Department of Emergency Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Emergency and Trauma Center, The International Medical Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Lipids Health Dis. 2021 Oct 17;20(1):137. doi: 10.1186/s12944-021-01571-0.
Lipid management is the first line of treatment for decreasing the incidence of cardiovascular events in patients with coronary heart disease (CHD), and a variety of indicators are used to evaluate lipid management. This work analyses the differences in LDL-C and apoB for lipid management evaluation, as well as explores the feasibility of skin cholesterol as a marker that can be measured non-invasively for lipid management.
The prospective study enrolled 121 patients who had been diagnosed with acute coronary syndrome (ACS) at the department of emergency medicine of the First Affiliated Hospital of the USTC from May 2020 to January 2021, and the patients were grouped into Group I (n=53) and Group II (n=68) according to whether they had comorbid hyperlipidemia and/or diabetes mellitus. All patients were administered 10 mg/day of rosuvastatin and observed for 12 weeks. Lipid management was assessed on the basis of LDL-C and apoB, and linear correlation models were employed to assess the relationship between changes in these well accepted markers to that of changes in skin cholesterol.
Out of 121 patients with ACS, 53 patients (43.80 %) had combined hyperlipidemia and/or diabetes mellitus (Group I), while 68 patients (56.20 %) did not (Group II). Cardiovascular events occur at earlier ages in patients with CHD who are comorbid for hyperlipidemia and/or diabetes (P<0.05). LDL-C attainment rate is lower than apoB attainment rate with rosuvastatin therapy (P<0.05), which is mainly attributable to patients with low initial LDL-C. Skin cholesterol reduction correlated with LDL-C reduction. (r=0.501, P<0.001) and apoB reduction (r=0.538, P<0.001). Skin cholesterol reduction continued over all time points measured.
Examination of changes in apoB levels give patients with low initial LDL-C more informative data on lipid management than LDL-C readings. In addition, non-invasive skin cholesterol measurements may have the potential to be used independently for lipid management evaluation.
血脂管理是降低冠心病(CHD)患者心血管事件发生率的一线治疗方法,多种指标用于评估血脂管理。本研究分析了 LDL-C 和载脂蛋白 B(apoB)在血脂管理评估中的差异,并探讨了皮肤胆固醇作为一种可无创测量的血脂管理标志物的可行性。
前瞻性研究纳入了 2020 年 5 月至 2021 年 1 月在我院急诊医学科诊断为急性冠脉综合征(ACS)的 121 例患者,根据是否伴有高脂血症和/或糖尿病将患者分为 I 组(n=53)和 II 组(n=68)。所有患者均给予瑞舒伐他汀 10mg/天,观察 12 周。根据 LDL-C 和 apoB 评估血脂管理,采用线性相关模型评估这些公认标志物变化与皮肤胆固醇变化的关系。
121 例 ACS 患者中,53 例(43.80%)合并高脂血症和/或糖尿病(I 组),68 例(56.20%)无合并症(II 组)。伴有高脂血症和/或糖尿病的 CHD 患者发生心血管事件的年龄更早(P<0.05)。与瑞舒伐他汀治疗相比,LDL-C 达标率低于 apoB 达标率(P<0.05),这主要归因于初始 LDL-C 较低的患者。皮肤胆固醇降低与 LDL-C 降低(r=0.501,P<0.001)和 apoB 降低(r=0.538,P<0.001)相关。皮肤胆固醇降低在所有测量时间点均持续存在。
检查 apoB 水平的变化可为初始 LDL-C 较低的患者提供比 LDL-C 读数更有价值的血脂管理数据。此外,无创性皮肤胆固醇测量可能具有作为独立的血脂管理评估指标的潜力。