比较欧洲和伊朗的甘油三酯/高密度脂蛋白胆固醇浓度切点在预测心血管疾病结局方面的差异。

Comparison between European and Iranian cutoff points of triglyceride/high-density lipoprotein cholesterol concentrations in predicting cardiovascular disease outcomes.

机构信息

Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Clin Lipidol. 2016 Jan-Feb;10(1):143-9. doi: 10.1016/j.jacl.2015.10.008. Epub 2015 Oct 24.

DOI:10.1016/j.jacl.2015.10.008

PMID:26892131

Abstract

BACKGROUND

High triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) are important cardiovascular risk factors. The exact prognostic value of the TG/HDL-C ratio, a marker for cardiovascular events, is currently unknown among Iranians so this study sought to determine the optimal cutoff point for the TG/HDL-C ratio in predicting cardiovascular disease events in the Iranian population.

METHOD

The Isfahan Cohort Study (ICS) is an ongoing, longitudinal, population-based study that was originally conducted on adults aged ≥ 35 years, living in urban and rural areas of three districts in central Iran. After 10 years of follow-up, 5431 participants were re-evaluated using a standard protocol similar to the one used for baseline. At both measurements, participants underwent medical interviews, physical examinations, and fasting blood measurements. "High-risk" subjects were defined by the discrimination power of indices, which were assessed using receiver operating characteristic (ROC) analysis; the optimal cutoff point value for each index was then derived.

RESULTS

The mean age of the participants was 50.7 ± 11.6 years. The TG/HDL-C ratio, at a threshold of 3.68, was used to screen for cardiovascular events among the study population. Subjects were divided into two groups ("low" and "high" risk) according to the TG/HDL-C concentration ratio at baseline. A slightly higher number of high-risk individuals were identified using the European cutoff points of 63.7% in comparison with the ICS cutoff points of 49.5%. The unadjusted hazard ratio (HR) was greatest in high-risk individuals identified by the ICS cutoff points (HR = 1.54, 95% CI [1.33-1.79]) vs European cutoff points (HR = 1.38, 95% [1.17-1.63]). There were no remarkable changes after adjusting for differences in sex and age (HR = 1.58, 95% CI [1.36-1.84] vs HR = 1.44, 95% CI [1.22-1.71]) for the ICS and European cutoff points, respectively.

CONCLUSION

The threshold of TG/HDL ≥ 3.68 is the optimal cutoff point for predicting cardiovascular events in Iranian individuals.

摘要

背景

高甘油三酯（TG）和低高密度脂蛋白胆固醇（HDL-C）是重要的心血管危险因素。在伊朗人群中，TG/HDL-C 比值作为心血管事件的标志物的精确预后价值尚不清楚，因此本研究旨在确定 TG/HDL-C 比值预测伊朗人群心血管疾病事件的最佳截断点。

方法

伊斯法罕队列研究（ICS）是一项正在进行的、纵向的、基于人群的研究，最初在伊朗中部三个区的城市和农村地区进行，年龄≥35 岁的成年人中进行。随访 10 年后，5431 名参与者采用与基线相似的标准方案进行重新评估。在两次测量中，参与者接受了医学访谈、身体检查和空腹血液测量。“高危”受试者通过指数的判别能力来定义，使用接收者操作特征（ROC）分析评估指数；然后推导出每个指数的最佳截断点值。

结果

参与者的平均年龄为 50.7±11.6 岁。TG/HDL-C 比值在 3.68 时用于筛查研究人群中的心血管事件。根据基线时 TG/HDL-C 浓度比值，将受试者分为两组（“低”和“高”风险）。与 ICS 截断值 49.5%相比，使用欧洲截断值 63.7%，稍高比例的高风险个体被识别出来。在未调整的危险比（HR）中，根据 ICS 截断值（HR=1.54，95%CI[1.33-1.79]）确定的高危个体最大，而根据欧洲截断值（HR=1.38，95%CI[1.17-1.63]）。调整性别和年龄差异后，无明显变化（ICS 截断值的 HR=1.58，95%CI[1.36-1.84]vs 欧洲截断值的 HR=1.44，95%CI[1.22-1.71]）。