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脂蛋白相关磷脂酶 A2 可评估颈动脉狭窄严重程度,并预测高危卒中人群中脑血管事件的发生。

Lp-PLA2 evaluates the severity of carotid artery stenosis and predicts the occurrence of cerebrovascular events in high stroke-risk populations.

机构信息

College of Medical Technology, Zhejiang Chinese Medical University, Hangzhou, China.

Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China.

出版信息

J Clin Lab Anal. 2021 Mar;35(3):e23691. doi: 10.1002/jcla.23691. Epub 2021 Jan 17.

Abstract

BACKGROUND

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an independent risk factor for cardiovascular disease. However, relationship between carotid artery stenosis and cerebrovascular events in high stroke-risk populations is still unclear.

METHODS

A total of 835 people at a high risk of stroke were screened from 15,933 people aged >40 years in April 2013 and followed at 3, 6, 12, and 24 months. Finally, 823 participants met the screening criteria, and the clinical data and biochemical parameters were investigated.

RESULTS

Among the 823 participants, 286 had varying degrees of carotid artery stenosis and 18 had cerebrovascular events. The level of Lp-PLA2 in the carotid artery stenosis group was higher than that in the no stenosis group, and the level in the event group was higher than that in the no event group (p < 0.05). Spearman correlation analysis showed that Lp-PLA2 was positively correlated with the degree of carotid artery stenosis (r = 0.093, p = 0.07) and stenosis involvement (r = 0.094, p = 0.07). The correlation coefficient between Lp-PLA2 and lipoprotein was the highest on the levels of sdLDL (r = 0.555, p < 0.001), followed by non-HDL, LDL, TC, and TG. Cox multivariate regression analysis revealed that, compared with the first quantile of Lp-PLA2 level (Q1, low level), the risk of cerebrovascular events in the fourth quantile of Lp-PLA2 was 10.170 times that of the first quantile (OR = 10.170, 95% CI 1.302-79.448, p = 0.027).

CONCLUSIONS

Lp-PLA2 levels can evaluate carotid artery stenosis and predict the occurrence of cerebrovascular events in high stroke-risk populations and provide scientific guidance for risk stratification management.

摘要

背景

脂蛋白相关磷脂酶 A2(Lp-PLA2)是心血管疾病的独立危险因素。然而,在高卒中风险人群中,颈动脉狭窄与脑血管事件之间的关系仍不清楚。

方法

2013 年 4 月,从 15933 名年龄>40 岁的人群中筛选出 835 名高卒中风险人群,并在 3、6、12 和 24 个月时进行随访。最终,823 名参与者符合筛选标准,并对其临床资料和生化参数进行了调查。

结果

在 823 名参与者中,286 名存在不同程度的颈动脉狭窄,18 名发生脑血管事件。颈动脉狭窄组的 Lp-PLA2 水平高于无狭窄组,事件组高于无事件组(p<0.05)。Spearman 相关分析显示,Lp-PLA2 与颈动脉狭窄程度呈正相关(r=0.093,p=0.07),与狭窄受累呈正相关(r=0.094,p=0.07)。Lp-PLA2 与脂蛋白的相关系数在 sdLDL 水平最高(r=0.555,p<0.001),其次是非 HDL、LDL、TC 和 TG。Cox 多变量回归分析显示,与 Lp-PLA2 水平第一四分位数(Q1,低水平)相比,Lp-PLA2 水平第四四分位数的脑血管事件风险是第一四分位数的 10.170 倍(OR=10.170,95%CI 1.302-79.448,p=0.027)。

结论

Lp-PLA2 水平可评估颈动脉狭窄,并预测高卒中风险人群中脑血管事件的发生,为风险分层管理提供科学指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbde/7957999/7b57e4572a60/JCLA-35-e23691-g002.jpg

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