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Kidney int:LDL、炎症以及心血管风险之间是一种怎样的关系?

2017-11-21 MedSci MedSci原创

一些炎症标志物,包括血浆C-反应蛋白(CRP),与心血管疾病的风险增加有关,并且有研究者认为这种关联存在着因果关系。然而,炎症与心血管疾病之间的关系尚未在慢性肾病患者中进行深入研究。近期,一项发表在杂志Kidney int上的研究旨在评估这两者之间的关系。研究者们使用心脏和肾脏保护研究(SHARP)的数据评估了循环系统汇总CRP和LDL胆固醇水平之间的关系以及血管和非血管结果的风险。主要血管事件被

一些炎症标志物,包括血浆C-反应蛋白(CRP),与心血管疾病的风险增加有关,并且有研究者认为这种关联存在着因果关系。然而,炎症与心血管疾病之间的关系尚未在慢性肾病患者中进行深入研究。


近期,一项发表在杂志Kidney int上的研究旨在评估这两者之间的关系。研究者们使用心脏和肾脏保护研究(SHARP)的数据评估了循环系统汇总CRP和LDL胆固醇水平之间的关系以及血管和非血管结果的风险。主要血管事件被定义为非致命性心肌梗塞,心源性死亡,中风或动脉血运重建,具有任何类型的血管事件的扩大的结果。

此项研究结果显示:较高基线的CRP水平与主要血管事件的风险增加相关(每3倍增加1.28; 95%置信区间为1.19-1.38)。基线LDL胆固醇水平较高也与主要血管事件发生风险增加有关(LDL胆固醇每升高0.6 mmol / L ,风险比为1.14;1.06-1.22)。

较高基线的CRP与一系列非血管事件的风险增加也相关(1.16,1.12-1.21),但基线LDL胆固醇与非血管事件之间存在弱的负相关性(0.96;0.92-0.99)。

在随机比较中,使用辛伐他汀/依泽替米贝降低LDL胆固醇对主要血管事件的功效与基线时的CRP浓度无关。

由此可见,对慢性肾脏疾病患者进行基于他汀类药物治疗的决定应以其动脉粥样硬化事件的绝对风险为指导。对这种风险的评估可能包括炎症的血浆生物标志物,但没有证据表明降低LDL胆固醇的相对有益作用是取决于血浆CRP浓度的。

原始出处:
Storey BC, Staplin N, et al. Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation. Kidney Int. 2017 Nov 14. pii: S0085-2538(17)30725-1. doi: 10.1016/j.kint.2017.09.011. 

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  2. [GetPortalCommentsPageByObjectIdResponse(id=2082434, encodeId=9fce208243456, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Fri Jan 05 05:32:00 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264325, encodeId=72d726432544, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Nov 26 02:13:15 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422555, encodeId=00c81422555ef, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Thu Nov 23 11:32:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603093, encodeId=b3981603093e9, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Nov 23 11:32:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263174, encodeId=73972631e4e1, content=一些炎症标志物.包括血浆C-反应蛋白(CRP).与心血管疾病的风险增加有关.并且有研究者认为这种关联存在着因果关系.然而.炎症与心血管疾病之间的关系尚未在慢性肾病患者中进行深入研究., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Tue Nov 21 21:50:29 CST 2017, time=2017-11-21, status=1, ipAttribution=)]
    2017-11-26 1209e435m98(暂无昵称)

    学习了.谢谢分享!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2082434, encodeId=9fce208243456, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Fri Jan 05 05:32:00 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264325, encodeId=72d726432544, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Nov 26 02:13:15 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422555, encodeId=00c81422555ef, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Thu Nov 23 11:32:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603093, encodeId=b3981603093e9, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Nov 23 11:32:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263174, encodeId=73972631e4e1, content=一些炎症标志物.包括血浆C-反应蛋白(CRP).与心血管疾病的风险增加有关.并且有研究者认为这种关联存在着因果关系.然而.炎症与心血管疾病之间的关系尚未在慢性肾病患者中进行深入研究., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Tue Nov 21 21:50:29 CST 2017, time=2017-11-21, status=1, ipAttribution=)]
    2017-11-23 zhwj
  4. [GetPortalCommentsPageByObjectIdResponse(id=2082434, encodeId=9fce208243456, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Fri Jan 05 05:32:00 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264325, encodeId=72d726432544, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Nov 26 02:13:15 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422555, encodeId=00c81422555ef, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Thu Nov 23 11:32:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603093, encodeId=b3981603093e9, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Nov 23 11:32:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263174, encodeId=73972631e4e1, content=一些炎症标志物.包括血浆C-反应蛋白(CRP).与心血管疾病的风险增加有关.并且有研究者认为这种关联存在着因果关系.然而.炎症与心血管疾病之间的关系尚未在慢性肾病患者中进行深入研究., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Tue Nov 21 21:50:29 CST 2017, time=2017-11-21, status=1, ipAttribution=)]
    2017-11-23 hb2008ye
  5. [GetPortalCommentsPageByObjectIdResponse(id=2082434, encodeId=9fce208243456, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Fri Jan 05 05:32:00 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264325, encodeId=72d726432544, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Nov 26 02:13:15 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422555, encodeId=00c81422555ef, content=<a href='/topic/show?id=58b810e5814' target=_blank style='color:#2F92EE;'>#LDL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10758, encryptionId=58b810e5814, topicName=LDL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=382c3719677, createdName=zhwj, createdTime=Thu Nov 23 11:32:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603093, encodeId=b3981603093e9, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Nov 23 11:32:00 CST 2017, time=2017-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263174, encodeId=73972631e4e1, content=一些炎症标志物.包括血浆C-反应蛋白(CRP).与心血管疾病的风险增加有关.并且有研究者认为这种关联存在着因果关系.然而.炎症与心血管疾病之间的关系尚未在慢性肾病患者中进行深入研究., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Tue Nov 21 21:50:29 CST 2017, time=2017-11-21, status=1, ipAttribution=)]
    2017-11-21 有备才能无患

    一些炎症标志物.包括血浆C-反应蛋白(CRP).与心血管疾病的风险增加有关.并且有研究者认为这种关联存在着因果关系.然而.炎症与心血管疾病之间的关系尚未在慢性肾病患者中进行深入研究.

    0

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高血脂症是一种已知的心血管疾病的风险因素。对于系统性疾病如心血管疾病与牙周病之间关系的生物学机制已得到一定程度的了解。这篇研究的目的是为了检测血脂情况与牙周炎之间的联系。

NEJM:LDL胆固醇水平升高的高心血管疾病风险患者inclisiran效果如何?

由此可见,inclisiran可以降低LDL胆固醇水平升高的高心血管疾病风险的患者的PCSK9和LDL胆固醇水平。

Circulation:胆固醇水平变化与认知能力减退有关

低密度脂蛋白(LDL),也被人们称为“坏”胆固醇,因为机体LDL水平过高不利于民众健康。最近的一项研究指出,LDL可能与民众认知能力下降有关。尽管LDL名声并不好,但胆固醇对人体功能的正常运转至关重要。细胞膜中胆固醇的含量约为30%,它对构成、保护和保持细胞膜功能及结构稳定至关重要。低密度脂蛋白胆固醇被认为是“坏的”,因为它可使动脉变硬并导致粥样硬化,从而增加民众出现心脏病发作和卒中的风险。高密度

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