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Lancet:高密度脂蛋白胆固醇外流能力与冠心病的联系

2015-05-28 崔倩 译 MedSci原创

背景  虽然高密度脂蛋白胆固醇浓度与冠状动脉心脏疾病风险强烈负相关,干预提高高密度脂蛋白胆固醇浓度但不降低冠状动脉心脏疾病的风险。高密度脂蛋白胆固醇外流能力—HDL作用的原型措施—调整HDL胆固醇后已与冠状动脉心脏疾病相关,但其对冠心病事件的风险的影响是不确定的。    方法  研究人员测量胆固醇流出的能力,并评估其25639人年龄在40-79岁的

背景  

虽然高密度脂蛋白胆固醇浓度与冠状动脉心脏疾病风险强烈负相关,干预提高高密度脂蛋白胆固醇浓度但不降低冠状动脉心脏疾病的风险。高密度脂蛋白胆固醇外流能力—HDL作用的原型措施—调整HDL胆固醇后已与冠状动脉心脏疾病相关,但其对冠心病事件的风险的影响是不确定的。
    
方法  

研究人员测量胆固醇流出的能力,并评估其25639人年龄在40-79岁的前瞻性EPIC-Norfolk研究巢式病例对照样本中的血管危险因素和冠心病事件发生的关系,评估从1993年至1997年,随访截止到2009年。研究人员在1745名冠心病患者和1749名没有心血管疾病的对照参与者量化了胆固醇流出能力,通过使用离体放射性示踪剂测定,涉及来自参与者载脂蛋白B缺乏的血清孵化胆固醇标记的J774巨噬细胞。
    
结果  

胆固醇流出量与高密度脂蛋白胆固醇水平(r=0.40,P<0.0001)和载脂蛋白A-1浓度(R=0.22,P<0.0001)正相关。与2型糖尿病(r=-0.18,P<0.0001)负相关,与饮酒情况正相关(r=0.12,P<0.0001)。与顶部分位和底部分位相比,胆固醇流出量与冠心病事件显著负相关,这依赖于年龄,性别,糖尿病高血压,吸烟和酗酒,腰臀比,体重指数,LDL胆固醇浓度,甘油三酯和高密度脂蛋白胆固醇或载脂蛋白A-1浓度(比值比0.64,95%Cl 0.51-0.80)。类似的多变量调整后,胆固醇流出能力每一个SD变化的冠心病事件的风险是0.8(95% Cl 0.70–0.90)。
    
结论  

高密度脂蛋白胆固醇流出的能力可能为HDL浓度之外的HDL通路治疗调节提供替代机制,以帮助减少冠心病的风险。

原始出处:

Dr Danish Saleheen, PhDcorrespondenceemail, Robert Scott, PhD, Sundas Javad, PhD, Wei Zhao, MS, Amrith Rodrigues, MS, Antonino Picataggi, BA, Daniya Lukmanova, MS, Megan L Mucksavage, MS, Robert Luben, PhD, Jeffery Billheimer, PhD, Prof John J P Kastelein, MD, S Matthijs Boekholdt, PhD, Prof Kay-Tee Khaw, PhD, Prof Nick Wareham, PhD, Prof Daniel J Rader, MDcorrespondenceemail,Association of HDL cholesterol efflux capacity with incident coronary heart disease events: a prospective case-control study,Lancet,May 26, 2015.

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    2015-08-06 hlycom3356

    期待有更多研究

    0

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    2015-05-31 huaxipanxing

    看看

    0

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