文章摘要
齐玥,刘静,王淼,孙佳艺,刘军,邓秋菊,赵冬.携带载脂蛋白E的HDL-C与冠心病发病风险的前瞻性队列研究[J].中华流行病学杂志,2021,42(2):297-302
携带载脂蛋白E的HDL-C与冠心病发病风险的前瞻性队列研究
Association between apolipoprotein E-containing HDL-C and coronary heart disease risk: a community-based cohort study
收稿日期:2020-03-10  出版日期:2021-02-24
DOI:10.3760/cma.j.cn112338-20200310-00302
中文关键词: 携带载脂蛋白E的高密度脂蛋白;冠心病;发病风险
英文关键词: Apolipoprotein E-containing HDL-C;Coronary heart disease;Incident risk
基金项目:国家自然科学基金(81570409);国家重点研发计划(2016YFC0900902);国家科技支撑计划(2011BAI09B01,2006BAI01A01)
作者单位E-mail
齐玥 首都医科大学附属北京安贞医院, 北京市心肺血管疾病研究所流行病研究室 100029  
刘静 首都医科大学附属北京安贞医院, 北京市心肺血管疾病研究所流行病研究室 100029  
王淼 首都医科大学附属北京安贞医院, 北京市心肺血管疾病研究所流行病研究室 100029  
孙佳艺 首都医科大学附属北京安贞医院, 北京市心肺血管疾病研究所流行病研究室 100029  
刘军 首都医科大学附属北京安贞医院, 北京市心肺血管疾病研究所流行病研究室 100029  
邓秋菊 首都医科大学附属北京安贞医院, 北京市心肺血管疾病研究所流行病研究室 100029  
赵冬 首都医科大学附属北京安贞医院, 北京市心肺血管疾病研究所流行病研究室 100029 deezhao@vip.sina.com 
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中文摘要:
      目的 探讨我国人群携带载脂蛋白E的HDL-C (APOE-HDL-C)与冠心病发病风险的关系。方法 选择中国多省市心血管病队列研究中参加2002年或2007年心血管病危险因素调查并随访至2013年12月31日的研究对象5 417人(排除基线有心血管病者)。检测研究对象基线APOE-HDL-C和总HDL-C水平。计算APOE-HDL-C/总HDL-C比值。采用Cox比例风险模型分析HDL-C相关指标与冠心病发病风险的关系。结果 研究对象平均随访6.8年,发生急性冠心病事件100例。调整潜在混杂因素后,基线HDL-C相关指标与冠心病发病风险显著负相关。与APOE-HDL-C/总HDL-C比值最低四分位组相比,最高四分位组的急性冠心病事件发病相对风险降低74%(HR=0.26,95%CI:0.12~0.71)。APOE-HDL-C/总HDL-C比值最高分位组的个体冠心病预测发病绝对风险最低[0.48%(0.44%~0.52%)],显著低于HDL-C最高分位组个体冠心病预测发病绝对风险[0.83%(0.78%~0.88%)]。结论 基线APOE-HDL-C/总HDL-C比值与急性冠心病事件发病风险显著负相关。APOE-HDL-C/总HDL-C比值升高者的冠心病预测发病绝对风险显著低于总HDL-C升高者。研究结果提示APOE-HDL-C可作为反映HDL抗动脉粥样硬化功能的新生物标志物。
英文摘要:
      Objective To assess whether apolipoprotein E-containing HDL-C (APOE-HDL-C) is causally associated with coronary heart disease (CHD) risk.Methods In total, 5 417 cardiovascular disease-free participants at baseline were followed up for up to 10 years in the Chinese Multi-provincial Cohort Study. APOE-HDL-C and HDL-C were measured in all participants. APOE-HDL-C/total HDL-C ratio was calculated. Multivariate Cox regression was employed to assess the association between HDL-C related biomarkers and 10-year CHD incident risk.Results A total of 100 incident CHD events occurred during a mean 6.8 years follow-up. High levels of baseline HDL-C related biomarkers were significantly negatively associated with incident CHD risk. Comparison with participant with lowest level of APOE-HDL-C/total HDL-C ratio, those with highest level of APOE-HDL-C/total HDL-C ratio had 74% decreased risk of CHD (HR=0.26, 95%CI:0.12-0.71). The individual with the highest level of APOE-HDL-C/total HDL-C ratio had the lowest absolute risk[0.48% (0.44%-0.52%)] of CHD, which was significantly lower than that[0.83% (0.78%-0.88%)] of the individual with the highest level of HDL-C.Conclusions Our findings revealed that the APOE-HDL-C/total HDL-C ratio was significantly related to a 10-year increased risk of incident CHD, even beyond HDL-C. It seemed that APOE-HDL-C could serve as a new indicator of the anti-atherosclerotic function of HDL.
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