Benn Marianne, Nordestgaard Børge G, Jensen Gorm Boje, Tybjaerg-Hansen Anne
Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark.
Arterioscler Thromb Vasc Biol. 2007 Mar;27(3):661-70. doi: 10.1161/01.ATV.0000255580.73689.8e. Epub 2006 Dec 14.
Apolipoprotein B (apoB) levels predict fatal myocardial infarction. Whether apoB also predicts nonfatal ischemic cardiovascular events is unclear. We tested the following hypotheses: apoB predicts ischemic cardiovascular events, and apoB is a better predictor of ischemic cardiovascular events than low-density lipoprotein cholesterol.
We studied 9231 asymptomatic women and men from the Danish general population followed prospectively for 8 years and observed the following incident events: ischemic heart disease 591, myocardial infarction 278, ischemic cerebrovascular disease 313, ischemic stroke 229, and any ischemic cardiovascular event 807. Women with apoB in the upper versus the lower tertile had hazard ratios for ischemic heart disease of 1.8 (1.2 to 2.5), for myocardial infarction 2.6 (1.4 to 4.7), and for any ischemic cardiovascular event 1.8 (1.3 to 2.3), and men had hazard ratios for ischemic heart disease of 1.9 (1.5 to 2.6), for myocardial infarction 2.4 (1.5 to 3.6), and for any ischemic cardiovascular event 1.6 (1.3 to 2.1). Women had similar hazard ratios for ischemic cerebrovascular disease and ischemic stroke. ApoB had a higher predictive ability than low-density lipoprotein cholesterol in the prediction of ischemic heart disease, myocardial infarction, any ischemic cardiovascular event, and any nonfatal ischemic cardiovascular event in both genders (P=0.03 to <0.001). Finally, in smokers older than 60 years with systolic blood pressure >160 mm Hg, apoB contributed 11% in women and 15% in men to the increase in absolute 10-year risk from the lower to the upper apoB tertile.
ApoB predicts ischemic cardiovascular events in both genders, and is better than low-density lipoprotein cholesterol in this respect. We suggest that prediction of future ischemic cardiovascular events could be improved by measuring apoB.
载脂蛋白B（apoB）水平可预测致命性心肌梗死。apoB是否也能预测非致命性缺血性心血管事件尚不清楚。我们检验了以下假设：apoB可预测缺血性心血管事件，且apoB在预测缺血性心血管事件方面优于低密度脂蛋白胆固醇。
我们对来自丹麦普通人群的9231名无症状男女进行了为期8年的前瞻性研究，观察到以下新发事件：缺血性心脏病591例、心肌梗死278例、缺血性脑血管病313例、缺血性卒中229例以及任何缺血性心血管事件807例。apoB处于上三分位数的女性与下三分位数的女性相比，发生缺血性心脏病的风险比为1.8（1.2至2.5），发生心肌梗死的风险比为2.6（1.4至4.7），发生任何缺血性心血管事件的风险比为1.8（1.3至2.3）；男性发生缺血性心脏病的风险比为1.9（1.5至2.6），发生心肌梗死的风险比为2.4（1.5至3.6），发生任何缺血性心血管事件的风险比为1.6（1.3至2.1）。女性发生缺血性脑血管病和缺血性卒中的风险比相似。在预测男女的缺血性心脏病、心肌梗死、任何缺血性心血管事件以及任何非致命性缺血性心血管事件方面，apoB比低密度脂蛋白胆固醇具有更高的预测能力（P=0.03至<0.001）。最后，在年龄大于60岁且收缩压>160 mmHg的吸烟者中，从apoB下三分位数到上三分位数，apoB导致女性10年绝对风险增加11%，男性增加15%。
apoB可预测男女的缺血性心血管事件，且在这方面优于低密度脂蛋白胆固醇。我们建议通过检测apoB来改善对未来缺血性心血管事件的预测。
