The Department of Cardiovascular Medicine, The University of Tokyo.
The Department of Advanced Cardiology, The University of Tokyo.
J Atheroscler Thromb. 2022 Oct 1;29(10):1475-1486. doi: 10.5551/jat.63166. Epub 2022 Jan 7.
Using a nationwide epidemiological database, we sought to examine whether there was a sex difference in the association between lipid profiles and subsequent cardiovascular disease (CVD) in young adults.
Medical records of 1,909,362 young adults (20-49 years old) without a prior history of CVD and not taking lipid-lowering medications were extracted. We conducted multivariable Cox regression analyses to identify the association between the number of abnormal lipid profiles and incident CVD.
After a mean follow-up of 3.4±2.6 years, myocardial infarction (MI), angina pectoris (AP), stroke, and heart failure (HF) developed in 2,575 (0.1%), 26,006 (1.4%), 10,748 (0.6%), and 24,875 (1.3%) subjects, respectively. The incidence of MI, AP, and HF increased with the number of abnormal lipid profiles in both men and women, whereas the incidence of stroke increased with the number of abnormal lipid profiles only in men but not in women. Multivariable adjusted hazard ratios (HRs) for MI per 1-point higher abnormal lipid profile were 1.57 (95% confidence interval [CI] 1.49-1.65) in men and 1.25 (95% CI 1.07-1.47) in women. HRs for AP, stroke, and HF per 1-point higher abnormal lipid profile were 1.14 (95% CI 1.12-1.16), 1.06 (95% CI 1.02-1.09), and 1.10 (95% CI 1.08-1.12) in men and 1.18 (95% CI 1.13-1.23), 1.09 (95% CI 1.03-1.16), and 1.10 (95% CI 1.05-1.14) in women.
Our analysis demonstrated an association between the number of abnormal lipid profiles and incident CVD in both men and women. The association between the number of abnormal lipid profiles and incident MI was pronounced in men.
利用全国性的流行病学数据库,我们试图研究在年轻成年人中,血脂谱异常与随后发生心血管疾病(CVD)之间的关联是否存在性别差异。
提取了 1909362 名无 CVD 既往史且未服用降脂药物的年轻成年人(20-49 岁)的病历记录。我们进行了多变量 Cox 回归分析,以确定异常血脂谱数量与 CVD 事件之间的关联。
平均随访 3.4±2.6 年后,2575 名(0.1%)、26006 名(1.4%)、10748 名(0.6%)和 24875 名(1.3%)患者分别发生心肌梗死(MI)、心绞痛(AP)、卒中和心力衰竭(HF)。在男性和女性中,随着异常血脂谱数量的增加,MI、AP 和 HF 的发生率均增加,而卒中的发生率仅在男性中随异常血脂谱数量的增加而增加,在女性中则无此现象。每增加一个异常血脂谱,男性发生 MI 的多变量校正风险比(HR)为 1.57(95%置信区间 [CI] 1.49-1.65),女性为 1.25(95% CI 1.07-1.47)。每增加一个异常血脂谱,男性发生 AP、卒中和 HF 的 HR 分别为 1.14(95% CI 1.12-1.16)、1.06(95% CI 1.02-1.09)和 1.10(95% CI 1.08-1.12),女性分别为 1.18(95% CI 1.13-1.23)、1.09(95% CI 1.03-1.16)和 1.10(95% CI 1.05-1.14)。
我们的分析表明,异常血脂谱数量与男性和女性 CVD 事件之间存在关联。异常血脂谱数量与 MI 事件之间的关联在男性中更为明显。