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评估脂蛋白(a)与动脉粥样硬化之间的潜在关联(来自居住在美国的南亚人群动脉粥样硬化中介研究队列)。

Evaluating the Potential Association Between Lipoprotein(a) and Atherosclerosis (from the Mediators of Atherosclerosis Among South Asians Living in America Cohort).

机构信息

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

出版信息

Am J Cardiol. 2019 Mar 15;123(6):919-921. doi: 10.1016/j.amjcard.2018.12.013. Epub 2018 Dec 19.

Abstract

We sought to report the distribution of Lp(a) levels in the Mediators of Atherosclerosis among South Asians Living in America cohort of participants who were free from clinical atherosclerotic cardiovascular disease (ASCVD) at baseline and to evaluate the cross-sectional association with atherosclerosis measured by coronary artery calcification (CAC) and carotid intima media thickness. Among 886 participants (mean [SD] age: 55.4 [9.4] years, 54% male), median lipoprotein (a) level was 17 (9, 33) mg/dl. Compared with the lowest quartile (9 mg/dl), subjects in the highest Lp(a) quartile (33 to 178 mg/dl) were more likely to be women (51% vs 37%, p <0.01) and had a higher mean (SD) total cholesterol (193 [37] mg/dl vs 181 [35] mg/dl, p <0.01). CAC was present in 42% and both the presence and degree of CAC was similar across Lp(a) quartiles (p = 0.58). Median Interquartile range (IQR) common and internal carotid intima-media thickness (IMT) thicknesses were 0.84 (0.73, 0.98) mm and 1.12 (0.95, 1.34) mm, respectively, and were also similar across Lp(a) quartiles. After adjustment for cardiovascular risk factors, Lp(a) quartile had no association with prevalent CAC (p = 0.98), internal carotid IMT (p = 0.46), or common carotid IMT (p = 0.97). Among South Asian Americans, mean Lp(a) levels were higher than previous reports among Whites, Hispanic/Latino, and Chinese-Americans but lower than in Blacks. Unlike findings from other race/ethnic groups, Lp(a) levels were not associated with atherosclerosis among South Asian Americans.

摘要

我们旨在报告美籍南亚人动脉粥样硬化中介物研究(MESA)参与者队列中,基线时无临床动脉粥样硬化性心血管疾病(ASCVD)者脂蛋白(a) [Lp(a)]水平的分布,并评估其与冠状动脉钙化(CAC)和颈动脉内膜中层厚度(cIMT)测量的动脉粥样硬化的横断面相关性。在 886 名参与者(平均[SD]年龄:55.4[9.4]岁,54%为男性)中,中位脂蛋白(a)水平为 17(9,33)mg/dl。与最低四分位(9mg/dl)相比,Lp(a)最高四分位(33-178mg/dl)的受试者更可能为女性(51%比 37%,p<0.01),且平均(SD)总胆固醇水平更高[193(37)mg/dl比 181(35)mg/dl,p<0.01]。42%的参与者存在 CAC,且各 Lp(a)四分位组 CAC 的存在及其程度相似(p=0.58)。中位数四分位间距(IQR)颈总动脉和颈内动脉内膜中层厚度(cIMT)分别为 0.84(0.73,0.98)mm 和 1.12(0.95,1.34)mm,各四分位组间也相似。在校正心血管危险因素后,Lp(a)四分位组与 CAC 患病率(p=0.98)、颈内动脉 cIMT(p=0.46)或颈总动脉 cIMT(p=0.97)均无相关性。在南亚裔美国人中,Lp(a)平均水平高于白人、西班牙裔/拉丁裔和华裔美国人的既往报告,但低于黑人。与其他种族/民族群体的研究结果不同,Lp(a)水平与南亚裔美国人的动脉粥样硬化无关。

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