中国低密度脂蛋白胆固醇基线水平较低患者中高密度脂蛋白胆固醇与冠状动脉造影病变严重程度之间缺乏相关性
Lack of Association between High-Density Lipoprotein Cholesterol and Angiographic Coronary Lesion Severity in Chinese Patients with Low Background Low-Density Lipoprotein Cholesterol.
作者信息
Su Chieh-Shou, Chen Kuan-Ju, Sheu Wayne Huey-Herng, Yang Ya-Ling, Liu Tsun-Jui, Chang Wei-Chun, Wang Kuo-Yang, Lee Wen-Lieng
机构信息
Cardiovascular Center, Taichung Veterans General Hospital, Taichun; ; Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei;
Cardiovascular Center, Taichung Veterans General Hospital, Taichun;
出版信息
Acta Cardiol Sin. 2015 Nov;31(6):528-35. doi: 10.6515/acs20150421a.
BACKGROUND
The atheroprotective role of high-density lipoprotein (HDL-C) particles as measured by HDL-C level in coronary arterial disease (CAD) remains unsettled. The aim of our study was to ascertain whether HDL-C was associated with the development and severity of coronary artery disease in Chinese patients who underwent coronary angiogram with low background Low-density lipoprotein (LDL-C) levels, which has not been previously investigated.
METHODS
Between March 1995 and May 2000, 566 consecutive patients (408 males, 66.7 ± 11.3 years of age) with background LDL-C less than 100 mg/dl who underwent coronary artery angiography at our cath lab for suspected CAD were retrospectively recruited into the study. The severity of coronary lesions was measured by conventional coronary angiography and modified Gensini scores.
RESULTS
In those subjects with significant coronary lesions, there were more males and conventional CAD risk factors of diabetes mellitus, smoking, and chronic renal disease. They were also older compared to those in the control group. However, total cholesterol, LDL-C, HDL-C, triglyceride levels and use of statins were similar in both groups. In those subjects with significant coronary lesions, there was no difference in conventional coronary lesion severity or modified Gensini score between the quartered HDL-C subgroups. Furthermore, there was no significant correlation between serum HDL-C level and modified Gensini scores. In linear regression analysis, HDL-C was not an independent predictor for modified Gensini scores. Furthermore, HDL-C was also not an independent risk factor for the presence of significant coronary lesions in low LDL-C patients in logistic regression analysis.
CONCLUSIONS
In Chinese patients with low background LDL-C, serum HDL-C was not associated with development of CAD or lesion severity in patients with suspected CAD. Therefore, HDL-C did not appear to be atheroprotective in these patients.
KEY WORDS
Coronary artery disease; Gensini score; High-density lipoprotein cholesterol.
背景
通过高密度脂蛋白胆固醇（HDL-C）水平衡量的高密度脂蛋白（HDL）颗粒在冠状动脉疾病（CAD）中的抗动脉粥样硬化作用仍未明确。我们研究的目的是确定HDL-C是否与背景低密度脂蛋白（LDL-C）水平较低且接受冠状动脉造影的中国患者的冠状动脉疾病的发生和严重程度相关，此前尚未对此进行过研究。
方法
在1995年3月至2000年5月期间，连续纳入566例（408例男性，年龄66.7±11.3岁）背景LDL-C低于100mg/dl且因疑似CAD在我们的心导管实验室接受冠状动脉造影的患者进行回顾性研究。通过传统冠状动脉造影和改良Gensini评分来衡量冠状动脉病变的严重程度。
结果
在那些有显著冠状动脉病变的受试者中，男性更多，且存在糖尿病、吸烟和慢性肾病等传统CAD危险因素。与对照组相比，他们的年龄也更大。然而，两组的总胆固醇、LDL-C、HDL-C、甘油三酯水平及他汀类药物的使用情况相似。在那些有显著冠状动脉病变的受试者中，四分位HDL-C亚组之间的传统冠状动脉病变严重程度或改良Gensini评分没有差异。此外，血清HDL-C水平与改良Gensini评分之间没有显著相关性。在线性回归分析中，HDL-C不是改良Gensini评分的独立预测因素。此外，在逻辑回归分析中，HDL-C也不是低LDL-C患者存在显著冠状动脉病变的独立危险因素。
结论
在背景LDL-C较低的中国患者中，血清HDL-C与疑似CAD患者的CAD发生或病变严重程度无关。因此，HDL-C在这些患者中似乎没有抗动脉粥样硬化作用。
关键词
冠状动脉疾病；Gensini评分；高密度脂蛋白胆固醇
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