Laforest Laurent, Souchet Thierry, Moulin Philippe, Ritleng Cécile, Desamericq Gaëlle, Le Jeunne Philippe, Schwalm Marie-Sophie, Van Ganse Eric
Service de neurologie, unité de neuro-épidémiologie et de pharmaco-épidémiologie, hôpital neurologique Pierre-Wertheimer, 59, boulevard Pinel, 69677 Bron cedex, France.
Arch Cardiovasc Dis. 2009 Jan;102(1):43-50. doi: 10.1016/j.acvd.2008.06.021. Epub 2009 Jan 25.
To estimate the prevalence of triglyceride and/or high density lipoprotein cholesterol (HDL-C) disorders and their relationships with other cardiovascular risk factors among patients with dyslipidaemia on lipid-lowering therapy.
In this cross-sectional study in dyslipidaemic patients receiving lipid-lowering therapy, lipid disorders were defined as triglyceride greater than 1.5 g/L, HDL-C lesser than 0.4 g/L and low-density lipoprotein cholesterol (LDL-C) above the recommended concentration according to French guidelines. Based on these disorders, patients were classified into four groups: group 1, no lipid disorders; group 2, low HDL-C and/or high triglyceride concentration with normal LDL-C; group 3, isolated elevated LDL-C; and group 4, elevated LDL-C and low HDL-C and/or high triglyceride. Patients' cardiovascular risk levels were compared across groups.
Among the 2727 patients (mean age 64.7 years, 46.7% women), 28% did not reach the target LDL-C concentration as defined by French guidelines. Prevalence rates of high triglyceride and low HDL-C were 27.2 and 10.3%, respectively. Over half (51.2%) of the patients were in group 1, 20.5% were in group 2, 16.2% in group 3 and 12.1% in group 4. Among patients meeting the target LDL-C, those with high triglyceride and/or low HDL-C exhibited a significantly higher number of risk factors (1.83 vs 1.68, p<0.001). Smoking, diabetes and hypertension were associated separately with low HDL-C and/or high triglyceride (p=0.01, p<0.0001, p=0.03, respectively). Conversely, these associations were not observed in patients who did not achieve the target LDL-C, with the exception of smoking (p<0.0001).
HDL-C and triglyceride disorders are relatively frequent among treated patients, particularly when cardiovascular risk level increased.
评估接受降脂治疗的血脂异常患者中甘油三酯和/或高密度脂蛋白胆固醇（HDL-C）紊乱的患病率及其与其他心血管危险因素的关系。
在这项针对接受降脂治疗的血脂异常患者的横断面研究中，根据法国指南，血脂紊乱定义为甘油三酯大于1.5 g/L、HDL-C小于0.4 g/L以及低密度脂蛋白胆固醇（LDL-C）高于推荐浓度。基于这些紊乱情况，患者被分为四组：第1组，无血脂紊乱；第2组，HDL-C低和/或甘油三酯浓度高且LDL-C正常；第3组，单纯LDL-C升高；第4组，LDL-C升高且HDL-C低和/或甘油三酯高。对各组患者的心血管风险水平进行比较。
在2727例患者（平均年龄64.7岁，46.7%为女性）中，28%未达到法国指南定义的LDL-C目标浓度。高甘油三酯和低HDL-C的患病率分别为27.2%和10.3%。超过一半（51.2%）的患者属于第1组，20.5%属于第2组，16.2%属于第3组，12.1%属于第4组。在达到LDL-C目标的患者中，甘油三酯高和/或HDL-C低的患者的危险因素数量显著更多（1.83对1.68，p<0.001）。吸烟、糖尿病和高血压分别与低HDL-C和/或高甘油三酯相关（分别为p=0.01、p<0.0001、p=0.03）。相反，在未达到LDL-C目标的患者中，除吸烟外（p<0.0001），未观察到这些关联。
HDL-C和甘油三酯紊乱在接受治疗的患者中相对常见，尤其是在心血管风险水平升高时。
