Institute of Cardiovascular Science, Faculty of Population Health, University College London, UK.
Department of Primary Care & Population Health, Faculty of Population Health, University College London, UK.
Eur J Prev Cardiol. 2020 Oct;27(15):1617-1626. doi: 10.1177/2047487319899621. Epub 2020 Jan 29.
Elevated low-density lipoprotein cholesterol (LDL-C) is a risk factor for cardiovascular disease; however, there is uncertainty about the role of total triglycerides and the individual triglyceride-containing lipoprotein sub-fractions. We measured 14 triglyceride-containing lipoprotein sub-fractions using nuclear magnetic resonance and examined associations with coronary heart disease and stroke.
Triglyceride-containing sub-fraction measures were available in 11,560 participants from the three UK cohorts free of coronary heart disease and stroke at baseline. Multivariable logistic regression was used to estimate the association of each sub-fraction with coronary heart disease and stroke expressed as the odds ratio per standard deviation increment in the corresponding measure.
The 14 triglyceride-containing sub-fractions were positively correlated with one another and with total triglycerides, and inversely correlated with high-density lipoprotein cholesterol (HDL-C). Thirteen sub-fractions were positively associated with coronary heart disease (odds ratio in the range 1.12 to 1.22), with the effect estimates for coronary heart disease being comparable in subgroup analysis of participants with and without type 2 diabetes, and were attenuated after adjustment for HDL-C and LDL-C. There was no evidence for a clear association of any triglyceride lipoprotein sub-fraction with stroke.
Triglyceride sub-fractions are associated with increased risk of coronary heart disease but not stroke, with attenuation of effects on adjustment for HDL-C and LDL-C.
低密度脂蛋白胆固醇（LDL-C）升高是心血管疾病的一个危险因素；然而，总甘油三酯和各种含甘油三酯的脂蛋白亚组份的作用仍存在不确定性。我们使用核磁共振测量了 14 种含甘油三酯的脂蛋白亚组份，并研究了它们与冠心病和中风的关系。
在基线时无冠心病和中风的三个英国队列的 11560 名参与者中可获得含甘油三酯亚组份的测量值。多变量逻辑回归用于估计每个亚组份与冠心病和中风的关联，其表达为相应测量值每标准差增加的比值比。
14 种含甘油三酯的亚组份彼此之间以及与总甘油三酯呈正相关，与高密度脂蛋白胆固醇（HDL-C）呈负相关。13 种亚组份与冠心病呈正相关（比值比范围为 1.12 至 1.22），在有和无 2 型糖尿病的参与者亚组分析中，冠心病的效应估计值是可比的，并且在调整了 HDL-C 和 LDL-C 后，效应减弱。没有明确的证据表明任何甘油三酯脂蛋白亚组份与中风有明显关联。
甘油三酯亚组份与冠心病风险增加相关，但与中风无关，在调整了 HDL-C 和 LDL-C 后，其效应减弱。
