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BMJ Open. 2021 Jun 23;11(6):e045576. doi: 10.1136/bmjopen-2020-045576.
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2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk.2019年欧洲心脏病学会/欧洲动脉粥样硬化学会血脂异常管理指南:通过血脂修饰降低心血管风险
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脂蛋白(a)与代谢综合征。

Lipoprotein(a) and Metabolic Syndrome.

机构信息

Department of Cardiology, Benjamin Franklin Campus, Charité - University Medical Center Berlin; Institute for Community Medicine, University Medical Center Greifswald; Biology of Aging Group, Department of Endocrinology and Metabolic Medicine (including Lipid Metabolism), Charité - University Medical Center Berlin, corporate member of Free University Berlin and Humboldt University of Berlin; Berlin Institute for Health Research at Charité - University Medical Center Berlin, BCRT - Berlin Center for Regenerative Therapy; Department of Internal Medicine B, University Medical Center Greifswald; German Center for Diabetes Research (DZD), Greifswald Site, Greifswald; German Center for Cardiovascular Research (DZHK), Greifswald Site, Greifswald; Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Greifswald; Department of Internal Medicine A, University Medical Center Greifswald; Lipid Clinic, Heart Institute (InCor), Medical Teaching Hospital, University of São Paulo, Brazil.

出版信息

Dtsch Arztebl Int. 2022 Apr 15;119(15):270-276. doi: 10.3238/arztebl.m2022.0153.

DOI:10.3238/arztebl.m2022.0153
PMID:35331368
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9400195/
Abstract

BACKGROUND

An inverse association between lipoprotein(a) (Lp[a]) and type 2 diabetes mellitus is well documented. However, data on the association of the metabolic syndrome (MetS) with Lp(a) are sparse.

METHODS

Cross-sectional data for MetS and Lp(a) were available for 5743 BASE-II and SHIP-0 participants (48.7% men; age 58 [20-85] years) (BASE, Berlin Aging Study; SHIP, Study of Health in Pomerania). The association of MetS and its components with Lp(a) was analyzed by means of median regression adjusted for age, sex, and study. Associations were evaluated for the total population as well as stratified by sex and menopausal status.

RESULTS

Overall, 27.6% (n = 1573) of the participants in the two studies had MetS and 22.5% (n = 1291) were premenopausal women. There was an inverse association between MetS and Lp(a) in the whole study sample (β = -11.9, 95% confidence interval [-21.3; -2.6]) as well as in men (β = -16.5 [-28.6; -4.3]). Participants with MetS (whole study sample) had 11.9 mmol/L lower Lp(a). Analogous results were found in postmenopausal women (β = -25.4 [-46.0; -4.8]). In premenopausal women with MetS, Lp(a) levels were higher by 39.1 mg/L on average [12.3; 65.9]) than in premenopausal women without MetS.

CONCLUSION

Hormonal aspects and menopausal alterations seem to affect the association between MetS and Lp(a), as the expected inverse association was not present in premenopausal women.

摘要

背景

脂蛋白(a)(Lp[a])与 2 型糖尿病之间呈负相关,这一关系已得到充分证实。然而,代谢综合征(MetS)与 Lp(a)之间的关联数据却很少。

方法

BASE-II 和 SHIP-0 研究的横断面数据可用于分析 MetS 和 Lp(a)(BASE 研究:柏林老龄化研究;SHIP 研究:波美拉尼亚健康研究)。采用中位数回归法,在调整年龄、性别和研究因素后,分析 MetS 及其组分与 Lp(a)之间的关系。在总人群中以及按性别和绝经状态分层后,评估了这些关联。

结果

两项研究的参与者中,共有 27.6%(n = 1573)患有 MetS,22.5%(n = 1291)为绝经前女性。在整个研究样本中,MetS 与 Lp(a)呈负相关(β = -11.9,95%置信区间 [-21.3;-2.6]),男性也存在同样的负相关(β = -16.5 [-28.6;-4.3])。患有 MetS 的参与者(整个研究样本)的 Lp(a)水平比没有 MetS 的参与者低 11.9mmol/L。绝经后女性也得到了类似的结果(β = -25.4 [-46.0;-4.8])。在患有 MetS 的绝经前女性中,Lp(a)水平平均升高 39.1mg/L[12.3;65.9])高于没有 MetS 的绝经前女性。

结论

激素方面和绝经改变似乎会影响 MetS 与 Lp(a)之间的关联,因为在绝经前女性中,并未观察到预期的负相关。