Center of Diabetes and Metabolism, Shin-Oyama City Hospital.
Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center.
J Atheroscler Thromb. 2018 Jul 1;25(7):621-633. doi: 10.5551/jat.42291. Epub 2018 Jan 12.
To investigate the associations of conventional lipid parameters with arterial stiffness assessed by cardio-ankle vascular index (CAVI).
A retrospective cross-sectional study was conducted in 23,257 healthy Japanese subjects (12,729 men and 10,528 women, aged 47.1±12.5 years, body mass index (BMI) 22.9±3.4 kg/m) who underwent health screening between 2004 and 2006 in Japan.
Male subjects had significantly higher BMI, CAVI and triglycerides (TG), and lower high-density lipoprotein cholesterol (HDL-C) compared to female subjects. After adjusting for confounders, including gender, age, systolic blood pressure and BMI identified by multiple regression analysis, adjusted CAVI was lower in normolipidemic than in dyslipidemic subjects. Among dyslipidemic subjects, those with hypertriglyceridemia had higher adjusted CAVI. A trend test detected linear relations between adjusted CAVI and all the conventional lipid parameters throughout the entire range of serum levels. After adjusting for confounders, logistic regression models showed that all lipid parameters contributed independently to high CAVI (≥90th percentile). Receiver-operating-characteristic analysis determined reliable cut-off values of 93 mg/dl for TG (area under the curve, AUC= 0.735), 114 mg/dl for low-density lipoprotein cholesterol (AUC=0.614) and 63 mg/dl for HDL-C (AUC=0.728) in predicting high CAVI. These cut-off values were confirmed to independently predict high CAVI in a bivariate logistic regression model.
The present study demonstrated independent contribution of conventional lipid parameters to CAVI, indicating a possible association of lipid parameters with early vascular damage.
探讨传统血脂参数与心血管踝臂指数(CAVI)评估的动脉僵硬度之间的相关性。
本研究是一项回顾性的横断面研究,共纳入 23257 名在日本接受健康筛查的日本健康人群(男性 12729 名,女性 10528 名,年龄 47.1±12.5 岁,体重指数(BMI)22.9±3.4kg/m),筛查时间为 2004 年至 2006 年。
与女性相比,男性的 BMI、CAVI 和甘油三酯(TG)更高,高密度脂蛋白胆固醇(HDL-C)更低。经多元回归分析确定的性别、年龄、收缩压和 BMI 等混杂因素校正后,血脂正常者的校正 CAVI 低于血脂异常者。在血脂异常者中,高 TG 者校正 CAVI 更高。趋势检验显示,在整个血清水平范围内,校正 CAVI 与所有传统血脂参数之间均存在线性关系。校正混杂因素后,Logistic 回归模型显示所有血脂参数均与高 CAVI(≥90 百分位数)独立相关。受试者工作特征分析确定了 TG(曲线下面积,AUC=0.735)为 93mg/dl、低密度脂蛋白胆固醇(AUC=0.614)为 114mg/dl、HDL-C(AUC=0.728)为 63mg/dl 的可靠截断值,可用于预测高 CAVI。在二元 Logistic 回归模型中,这些截断值被证实可独立预测高 CAVI。
本研究表明传统血脂参数对 CAVI 有独立的贡献,提示血脂参数与早期血管损伤可能存在关联。