Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA.
Clin Epidemiol. 2015 Feb 26;7:201-12. doi: 10.2147/CLEP.S77676. eCollection 2015.
With the emergence of new lipid-lowering therapies, more patients are expected to achieve substantial lowering of low-density lipoprotein cholesterol (LDL-C). However, there are limited data examining the clinical experience of patients with low (<1.3 mmol/L) or very low (<0.65 mmol/L) levels of LDL-C. To provide information on patients with low LDL-C, we identified and characterized persons with low LDL-C using data from Danish medical databases.
Using a population-based clinical laboratory database, we identified adults with at least one LDL-C measurement in northern Denmark between 1998 and 2011 (population approximately 1.5 million persons). Based on the lowest measurement during the study period, we divided patients into groups with low (<1.3 mmol/L), moderate (1.3-3.3 mmol/L), or high (>3.3 mmol/L) LDL-C. We described their demographic characteristics, entire comorbidity history, and 90-day prescription history prior to the lowest LDL-C value measured. Finally, we further restricted the analysis to individuals with very low LDL-C (<0.65 mmol/L).
Among 765,503 persons with an LDL-C measurement, 23% had high LDL-C, 73% had moderate LDL-C, and 4.8% had low LDL-C. In the latter group, 9.6% (0.46% of total) had very low LDL-C. Compared with the moderate and high LDL-C categories, the low LDL-C group included more males and older persons with a higher prevalence of cardiovascular disease, diabetes, chronic pulmonary disease, ulcer disease, and obesity, as measured by hospital diagnoses or relevant prescription drugs for these diseases. Cancer and use of psychotropic drugs were also more prevalent. These patterns of distribution became even more pronounced when restricting to individuals with very low LDL-C.
Using Danish medical databases, we identified a cohort of patients with low LDL-C and found that cohort members differed from patients with higher LDL-C levels. These differences may be explained by various factors, including prescribing patterns of lipid-lowering therapies.
随着新的降脂治疗方法的出现，预计将有更多患者的低密度脂蛋白胆固醇（LDL-C）显著降低。然而，目前关于 LDL-C 水平较低（<1.3mmol/L）或极低（<0.65mmol/L）的患者的临床经验数据有限。为了提供关于 LDL-C 水平较低患者的信息，我们使用丹麦医疗数据库中的数据，确定并描述了具有较低 LDL-C 的患者。
我们使用基于人群的临床实验室数据库，确定了 1998 年至 2011 年期间在丹麦北部进行了至少一次 LDL-C 检测的成年人（约 150 万人口）。根据研究期间的最低测量值，我们将患者分为 LDL-C 水平较低（<1.3mmol/L）、中等（1.3-3.3mmol/L）或较高（>3.3mmol/L）的组。我们描述了他们的人口统计学特征、整个合并症病史以及在测量到的最低 LDL-C 值之前的 90 天处方史。最后，我们将分析进一步限制在 LDL-C 极低（<0.65mmol/L）的个体中。
在 765503 名进行 LDL-C 检测的人中，23%的患者 LDL-C 水平较高，73%的患者 LDL-C 水平中等，4.8%的患者 LDL-C 水平较低。在后者组中，9.6%（占总数的 0.46%）的患者 LDL-C 极低。与中等和较高 LDL-C 类别相比，低 LDL-C 组中男性和年龄较大的患者比例较高，心血管疾病、糖尿病、慢性肺部疾病、溃疡病和肥胖的患病率也较高，这些疾病通过医院诊断或相关处方药物来衡量。癌症和使用精神类药物的比例也更高。当将分析进一步限制在 LDL-C 极低的个体中时，这些分布模式变得更加明显。
我们使用丹麦医疗数据库确定了一个 LDL-C 水平较低的患者队列，并发现该队列成员与 LDL-C 水平较高的患者不同。这些差异可能由各种因素引起，包括降脂治疗药物的处方模式。
