Guo Li-Ling, Chen Yan-Qiao, Lin Qiu-Zhen, Tian Feng, Xiang Qun-Yan, Zhu Li-Yuan, Xu Jin, Wen Tie, Liu Ling
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Research Institute of Blood Lipid and Atherosclerosis, Center South University, Changsha, China.
Front Cardiovasc Med. 2021 Apr 1;8:649181. doi: 10.3389/fcvm.2021.649181. eCollection 2021.
This study aimed to compare the percentage attainment of fasting and non-fasting LDL-C and non-HDL-C target levels in coronary heart disease (CHD) patients receiving short-term statin therapy. This study enrolled 397 inpatients with CHD. Of these, 197 patients took statins for <1 month (m) or did not take any statin before admission (CHD1 group), while 204 patients took statins for ≥1 m before admission (CHD2 group). Blood lipid levels were measured at 0, 2, and 4 h after a daily breakfast. Non-fasting LDL-C and non-HDL-C levels significantly decreased after a daily meal ( < 0.05). Both fasting and non-fasting LDL-C or non-HDL-C levels were significantly lower in the CHD2 group. The percentage attainment of LDL-C <1.4 mmol/L at 2 and 4 h after a daily breakfast was significantly higher than that during fasting ( < 0.05), but the percent attainment of non-fasting non-HDL-C <2.2 mmol/L was close to its fasting value ( > 0.05). Analysis of c-statistic showed that non-fasting cut-off points for LDL-C and non-HDL-C were 1.19 and 2.11 mmol/L, corresponding to their fasting goal levels of 1.4 and 2.2 mmol/L, respectively. When post-prandial LDL-C and non-HDL-C goal attainments were re-evaluated using non-fasting cut-off points, there were no significant differences in percentage attainment between fasting and non-fasting states. Non-HDL-C is more stable than LDL-C in assessing the percent attainment of non-fasting lipid for coronary heart disease patients. If we want to use LDL-C to assess the percent attainment of post-prandial blood lipids, we may need to determine a lower non-fasting cut-off point.
本研究旨在比较接受短期他汀类药物治疗的冠心病（CHD）患者空腹和非空腹低密度脂蛋白胆固醇（LDL-C）及非高密度脂蛋白胆固醇（非HDL-C）目标水平的达标率。本研究纳入了397例冠心病住院患者。其中，197例患者服用他汀类药物<1个月（m）或入院前未服用任何他汀类药物（CHD1组），而204例患者入院前服用他汀类药物≥1 m（CHD2组）。在每日早餐后0、2和4小时测量血脂水平。每日餐后非空腹LDL-C和非HDL-C水平显著降低（<0.05）。CHD2组的空腹和非空腹LDL-C或非HDL-C水平均显著较低。每日早餐后2和4小时LDL-C<1.4 mmol/L的达标率显著高于空腹时（<0.05），但非空腹非HDL-C<2.2 mmol/L的达标率接近其空腹值（>0.05）。c统计量分析表明，LDL-C和非HDL-C的非空腹切点分别为1.19和2.11 mmol/L，分别对应其空腹目标水平1.4和2.2 mmol/L。当使用非空腹切点重新评估餐后LDL-C和非HDL-C目标达标情况时，空腹和非空腹状态下的达标率百分比无显著差异。在评估冠心病患者非空腹血脂达标率方面，非HDL-C比LDL-C更稳定。如果我们想用LDL-C来评估餐后血脂达标率，可能需要确定一个更低的非空腹切点。
