| 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） |
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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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