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血脂水平并不影响静脉血栓栓塞的风险。基于人群的队列研究结果。

Lipid levels do not influence the risk of venous thromboembolism. Results of a population-based cohort study.

机构信息

Division of Haemostasis and Thrombosis, Department of Haematology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

出版信息

Thromb Haemost. 2012 Nov;108(5):923-9. doi: 10.1160/TH12-06-0426. Epub 2012 Sep 5.

Abstract

Studies on the association between lipid profile and venous thromboembolism (VTE) are inconsistent. This could be caused by classical lipoproteins being inferior to apolipoproteins as markers for VTE risk. Therefore, we examined whether apolipoproteins are more strongly related to VTE than lipoproteins. For this analysis we used the PREVEND prospective community based observational cohort study. Levels of apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), total cholesterol (TC), high-density lipoprotein (HDL), non-HDL, low-density lipoprotein (LDL), triglycerides (TG), lipoprotein(a), ApoB/ApoA1 and TC/HDL ratio were assessed. Subjects with VTE were identified using databases of the national registries of hospital discharge diagnoses, death certificates, and the regional anticoagulation clinic. Out of 7,627 subjects, 110 developed VTE during a median follow-up of 10.5 years. In both univariate and multivariable analyses no significant associations between apolipoproteins and overall VTE were observed. Of the classical lipoproteins, TC, non-HDL, LDL, TG, and TC/HDL ratio were significantly associated with overall VTE in univariate analysis. Significant associations were no longer present in multivariable analysis. TGL and LDL were significantly associated with unprovoked VTE in univariate analysis. After adjustment for age and sex this significance was lost. No significant associations between (apo-) lipoproteins and provoked VTE were found. We conclude that apolipoproteins are not better in predicting VTE risk than the classical lipoproteins. Our population-based cohort study does not show an association between both apolipoproteins and the classical lipoproteins and VTE risk.

摘要

关于血脂谱与静脉血栓栓塞症(VTE)之间的相关性研究结果并不一致。这可能是由于经典脂蛋白作为 VTE 风险标志物的作用不及载脂蛋白。因此,我们研究了载脂蛋白是否与 VTE 的相关性强于脂蛋白。为此,我们使用了 PREVEND 前瞻性社区为基础的观察性队列研究。评估了载脂蛋白 A1(ApoA1)、载脂蛋白 B(ApoB)、总胆固醇(TC)、高密度脂蛋白(HDL)、非高密度脂蛋白、低密度脂蛋白(LDL)、甘油三酯(TG)、脂蛋白(a)、ApoB/ApoA1 和 TC/HDL 比值。使用国家住院诊断数据库、死亡证明数据库和区域抗凝诊所的数据库来确定 VTE 患者。在 7627 名受试者中,有 110 名在中位随访 10.5 年后发生了 VTE。在单变量和多变量分析中,载脂蛋白与总体 VTE 之间均无显著相关性。在单变量分析中,经典脂蛋白中 TC、非高密度脂蛋白、LDL、TG 和 TC/HDL 比值与总体 VTE 显著相关。在多变量分析中,这些相关性不再存在。在单变量分析中,TG 和 LDL 与无诱因 VTE 显著相关。在校正年龄和性别后,这种相关性丧失。在多变量分析中,载脂蛋白与有诱因 VTE 之间无显著相关性。我们的结论是,载脂蛋白在预测 VTE 风险方面并不优于经典脂蛋白。我们的基于人群的队列研究未显示载脂蛋白与经典脂蛋白与 VTE 风险之间存在相关性。

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