Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH, USA.
Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH, USA.
J Clin Lipidol. 2017 Jul-Aug;11(4):1023-1031. doi: 10.1016/j.jacl.2017.05.011. Epub 2017 Jun 3.
In adults, dyslipidemia is associated with higher carotid thickness and arterial stiffness, predictors of cardiovascular events. In young subjects, lipid concentrations have not been consistently associated with vascular measures.
The objective of the study was to compare nuclear magnetic resonance (NMR) measures of lipoprotein particle number (low-density lipoprotein [LDL] particle, low-density lipoprotein [HDL] particle, very low-density lipoprotein [VLDL] particle) and size (LDL size, HDL size, and VLDL size) to determine if they were associated with vascular measures more strongly than lipid concentrations (LDL cholesterol, HDL cholesterol, and triglyceride [TG]).
We evaluated 214 lean (L), 228 obese (O), and 214 diabetic (T2DM) subjects aged 10 to 24 years (33% male and 39% Caucasian). Cardiovascular risk factors, vascular structure, and arterial stiffness were measured. General linear models were constructed including demographics, risk factors, and traditional or NMR lipid parameters. A composite vascular function score was developed as the outcome in receiver operator characteristic scores for determining which lipid parameter was superior in predicting vascular damage.
Risk factors worsened from L to O to T. However, LDL cholesterol was similar in O and T, whereas LDL size differentiated the 3 groups (T > O > L, P ≤ .0001). Models demonstrated the superiority of NMR values, which entered for all but 1 vascular outcome and explained more of the variance than traditional lipid concentrations. Receiver operator characteristic curves demonstrated that NMR values were superior in predicting vascular outcomes. Models stratified by race were similar but cutpoints predicting vascular outcomes differed by race for TG, TG/HDL, and VLDL.
Lipoprotein particle number and size are more strongly related to vascular structure and function than traditional lipid values. NMR lipid measures may be a better indicator of risk for target organ damage than traditional lipid measures in adolescents and young adults.
在成年人中，血脂异常与颈动脉厚度和动脉僵硬度增加有关，而后者是心血管事件的预测指标。在年轻人群中，脂质浓度与血管测量值之间的相关性并不一致。
本研究旨在比较脂蛋白颗粒数（低密度脂蛋白[LDL]颗粒、高密度脂蛋白[HDL]颗粒、极低密度脂蛋白[VLDL]颗粒）和大小（LDL 大小、HDL 大小和 VLDL 大小）的核磁共振（NMR）测量值，以确定它们与血管测量值的相关性是否强于脂质浓度（LDL 胆固醇、HDL 胆固醇和甘油三酯[T G]）。
我们评估了 214 名年龄在 10 至 24 岁的瘦（L）、228 名肥胖（O）和 214 名 2 型糖尿病（T2DM）患者（33%为男性，39%为白种人）。测量了心血管危险因素、血管结构和动脉僵硬度。构建了包含人口统计学、危险因素和传统或 NMR 脂质参数的一般线性模型。作为接受者操作特征评分的结果，开发了一个综合血管功能评分，以确定哪种脂质参数在预测血管损伤方面更具优势。
危险因素从 L 到 O 再到 T 逐渐恶化。然而，O 和 T 中的 LDL 胆固醇相似，而 LDL 大小则将 3 组区分开来（T＞O＞L，P≤.0001）。模型表明 NMR 值具有优越性，这些值除了 1 个血管结果外都进入了模型，并比传统脂质浓度解释了更多的变异。接受者操作特征曲线表明，NMR 值在预测血管结局方面具有优越性。按种族分层的模型相似，但 TG、TG/HDL 和 VLDL 的血管结局预测切点因种族而异。
脂蛋白颗粒数和大小与血管结构和功能的相关性强于传统脂质值。在青少年和年轻成年人中，NMR 脂质测量值可能比传统脂质测量值更好地预测靶器官损伤的风险。
