“高三酰甘油腰围”与多种族人群亚临床动脉粥样硬化 5 年风险增加的相关性：一项前瞻性队列研究。
Association of "hypertriglyceridemic waist" with increased 5-year risk of subclinical atherosclerosis in a multi-ethnic population: a prospective cohort study.
机构信息
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada.
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada.
出版信息
BMC Cardiovasc Disord. 2021 Feb 2;21(1):63. doi: 10.1186/s12872-021-01882-1.
BACKGROUND
Hypertriglyceridemic waist (HTGW), which incorporates measures of waist circumference and levels of triglyceride in blood, could act as an early-stage predictor to identify the individuals at high-risk for subclinical atherosclerosis. Previous studies have explored the cross-sectional association between HTGW and atherosclerosis; however, understanding how this association might change over time is necessary. This study will assess the association between HTGW with 5-year subclinical carotid atherosclerosis.
METHODS
517 participants of Aboriginal, Chinese, European, and South Asian ethnicities were examined for baseline HTGW and 5-year indices of subclinical atherosclerosis (intima media thickness (mm), total area (mm), and plaque presence). Family history of cardiovascular disease, sociodemographic measures (age, sex, ethnicity, income level, maximum education), and traditional risk factors (systolic blood pressure, smoking status, total cholesterol, high-density lipoprotein cholesterol, body mass index) were incorporated into the models of association. These models used multiple linear regression and logistic regression.
RESULTS
Baseline HTGW phenotype is a statistically significant and clinically meaningful predictor of 5-year intima media thickness (β = 0.08 [0.04, 0.11], p < 0.001), total area (β = 0.20 [0.07, 0.33], p = 0.002), and plaque presence (OR = 2.17 [1.13, 4.19], p = 0.02) compared to the non-HTGW group independent of sociodemographic factors and family history. However, this association is no longer significant after adjusting for the traditional risk factors of atherosclerosis (p = 0.27, p = 0.45, p = 0.66, respectively). Moreover, change in status of HTGW phenotype does not correlate with change in indices of atherosclerosis over 5 years.
CONCLUSIONS
Our results suggest that when the traditional risk factors of atherosclerosis are known, HTGW may not offer additional value as a predictor of subclinical atherosclerosis progression over 5 years.
背景
高脂血症性腰围（HTGW）将腰围和血液中甘油三酯水平结合起来，可以作为识别亚临床动脉粥样硬化高危个体的早期预测指标。先前的研究已经探讨了 HTGW 与动脉粥样硬化之间的横断面相关性；然而，了解这种相关性如何随时间变化是必要的。本研究将评估 HTGW 与 5 年亚临床颈动脉粥样硬化之间的相关性。
方法
对 517 名原住民、华人、欧洲人和南亚人进行了基线 HTGW 和 5 年亚临床动脉粥样硬化指标（内膜中层厚度（mm）、总面积（mm）和斑块存在）的检测。心血管疾病家族史、社会人口统计学指标（年龄、性别、族裔、收入水平、最高教育程度）和传统危险因素（收缩压、吸烟状况、总胆固醇、高密度脂蛋白胆固醇、体重指数）纳入了关联模型。这些模型使用多元线性回归和逻辑回归。
结果
基线 HTGW 表型是 5 年内内膜中层厚度（β=0.08 [0.04, 0.11]，p<0.001）、总面积（β=0.20 [0.07, 0.33]，p=0.002）和斑块存在（OR=2.17 [1.13, 4.19]，p=0.02）的统计学上显著且具有临床意义的预测指标，与非 HTGW 组相比，独立于社会人口统计学因素和家族史。然而，在调整动脉粥样硬化的传统危险因素后，这种相关性不再显著（p=0.27，p=0.45，p=0.66）。此外，HTGW 表型状态的变化与 5 年内动脉粥样硬化指数的变化无关。
结论
我们的研究结果表明，当已知动脉粥样硬化的传统危险因素时，HTGW 可能无法作为 5 年内亚临床动脉粥样硬化进展的预测指标提供额外价值。
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