Chien Kuo-Liong, Hsu Hsiu-Ching, Su Ta-Chen, Sung Fung-Chang, Chen Ming-Fong, Lee Yuan-Teh
Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Clin Chem. 2008 Feb;54(2):285-91. doi: 10.1373/clinchem.2007.090969. Epub 2007 Dec 18.
Little is known about lipoprotein(a) [Lp(a)] as a predictor of vascular events among ethnic Chinese. We prospectively investigated the association of Lp(a) with cardiovascular disease and all-cause death in a community-based cohort.
We conducted a community-based prospective cohort study of 3484 participants (53% women; age range, 35-97 years) who had complete lipid measurements and were free of a cardiovascular disease history at the time of recruitment. Over a median follow-up of 13.8-years, we documented 210 cases of stroke, 122 cases of coronary heart disease (CHD), and 781 deaths.
The incidences for each event increased appreciably with Lp(a) quartile for stroke and all-cause death, but not for CHD. Baseline Lp(a) concentration by quartile was not significantly associated with stroke, all-cause death, and CHD in multivariate analyses. The multivariate relative risk was significant for stroke at the 90th and 95th percentiles and for total death at the 95th and 99th percentiles.
Our findings suggest a threshold relationship with little gradient of risk across lower Lp(a) values for stroke and all-cause death in Chinese adults.
关于脂蛋白(a)[Lp(a)]作为华裔人群血管事件预测指标的研究较少。我们前瞻性地研究了基于社区的队列中Lp(a)与心血管疾病及全因死亡之间的关联。
我们对3484名参与者(53%为女性;年龄范围35 - 97岁)进行了一项基于社区的前瞻性队列研究,这些参与者在招募时血脂测量完整且无心血管疾病病史。在中位随访13.8年期间,我们记录了210例中风、122例冠心病(CHD)和781例死亡病例。
中风和全因死亡的各事件发生率随Lp(a)四分位数显著增加,但冠心病并非如此。在多变量分析中,按四分位数划分的基线Lp(a)浓度与中风、全因死亡和冠心病均无显著关联。在第90和第95百分位数时中风的多变量相对风险显著,在第95和第99百分位数时全因死亡的多变量相对风险显著。
我们的研究结果表明,在中国成年人中,中风和全因死亡在较低Lp(a)值范围内与风险的梯度关系不大,存在阈值关系。