Tada Hayato, Shibayama Junichi, Nishikawa Tetsuo, Okada Hirofumi, Nomura Akihiro, Usui Soichiro, Sakata Kenji, Hashiba Atsushi, Inazu Akihiro, Takamura Masayuki, Kawashiri Masa-Aki
Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
Kanazawa Medical Association, Kanazawa, Japan.
Pract Lab Med. 2020 Oct 19;22:e00181. doi: 10.1016/j.plabm.2020.e00181. eCollection 2020 Nov.
The prevalence of familial hypercholesterolemia (FH) among Japanese populations is still unclear. In addition, no prior data exist regarding the self-awareness. Accordingly, we aimed to investigate the prevalence, self-awareness, and LDL-C of patients with highly suspected as FH using data obtained in a community-based medical checkups.
This study included 52,276 subjects (18,588 men, 35.6%) aged ≥40 years who underwent the Japanese specific health checkup in Kanazawa City during 2018. We assessed the self-awareness of dyslipidemia (and the age) as well as the prevalence of patients with highly suspected as FH whose naïve LDL-C levels were ≥250 mg/dl. Naïve LDL-C levels were estimated by the adjustment (LDL-C/0.7) for those on lipid-lowering medication. We divided subjects into 3 groups based on their naïve LDL cholesterol level (≥250 mg/dl, 140-249, and ≤139 mg/dl).
We identified 262 (0.5%) individuals highly suspected as FH whose naïve LDL-C levels were ≥250 mg/dl. Most of them (234 among 262, 89%) were under lipid-lowering medication; however, the self-awareness as dyslipidemia was not quite high (200 among 262, 76%), and their mean LDL-C level under lipid-lowering medication was 203 ± 35 mg/dl. Interestingly, the age of acknowledgement of dyslipidemia among the patients with highly suspected as FH was significantly younger than those in other categories (58 vs. 60/62 yrs, respectively, p < 0.05 for both).
The prevalence of patients highly suspected as FH was around 1 in 200, and their self-awareness as well as control were not still good enough among Japanese general populations.
日本人群中家族性高胆固醇血症(FH)的患病率仍不清楚。此外,关于自我认知方面此前尚无相关数据。因此,我们旨在利用社区医疗检查获得的数据,调查高度疑似FH患者的患病率、自我认知情况以及低密度脂蛋白胆固醇(LDL-C)水平。
本研究纳入了2018年在金泽市接受日本特定健康检查的52276名年龄≥40岁的受试者(18588名男性,占35.6%)。我们评估了血脂异常的自我认知情况(以及年龄),以及初诊低密度脂蛋白胆固醇水平≥250mg/dl的高度疑似FH患者的患病率。对于正在服用降脂药物的患者,通过调整(LDL-C/0.7)来估算初诊低密度脂蛋白胆固醇水平。我们根据初诊低密度脂蛋白胆固醇水平将受试者分为三组(≥250mg/dl、140 - 249mg/dl和≤139mg/dl)。
我们确定了262名(0.5%)初诊低密度脂蛋白胆固醇水平≥250mg/dl的高度疑似FH患者。他们中的大多数(262名中的234名,占89%)正在服用降脂药物;然而,血脂异常的自我认知情况并不高(262名中的200名,占76%),且他们在服用降脂药物情况下的平均低密度脂蛋白胆固醇水平为203±35mg/dl。有趣的是,高度疑似FH患者中认识到血脂异常的年龄明显低于其他类别患者(分别为58岁与60/62岁,两者p均<0.05)。
在日本普通人群中,高度疑似FH患者的患病率约为1/200,他们的自我认知以及病情控制情况仍不够理想。