.38；高胆固醇血症相对风险：1.22,95% CI: 1.11至1.34）。脂质参数与种族、性别或高敏c反应蛋白之间的相互作用对任何结果都不显著。结论：在相对健康的多民族人群中，合并高脂血症和单纯性高胆固醇血症与CIMT升高和CAC流行相关。[J]中华医学会心脏科杂志，2010;32 (3):391 - 391
Objectives The purpose of this study was to determine the association of combinations of lipid parameters with subclinical atherosclerosis.Background Carotid intima-media thickness (CIMT) and coronary artery calcium (CAC) are significantly associated with incident cardiovascular disease (CVD). The association between common dyslipidemias (combined hyperlipidemia, [simple] hypercholesterolemia, dyslipidemia of metabolic syndrome, isolated low high-density lipoprotein cholesterol, and isolated hypertriglyceridemia) compared with normolipemia, and CIMT and CAC has not been previously examined.Methods The MESA (Multi-Ethnic Study of Atherosclerosis) participants were White, Chinese, African-American, or Hispanic adults without clinical CVD. Subjects with diabetes mellitus or who were receiving lipid-lowering therapy were excluded. Every participant was classified into only 1 of 6 groups defined by specific low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglyceride cut points. Multivariate linear and relative risk regressions evaluated the cross-sectional associations with CIMT and CAC after adjusting for CVD risk factors. Interactions with race, sex, and high-sensitivity C-reactive protein were evaluated for CIMT and CAC outcomes.Results Among 4,792 participants, only those with combined hyperlipidemia and hypercholesterolemia demonstrated both increased common CIMT (combined hyperlipidemia 0.048 mm thicker, 95% confidence interval [CI]: 0.016 to 0.080 mm; hypercholesterolemia 0.048 mm thicker, 95% CI: 0.029 to 0.067 mm) and internal CIMT (combined hyperlipidemia 0.120 mm thicker, 95% CI: 0.032 to 0.208 mm; and hypercholesterolemia 0.161 mm thicker, 95% CI: 0.098 to 0.223 mm) as well as increased risk for prevalent CAC (combined hyperlipidemia relative risk: 1.22, 95% CI: 1.08 to 1.38; hypercholesterolemia relative risk: 1.22, 95% CI: 1.11 to 1.34) compared with normolipemia. The interactions between lipid parameters and race, sex, or high-sensitivity C-reactive protein were not significant for any outcomes.Conclusions Combined hyperlipidemia and simple hypercholesterolemia were associated with increased CIMT and prevalent CAC in a relatively healthy multiethnic population. (J Am Coll Cardiol 2010; 56: 1034-41) (C) 2010 by the American College of Cardiology Foundation