Abstract
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].Chinese journal of Epidemiology,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
Received:March 10, 2020  
DOI:10.3760/cma.j.cn112338-20200310-00302
KeyWord: 携带载脂蛋白E的高密度脂蛋白  冠心病  发病风险
English Key Word: Apolipoprotein E-containing HDL-C  Coronary heart disease  Incident risk
FundProject: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)
Author NameAffiliationE-mail
Qi Yue Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China  
Liu Jing Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China  
Wang Miao Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China  
Sun Jiayi Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China  
Liu Jun Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China  
Deng Qiuju Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China  
Zhao Dong Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China deezhao@vip.sina.com 
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Abstract:
      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。
English Abstract:
      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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