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当 LDL-C 低于 104mg/dL 时，脂蛋白(a)与冠状动脉粥样硬化病变的相关性强于 LDL-C。

The correlation between lipoprotein(a) and coronary atherosclerotic lesion is stronger than LDL-C, when LDL-C is less than 104 mg/dL.

机构信息

Faculty of Graduate, The Logistic University of Chinese People's Armed Police Force, Tianjin, China.

Department of Thoracic and Cardiovascular Surgery, Special Medical Center of Chinese People's Armed Police Force, 220 Chenglin Road, Tianjin, 300162, China.

出版信息

BMC Cardiovasc Disord. 2021 Jan 19;21(1):41. doi: 10.1186/s12872-021-01861-6.

DOI:10.1186/s12872-021-01861-6
PMID:33468066
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7816444/
Abstract

BACKGROUND: Lp(a) and LDL-C are both risk factors of atherosclerotic cardiovascular disease (ASCVD). But there was a contradiction point in LDL-C and Lp(a) control. The appropriate level of LDL-C and Lp(a) in the prevention of ASCVD is still pending. OBJECTIVE: To investigate the correlation of Lp(a) and coronary atherosclerotic lesion, and find out the balance point in LDL-C and Lp(a) control. METHOD: 3449 patients were divided to coronary atherosclerotic heart disease (CAHD) Group and Non-CAHD Group based on the result of coronary angiography. The clinical characteristics were compared, and Logistic regressions were applied to find the CAHD risk factors in total, High-LDL-C Group (LDL-C ≥ 100 mg/dL) and Low-LDL-C Group (LDL-C < 100 mg/dL) patients. Spearman correlation analysis of Lp(a), LDL-C and Gensini Score was performed in patients with different LDL-C concentration. RESULTS: Except male and diabetes, the traditional CAHD risk factors were well matched between two groups. But triglyceride, LDL-C and Lp(a) were higher, HDL-C and Apo-A1 were lower in CAHD group (2771). In the Logistic regression analysis, diabetes, LDL-C and Lp(a) are risk factors of CAHD in all patients, while in High-LDL-C Group, they were age, LDL-C, non-HDL-C and ApoB, in Low-LDL-C Group, they were age, Lp(a) and ApoB. Lp(a) correlated with Gensini with coefficient r = 0.41 in all patients, 0.67 in Low-LDL-C Group and 0.32 in High-LDL-C Group. The coefficient r for Lp(a) and Gensini decreased, while the r for LDL-C and Gensini increased with LDL-C concentration increasing. The two fitted lines of rs crossed at LDL-C = 2.7 mmol/L (104 mg/dL). CONCLUSION: Lp(a) was the risk factor of CAHD in patients with LDL-C < 100 mg/dL. The correlation between Lp(a) and Gensini was influenced by LDL-C concentration, and the correlation was stronger than LDL-C when LDL-C < 104 mg/dl.

摘要

背景：Lp(a) 和 LDL-C 都是动脉粥样硬化性心血管疾病（ASCVD）的危险因素。但是，在 LDL-C 和 Lp(a) 控制方面存在矛盾点。预防 ASCVD 中 LDL-C 和 Lp(a) 的适当水平仍有待确定。

目的：探讨 Lp(a) 与冠状动脉粥样硬化性病变的相关性，找出 LDL-C 和 Lp(a) 控制的平衡点。

方法：根据冠状动脉造影结果，将 3449 例患者分为冠状动脉粥样硬化性心脏病（CAHD）组和非 CAHD 组。比较临床特征，应用 Logistic 回归分析总人群、高 LDL-C 组（LDL-C≥100mg/dL）和低 LDL-C 组（LDL-C<100mg/dL）患者的 CAHD 危险因素。对不同 LDL-C 浓度患者的 Lp(a)、LDL-C 和 Gensini 评分进行 Spearman 相关性分析。

结果：除了男性和糖尿病，两组之间传统的 CAHD 危险因素匹配良好。但 CAHD 组患者的甘油三酯、LDL-C 和 Lp(a)水平较高，HDL-C 和 Apo-A1 水平较低（2771）。Logistic 回归分析显示，糖尿病、LDL-C 和 Lp(a)是所有患者 CAHD 的危险因素，而在高 LDL-C 组中，年龄、LDL-C、非 HDL-C 和 ApoB 是 CAHD 的危险因素，在低 LDL-C 组中，年龄、Lp(a)和 ApoB 是 CAHD 的危险因素。在所有患者中，Lp(a)与 Gensini 呈正相关，相关系数 r 为 0.41，在低 LDL-C 组中 r 为 0.67，在高 LDL-C 组中 r 为 0.32。随着 LDL-C 浓度的增加，Lp(a)与 Gensini 的相关系数 r 减小，而 LDL-C 与 Gensini 的相关系数 r 增大。在 LDL-C=2.7mmol/L（104mg/dL）时，两条 r 值拟合线相交。

结论：Lp(a)是 LDL-C<100mg/dL 患者 CAHD 的危险因素。Lp(a)与 Gensini 之间的相关性受 LDL-C 浓度的影响，当 LDL-C<104mg/dl 时，相关性强于 LDL-C。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/f05850c57664/12872_2021_1861_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/26fe2c518d82/12872_2021_1861_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/983608b7c96e/12872_2021_1861_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/e9a57960d4ab/12872_2021_1861_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/f05850c57664/12872_2021_1861_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/26fe2c518d82/12872_2021_1861_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/983608b7c96e/12872_2021_1861_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/e9a57960d4ab/12872_2021_1861_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31b/7816444/f05850c57664/12872_2021_1861_Fig4_HTML.jpg

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本文引用的文献

[1]
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