Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Departments of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, United States.
Elife. 2021 Feb 9;10:e60999. doi: 10.7554/eLife.60999.
Adherence to healthy lifestyles is associated with reduced risk of coronary heart disease (CHD), but uncertainty persists about the underlying lipid pathway. In a case-control study of 4681 participants nested in the prospective China Kadoorie Biobank, 61 lipidomic markers in baseline plasma were measured by targeted nuclear magnetic resonance spectroscopy. Baseline lifestyles included smoking, alcohol consumption, dietary habit, physical activity, and adiposity levels. Genetic instrument was used to mimic the lipid-lowering effect of statins. We found that 35 lipid metabolites showed statistically significant mediation effects in the pathway from healthy lifestyles to CHD reduction, including very low-density lipoprotein (VLDL) particles and their cholesterol, large-sized high-density lipoprotein (HDL) particle and its cholesterol, and triglyceride in almost all lipoprotein subfractions. The statins genetic score was associated with reduced intermediate- and low-density lipoprotein, but weak or no association with VLDL and HDL. Lifestyle interventions and statins may improve different components of the lipid profile.
坚持健康的生活方式与降低冠心病（CHD）风险有关，但脂质通路的潜在机制仍存在不确定性。在对嵌套于前瞻性中国科克伦生物银行的 4681 名参与者的病例对照研究中，通过靶向核磁共振光谱法测量了基线血浆中的 61 种脂质组学标志物。基线生活方式包括吸烟、饮酒、饮食习惯、身体活动和肥胖水平。遗传工具被用来模拟他汀类药物的降低血脂作用。我们发现，35 种脂质代谢物在健康生活方式与 CHD 降低的通路中显示出统计学上显著的中介作用，包括极低密度脂蛋白（VLDL）颗粒及其胆固醇、大尺寸高密度脂蛋白（HDL）颗粒及其胆固醇，以及几乎所有脂蛋白亚组分中的甘油三酯。他汀类药物遗传评分与中间密度脂蛋白和低密度脂蛋白降低有关，但与 VLDL 和 HDL 的相关性较弱或没有。生活方式干预和他汀类药物可能改善血脂谱的不同成分。
