Department of Family Medicine, Taipei MacKay Memorial Hospital, No. 92, Section 2, Zhongshan North Road, Taipei City, 10449, Taiwan.
Institute of Epidemiology and Preventive Medicine, National Taiwan University, Room 517, No. 17, Xu-Zhou Rd., Taipei City, 10055, Taiwan.
Sci Rep. 2021 Apr 1;11(1):7381. doi: 10.1038/s41598-021-86336-6.
High baseline atherogenic lipid level has been an established risk factor for the risk of cardiovascular events. Evidence concerning the role of lipid changes in cardiovascular and death risks are inconclusive. A cohort study was conducted based on the Taiwanese Survey on Hypertension, Hyperglycemia, and Hyperlipidemia (n = 4072, mean 44.8 years, 53.5% women) assessing lipid levels of the participants repeatedly measured in 2002 and 2007. Combined baseline and changes in lipid levels were classified into four groups-stable or decreasing lipid changes and increasing lipid changes with low- and high-risk baseline lipid levels. Developing cardiovascular events (n = 225) and all-cause deaths (n = 345) were ascertained during a median follow-up of 13.3 years. Participants with increasing and higher total cholesterol level were more likely to develop cardiovascular risks. Similar patterns for cardiovascular events were observed across other lipid profile changes. However, participants with increasing total cholesterol, LDL-C, and non-high-density lipoprotein cholesterol (non-HDL-C) levels were more likely to be at a lower risk for all-cause deaths. Baseline and changes in total cholesterol, triglycerides, and LDL-C levels were positively associated with the risk of cardiovascular diseases, whereas baseline and changes in total cholesterol and LDL-C and non-HDL-C levels were inversely associated with all-cause deaths.
高基线致动脉粥样硬化脂质水平一直是心血管事件风险的既定危险因素。关于脂质变化与心血管和死亡风险的关系的证据尚无定论。一项基于台湾高血压、高血糖和高血脂调查的队列研究(n=4072,平均年龄 44.8 岁,53.5%为女性)评估了参与者在 2002 年和 2007 年反复测量的脂质水平。将基线和脂质水平变化联合起来分为四组——稳定或降低的脂质变化和基线脂质水平低和高的升高的脂质变化。在中位随访 13.3 年后,确定了心血管事件(n=225)和全因死亡(n=345)的发生情况。总胆固醇水平升高的参与者发生心血管风险的可能性更高。其他脂质谱变化也观察到了类似的心血管事件模式。然而,总胆固醇、LDL-C 和非高密度脂蛋白胆固醇(非-HDL-C)水平升高的参与者全因死亡的风险较低。总胆固醇、甘油三酯和 LDL-C 水平的基线和变化与心血管疾病的风险呈正相关,而总胆固醇和 LDL-C 以及非-HDL-C 水平的基线和变化与全因死亡呈负相关。