Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Shiga University of Medical Science, Otsu, Shiga, Japan.
Open Heart. 2019 Dec 29;6(2):e001119. doi: 10.1136/openhrt-2019-001119. eCollection 2019.
This cross-sectional study examined whether contrasting distributions of nuclear magnetic resonance (NMR)-measured lipoproteins contribute to differences in the prevalence of subclinical atherosclerosis measured using coronary artery calcium (CAC) between the two groups of middle-aged males: the US-residing Caucasian (US-White) and Japan-residing Japanese (Japanese).
In a population-based study of 570 randomly selected asymptomatic men aged 40-49 years (270 US-White and 300 Japanese), we examined the relationship between race/ethnicity, NMR-measured lipoproteins and CAC (measured by Electron Beam CT and quantified using the Agatston method) using multivariable robust Poisson regression adjusting for traditional and novel risk factors for coronary heart disease (CHD).
The US-White compared with the Japanese had significantly different NMR-measured lipoprotein particle distributions. The US-White had a significantly higher prevalence of CAC≥10 (CAC-prevalence) compared with the Japanese adjusting for CHD risk factors (prevalence ratio (PR)=2.10; 95% CI=1.24 to 3.48), and this difference was partially attenuated (~18%) with further adjustment for lipoprotein levels (PR=1.73; 95% CI=1.02 to 3.08). There was no reclassification improvement with further addition of lipoproteins particle concentrations/size to a model that already included traditionally measured lipids (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), cardiovascular risk factors, and inflammatory markers (net reclassification improvement index=-2% to 3%).
Variations in the distribution of NMR-measured lipoprotein particles partially accounted for the difference in the CAC-prevalence between middle-aged US-White and Japanese men.
本横断面研究旨在探讨中老年人中,磁共振(NMR)测量的脂蛋白分布差异是否会导致冠状动脉钙(CAC)测量的亚临床动脉粥样硬化患病率存在差异,该人群分为两组:居住在美国的白种人(美国白人)和居住在日本的日本人(日本人)。
在一项基于人群的研究中,我们对 570 名年龄在 40-49 岁的无症状男性(270 名美国白人,300 名日本人)进行了研究,使用多变量稳健泊松回归分析,调整了冠心病(CHD)的传统和新型危险因素,考察了种族/民族、NMR 测量的脂蛋白与 CAC(电子束 CT 测量,采用 Agatston 法量化)之间的关系。
与日本人相比,美国白人的 NMR 测量脂蛋白颗粒分布明显不同。美国白人的 CAC≥10(CAC 患病率)的患病率明显高于日本人,调整 CHD 危险因素后(患病率比(PR)=2.10;95%可信区间(CI)=1.24 至 3.48),这种差异在用脂蛋白水平进一步调整后部分减弱(PR=1.73;95%CI=1.02 至 3.08)。在用传统测量的脂质(低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯)、心血管危险因素和炎症标志物进一步加入脂蛋白颗粒浓度/大小后,模型的重新分类改善没有改善(净重新分类改善指数=-2%至 3%)。
NMR 测量的脂蛋白颗粒分布的差异部分解释了美国白人和日本中年男性 CAC 患病率的差异。