Health Management Centre, Kaifeng Central Hospital, Kaifeng, 475000, Henan, China.
Shanghai Zhangjiang Institue of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd, Shanghai, 201204, China.
BMC Cardiovasc Disord. 2021 Apr 27;21(1):216. doi: 10.1186/s12872-021-02023-4.
To investigate the relationship of small dense low-density lipoprotein cholesterol (sdLDL-C) to carotid artery intima-media thickness (CA-IMT) and carotid plaque (CAP) in Chinese general population, and to evaluate whether sdLDL-C could be an independent risk factor for individuals with subclinical atherosclerosis.
A total of 729 subjects were randomly collected from consecutive individuals from April 2019 to April 2020 for an annual health checkup. CA-IMT > 1.0 mm was defined as abnormal IMT. Plaque stability was measured by ultrasound examination based on the property of the echo. And sdLDL-C levels were detected by LipoPrint system. Multivariate logistic regression analysis was performed to identify factors associated with CA-IMT and carotid plaque.
The abnormal IMT group had significantly higher sdLDL-C levels than control group (p < 0.0001). And sdLDL-C levels were significantly positively correlated with IMT value (r = 0.1396, p = 0.0021) and presence of carotid plaque (r = 0.14, p = 0.002) in the subjects with abnormal IMT. In addition, subjects with higher levels of sdLDL-C (r = 0.11, p = 0.035) tended to have unstable CAP. After adjustment for age, gender and blood glucose, sdLDL-C level was an independent risk factor of the presence of CAP (OR = 1.59, 95% CI: 1.02-1.83, p = 0.034) in subjects with abnormal IMT.
SdLDL-C is an independent risk factor of the occurrence of CAP in the Chinese subjects with abnormal IMT. Our findings provide supporting evidence that sdLDL-C might be an alternative way to predict CVD in early stage.
探讨中国一般人群中小而密低密度脂蛋白胆固醇（sdLDL-C）与颈动脉内膜中层厚度（CA-IMT）和颈动脉斑块（CAP）的关系，并评估 sdLDL-C 是否可作为亚临床动脉粥样硬化个体的独立危险因素。
本研究共纳入 729 例 2019 年 4 月至 2020 年 4 月期间连续参加年度健康检查的个体。CA-IMT＞1.0mm 定义为 IMT 异常。通过超声检查斑块的回声特性来测量斑块稳定性。采用 LipoPrint 系统检测 sdLDL-C 水平。采用多变量 logistic 回归分析确定与 CA-IMT 和颈动脉斑块相关的因素。
IMT 异常组的 sdLDL-C 水平明显高于对照组（p＜0.0001）。并且，sdLDL-C 水平与 IMT 值（r=0.1396，p=0.0021）和颈动脉斑块的存在（r=0.14，p=0.002）呈显著正相关。此外，在 IMT 异常的受试者中，sdLDL-C 水平较高（r=0.11，p=0.035）的受试者倾向于存在不稳定的 CAP。在校正年龄、性别和血糖后，sdLDL-C 水平是 IMT 异常患者 CAP 存在的独立危险因素（OR=1.59，95%CI：1.02-1.83，p=0.034）。
sdLDL-C 是中国 IMT 异常患者 CAP 发生的独立危险因素。我们的研究结果提供了支持性证据，表明 sdLDL-C 可能是预测早期 CVD 的替代方法。
