Department of Geriatrics, The First People's Hospital of Changzhou, Changzhou, China; Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Cardiology, The First People's Hospital of Changzhou, Changzhou, China; Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
J Clin Lipidol. 2020 Jan-Feb;14(1):133-142.e3. doi: 10.1016/j.jacl.2019.12.002. Epub 2019 Dec 20.
There is an increasing body of evidence associating traditional cardiovascular risk factors with atrial fibrillation (AF), but the relationship between blood lipid profiles and the risk of AF remains controversial.
This study aimed to conduct a systemic review and meta-analysis of large cohort studies to evaluate the relationship between blood lipid profiles and incident AF.
PubMed and Embase were searched up to January 31, 2019, for cohort studies that reported the relationship between blood lipid levels and incident AF. The hazard ratios or odds ratios of the highest vs lowest categories of lipid levels were extracted to calculate pooled estimates. Sensitivity analysis and meta-regression were performed to explore potential sources of heterogeneity.
Eleven studies were included in the meta-analysis, including 9 studies for total cholesterol (TC), 5 for low-density lipoprotein cholesterol (LDL-C), 8 for high-density lipoprotein cholesterol (HDL-C), and 8 for triglyceride. Serum TC and LDL-C levels were inversely related to AF risk (relative risk [RR] = 0.81, 95% confidence interval [CI]: 0.72-0.92; RR = 0.79, 95% CI: 0.70-0.88, respectively). Likewise, elevated HDL-C levels were associated with a reduced AF risk (RR = 0.86, 95% CI: 0.76-0.97), whereas no significant association was observed between triglyceride levels and incident AF (RR = 1.02, 95% CI: 0.90-1.17).
Our meta-analysis of large cohort studies found an inverse relationship between serum TC, LDL-C, and HDL-C levels and AF risk, although there was no significant association between TG levels and incident AF. Future studies regarding AF risk stratification may take these blood lipids into consideration, and further efforts are needed to investigate the potential mechanisms.
越来越多的证据表明，传统心血管危险因素与心房颤动（房颤）有关，但血脂谱与房颤风险之间的关系仍存在争议。
本研究旨在对大型队列研究进行系统评价和荟萃分析，以评估血脂谱与房颤发生风险之间的关系。
检索 PubMed 和 Embase 数据库，截至 2019 年 1 月 31 日，以获取报道血脂水平与房颤发生风险之间关系的队列研究。提取最高与最低血脂水平分类的风险比或优势比，以计算汇总估计值。进行敏感性分析和荟萃回归分析以探索潜在的异质性来源。
荟萃分析纳入 11 项研究，其中 9 项研究评估了总胆固醇（TC），5 项研究评估了低密度脂蛋白胆固醇（LDL-C），8 项研究评估了高密度脂蛋白胆固醇（HDL-C），8 项研究评估了甘油三酯。血清 TC 和 LDL-C 水平与房颤风险呈负相关（相对风险 [RR] = 0.81，95%置信区间 [CI]：0.72-0.92；RR = 0.79，95% CI：0.70-0.88）。同样，升高的 HDL-C 水平与房颤风险降低相关（RR = 0.86，95% CI：0.76-0.97），而甘油三酯水平与房颤发生之间无显著关联（RR = 1.02，95% CI：0.90-1.17）。
我们对大型队列研究的荟萃分析发现，血清 TC、LDL-C 和 HDL-C 水平与房颤风险呈负相关，尽管甘油三酯水平与房颤发生之间无显著关联。未来关于房颤风险分层的研究可能需要考虑这些血脂因素，并且需要进一步努力研究潜在的机制。
