美国成年人在接受他汀类药物治疗后的高甘油三酯血症：国家健康和营养调查。

Hypertriglyceridemia in statin-treated US adults: the National Health and Nutrition Examination Survey.

机构信息

Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA, USA.

Medical Affairs, Amarin Pharm, Inc, Bedminster, NJ, USA.

出版信息

J Clin Lipidol. 2019 Jan-Feb;13(1):100-108. doi: 10.1016/j.jacl.2018.11.008. Epub 2018 Dec 1.

DOI:10.1016/j.jacl.2018.11.008

PMID:30594443

Abstract

BACKGROUND

Statin therapy remains the primary treatment for mixed dyslipidemia, even with moderate triglyceride (TG) elevations.

OBJECTIVE

We examined the prevalence of elevated TG levels in adults with and without statin use and the associated 10-year predicted atherosclerotic cardiovascular disease (ASCVD) risk.

METHODS

We studied 9593 US adults aged ≥20 years (219.9 million projected) in the US National Health and Nutrition Examination Surveys, 2007 to 2014. We determined the proportions of TG categories (<150, 150-199, 200-499, and ≥500 mg/dL) according to statin use, as well as the 10-year estimated ASCVD risk and number of events.

RESULTS

Among those not taking statin therapy, the prevalence of TG < 150, 150 to 199, and ≥200 mg/dL was 75.3%, 12.8%, and 11.9%; among statin users, these proportions were 68.4%, 16.2%, and 15.4%, respectively. Among persons with low-density lipoprotein cholesterol <100 mg/dL (or <70 mg/dL in those with ASCVD), despite statin use, 27.7% had TG ≥ 150 mg/dL. The odds of TG ≥ 150 mg/dL in statin users was associated with greater age, higher body mass index, lower high-density lipoprotein cholesterol, higher low-density lipoprotein cholesterol, and diabetes. Estimated mean 10-year ASCVD risk from TG < 150 to ≥500 mg/dL, ranged from 11.3% to 19.1% in statin users and 6.0% to 15.6% in nonusers, with an overall 3.4 million ASCVD events expected in the next 10 years.

CONCLUSIONS

One-fourth of US adults overall, including nearly one-third of those on statin therapy, have suboptimal TG levels. More than 3 million ASCVD events are expected to occur over the next decade in those with TG ≥ 150 mg/dL, with approximately 1 million events expected in statin users.

摘要

背景

即使甘油三酯（TG）水平中度升高，他汀类药物治疗仍是混合性血脂异常的主要治疗方法。

目的

我们研究了使用和不使用他汀类药物的成年人中 TG 水平升高的患病率，以及与 10 年预测的动脉粥样硬化性心血管疾病（ASCVD）风险的关系。

方法

我们研究了美国国家健康和营养检查调查中的 9593 名年龄≥20 岁的美国成年人（预计有 2.199 亿人），时间范围为 2007 年至 2014 年。我们根据他汀类药物的使用情况确定了 TG 类别（<150、150-199、200-499 和≥500mg/dL）的比例，以及 10 年估计的 ASCVD 风险和事件数量。

结果

在未服用他汀类药物的人群中，TG<150、150-199 和≥200mg/dL 的比例分别为 75.3%、12.8%和 11.9%；在服用他汀类药物的人群中，这些比例分别为 68.4%、16.2%和 15.4%。在低密度脂蛋白胆固醇<100mg/dL（或 ASCVD 患者<70mg/dL）的人群中，尽管使用了他汀类药物，仍有 27.7%的人 TG≥150mg/dL。他汀类药物使用者中 TG≥150mg/dL 的可能性与年龄较大、体重指数较高、高密度脂蛋白胆固醇较低、低密度脂蛋白胆固醇较高和糖尿病有关。从 TG<150 到≥500mg/dL，他汀类药物使用者和非使用者的估计平均 10 年 ASCVD 风险分别为 11.3%至 19.1%和 6.0%至 15.6%，预计未来 10 年将发生 340 万例 ASCVD 事件。