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健康职业人群中 LDL 和 HDL 大小和数量的核磁共振分析:脂质研究。

Analysis of LDL and HDL size and number by nuclear magnetic resonance in a healthy working population: The LipoLab Study.

机构信息

Health Surveillance Unit, Castellón Mutual Insurance Union, Castellon, Spain.

Department of Medicine, Jaume I University, Castellón, Spain.

出版信息

Int J Clin Pract. 2021 Jan;75(1):e13610. doi: 10.1111/ijcp.13610. Epub 2020 Nov 8.

Abstract

BACKGROUND AND AIM

Atherosclerosis is the underlying process in cardiovascular disease (CVD), the first cause of death in developed countries. We aimed to identify people with no known CVD and normal values of LDL-C and HDL-C, but with alterations in the number and size of lipoprotein particles (as measured by nuclear magnetic resonance [NMR]) and to analyse their sociodemographic, clinical and biochemical characteristics.

METHODS

Cross-sectional study in occupational risks prevention centre in Castellón (Spain) in 2017 and 2018, in consecutively recruited adults (18-65 years) with no known CVD. Sociodemographic, clinical and biochemical variables were collected. Lipid profiles were analysed (Liposcale test), along with the concentration, size and number of the main types of lipoprotein particles, determined by 2D diffusion-ordered NMR spectroscopy. Using contingency tables, we analysed the characteristics of people with normal LDL and HDL cholesterol but abnormal levels of LDL and HDL particles. The magnitude of association between explanatory variables and abnormal levels of each kind of lipoprotein was assessed with multivariable logistic regression models.

RESULTS

Of the 400 total participants (31.3% women; age 46.4 ± 4.3 years), 169 had normal LDL and HDL cholesterol. Abnormal lipoprotein particle values depended on the subtype: prevalence of abnormal LDL levels ranged from 8.3% to 36.7%; and of HDL, from 28.4% to 42.6%. High systolic blood pressure and total cholesterol were significantly associated with abnormal LDL levels. Male sex and high systolic blood pressure were associated with abnormalities in HDL.

CONCLUSIONS

An extended lipids profile, obtained by NMR, enables the identification of people with normal HDL-C and LDL-C levels who present abnormal levels of LDL-P and/or HDL-P. Higher total cholesterol, systolic blood pressure, BMI and male sex were significantly associated with these abnormal values.

摘要

背景与目的

动脉粥样硬化是心血管疾病(CVD)的潜在过程,也是发达国家的首要死因。我们旨在识别那些没有已知 CVD 且 LDL-C 和 HDL-C 值正常,但脂蛋白颗粒数量和大小发生改变的人群(通过磁共振 [NMR] 测量),并分析其社会人口学、临床和生化特征。

方法

2017 年至 2018 年,在西班牙卡斯特利翁的职业风险预防中心进行了一项横断面研究,纳入了连续招募的无已知 CVD 的成年(18-65 岁)。收集了社会人口学、临床和生化变量。分析了血脂谱(Liposcale 测试),以及通过 2D 扩散排序 NMR 光谱法确定的主要脂蛋白类型的浓度、大小和数量。使用列联表,我们分析了 LDL 和 HDL 胆固醇正常但 LDL 和 HDL 颗粒水平异常的人群的特征。使用多变量逻辑回归模型评估解释变量与每种脂蛋白异常水平之间关联的大小。

结果

在 400 名总参与者中(31.3%为女性;年龄 46.4±4.3 岁),有 169 名 LDL 和 HDL 胆固醇正常。脂蛋白颗粒值异常取决于亚型:异常 LDL 水平的患病率范围为 8.3%至 36.7%;HDL 为 28.4%至 42.6%。高血压和总胆固醇高与 LDL 水平异常显著相关。男性和高血压与 HDL 异常相关。

结论

通过 NMR 获得的扩展脂质谱可识别 LDL-C 和 HDL-C 水平正常但 LDL-P 和/或 HDL-P 水平异常的人群。较高的总胆固醇、收缩压、BMI 和男性与这些异常值显著相关。

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