冠状动脉钙化的种族差异并非归因于脂蛋白颗粒大小的差异：关注风险评估的心脏策略（Heart SCORE）研究。

Racial differences in coronary artery calcification are not attributed to differences in lipoprotein particle sizes: the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) Study.

作者信息

Aiyer Aryan N, Kip Kevin E, Marroquin Oscar C, Mulukutla Suresh R, Edmundowicz Daniel, Reis Steven E

机构信息

Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Am Heart J. 2007 Feb;153(2):328-34. doi: 10.1016/j.ahj.2006.11.002.

DOI:10.1016/j.ahj.2006.11.002

PMID:17239697

Abstract

BACKGROUND

Lipoprotein particle levels and size distributions differ by race. As a group, blacks have less coronary artery calcification (CAC) than whites. We evaluated whether racial differences in CAC are explained by differences in lipoprotein levels and particle sizes.

METHODS

A total of 721 blacks and 988 whites underwent measurement of fasting lipoprotein levels and particle sizes. There were 608 subjects who had CAC quantified by electron beam computed tomography. Distributions and interrelationships among lipoprotein levels, particle sizes, and CAC were evaluated by race and sex.

RESULTS

Blacks had nominally higher adjusted high-density lipoprotein cholesterol levels (men, 51 vs 50 mg/dL; women, 63 vs 61 mg/dL; P = .05), lower intermediate-density lipoprotein cholesterol levels (women only, 17 vs 18 mg/dL; P = .02), and significantly lower triglyceride levels (men, 116 vs 138 mg/dL; women, 103 vs 136 mg/dL; P < .0001) than whites. Adjusted small dense low-density lipoprotein 3 particle levels were significantly lower (P < .0001) in black men (47 vs 53 mg/dL) and black women (43 vs 48 mg/dL) compared with white men and women, respectively. Black race was associated with a 48% lower adjusted odds of moderate or significant CAC (odds ratio, 0.52; 95% confidence interval, 0.34-0.80). However, this strong association between race and CAC was independent of lipoprotein levels and particle sizes.

CONCLUSIONS

Blacks have less CAC and more favorable lipoprotein profiles than whites. Racial differences in CAC are not attributable to differences in lipoprotein particle sizes. Future studies of mechanisms of race-related differences in CAC may enhance understanding of the pathophysiology of racial differences in cardiovascular disease.

摘要

背景

脂蛋白颗粒水平和大小分布因种族而异。总体而言，黑人的冠状动脉钙化（CAC）比白人少。我们评估了CAC的种族差异是否由脂蛋白水平和颗粒大小的差异所解释。

方法

共有721名黑人和988名白人接受了空腹脂蛋白水平和颗粒大小的测量。其中608名受试者通过电子束计算机断层扫描对CAC进行了量化。按种族和性别评估脂蛋白水平、颗粒大小和CAC之间的分布及相互关系。

结果

黑人的校正后高密度脂蛋白胆固醇水平名义上较高（男性，51 vs 50 mg/dL；女性，63 vs 61 mg/dL；P = 0.05），中密度脂蛋白胆固醇水平较低（仅女性，[17 vs 18 mg/dL；P = 0.02]），甘油三酯水平显著较低（男性，116 vs 138 mg/dL；女性，103 vs 136 mg/dL；P < 0.0001）。与白人男性和女性相比，黑人男性（47 vs 53 mg/dL）和黑人女性（43 vs 48 mg/dL）的校正后小而密低密度脂蛋白颗粒水平显著较低（P < 0.0001）。黑人种族与中度或重度CAC的校正后几率降低48%相关（优势比，0.52；95%置信区间，0.34 - 0.80）。然而，种族与CAC之间的这种强关联独立于脂蛋白水平和颗粒大小。