脂质蓄积产物与白种成年人 10 年心血管疾病发病率的关系：ATTICA 研究。

Lipid accumulation product in relation to 10-year cardiovascular disease incidence in Caucasian adults: The ATTICA study.

机构信息

Department of Science of Dietetics and Nutrition, School of Health Science and Education, Harokopio University, Athens, Greece; Aston Medical Research Institute, Aston Medical School, Aston University, B4 7ET, Birmingham, UK; Translational & Experimental Medicine, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK; WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, CV2 2DX, Coventry, UK.

Department of Science of Dietetics and Nutrition, School of Health Science and Education, Harokopio University, Athens, Greece; Faculty of Health, University of Canberra, Canberra, Australia.

出版信息

Atherosclerosis. 2018 Dec;279:10-16. doi: 10.1016/j.atherosclerosis.2018.10.015. Epub 2018 Oct 17.

DOI:10.1016/j.atherosclerosis.2018.10.015

PMID:30366186

Abstract

BACKGROUND AND AIMS

The lipid accumulation product (LAP) is an index describing lipid over-accumulation based on waist circumference (WC) and fasting triglycerides, and can outperform the body mass index (BMI) in recognizing cardiovascular disease (CVD) risk. We aimed to explore the association of LAP with long-term CVD risk and compare its CVD-predictive value against common anthropometric indices/ratios of obesity.

METHODS

ATTICA is a prospective, population-based cohort that recruited 3042 adults without pre-existing CVD from the Greek general population (age 18-89 years; 1514 men). The 10-year study follow-up (2011-2012) captured the fatal/non-fatal CVD incidence in 2020 participants (50% men). Baseline LAP (cm·mmol/L) was calculated and analyzed in relation to the 10-year CVD incidence.

RESULTS

In total, 317 CVD cases (15.7%) were documented during the follow-up. Baseline LAP showed a significant positive association with the 10-year CVD incidence, even after adjusting for hypertension, diabetes, hypercholesterolemia, smoking, physical activity, Mediterranean diet adherence, and key pro-inflammatory biomarkers (Hazard Ratios per 10 cm·mmol/L of LAP ranging from 1.1 to 1.21, p = 0.04). Moreover, LAP predicted the 10-year CVD study incidence better than common obesity indices (BMI, WC, waist-to-hip, waist-to-height ratio).

CONCLUSIONS

These findings support a positive association between LAP and long-term CVD incidence in CVD-free Caucasian adults from the general population.

摘要

背景与目的

脂堆积产物（LAP）是一种基于腰围（WC）和空腹甘油三酯描述脂质过度堆积的指标，其在识别心血管疾病（CVD）风险方面优于体重指数（BMI）。我们旨在探讨 LAP 与长期 CVD 风险的相关性，并比较其与常见肥胖人体测量指数/比值的 CVD 预测价值。

方法

ATTICA 是一项前瞻性、基于人群的队列研究，从希腊一般人群中招募了 3042 名无预先存在的 CVD 的成年人（年龄 18-89 岁；男性 1514 人）。10 年的研究随访（2011-2012 年）在 2020 名参与者中（50%为男性）捕捉了致命/非致命 CVD 的发病率。计算并分析了基线 LAP（cm·mmol/L）与 10 年 CVD 发病率的关系。

结果

在随访期间共记录了 317 例 CVD 病例（15.7%）。基线 LAP 与 10 年 CVD 发病率呈显著正相关，即使在调整了高血压、糖尿病、高胆固醇血症、吸烟、身体活动、地中海饮食依从性和关键促炎生物标志物后也是如此（LAP 每增加 10 cm·mmol/L，10 年 CVD 发病风险比为 1.1 至 1.21，p=0.04）。此外，LAP 比常见的肥胖指数（BMI、WC、腰臀比、腰高比）更好地预测了 10 年 CVD 研究的发病率。