Division of Cardiology, University of Southern California, Los Angeles, CA, USA.
Department of Biostatistics, University of Washington, Seattle, WA, USA.
Atherosclerosis. 2020 Mar;297:81-86. doi: 10.1016/j.atherosclerosis.2020.02.007. Epub 2020 Feb 15.
We aimed to assess the relationship of HDL (high-density lipoprotein)-mediated cholesterol mass efflux capacity (CMEC) with risk of incident peripheral artery disease (PAD).
CMEC was measured in 1458 Multi-Ethnic Study of Atherosclerosis participants between 2000 and 2002 as part of a case-control study matched for incident cardiovascular disease and progression of carotid plaque by ultrasound. Incident clinical PAD, adjudicated on the basis of a positive history for the presence of disease-related symptoms or treatment, was ascertained through 2015 in 1419 individuals without clinical PAD at baseline. Subclinical PAD, defined as an ankle-brachial index (ABI) ≤1.0, was assessed among 1255 individuals with a baseline ABI >1.0 and at least one follow-up ABI measurement 3-10 years later. Cox proportional hazards and relative risk regression modeling per SD increment of CMEC were used to determine the association of CMEC with clinical and subclinical PAD, respectively.
There were 38 clinical PAD and 213 subclinical PAD events that occurred over a mean follow-up of 6.0 and 6.5 years respectively. After adjustment for age, gender, and race, higher CMEC levels were not associated with clinical PAD (hazard ratio 1.25; 95% CI 0.89, 1.75) or subclinical PAD (risk ratio 1.02; 95% CI, 0.94, 1.11).
These findings suggest that HDL-mediated cholesterol efflux is not significantly associated with incident clinical and subclinical PAD.
我们旨在评估高密度脂蛋白（HDL）介导的胆固醇质量外排能力（CMEC）与外周动脉疾病（PAD）发病风险的关系。
在 2000 年至 2002 年间，作为一项病例对照研究的一部分，对 1458 名动脉粥样硬化多民族研究参与者进行了 CMEC 测量，该研究通过超声匹配心血管疾病发病和颈动脉斑块进展。在基线时无临床 PAD 的 1419 名个体中，通过 2015 年的确定，根据存在与疾病相关的症状或治疗的阳性病史，确定了临床 PAD 的发病情况。在基线 ABI>1.0 且至少有一次后续 ABI 测量在 3-10 年内的 1255 名个体中，评估了亚临床 PAD，定义为踝臂指数（ABI）≤1.0。使用 Cox 比例风险和相对风险回归模型，每 SD 递增 CMEC 来确定 CMEC 与临床和亚临床 PAD 的相关性。
在平均随访 6.0 和 6.5 年时，分别发生了 38 例临床 PAD 和 213 例亚临床 PAD 事件。在调整年龄、性别和种族后，CMEC 水平较高与临床 PAD（风险比 1.25；95%CI 0.89，1.75）或亚临床 PAD（风险比 1.02；95%CI，0.94，1.11）无关。
这些发现表明，HDL 介导的胆固醇外排与新发临床和亚临床 PAD 无明显相关性。
