Jia Xiaojing, Qi Yan, Zheng Ruizhi, Lin Lin, Hu Chunyan, Zhu Yuanyue, Cao Qiuyu, Wu Xueyan, Qi Hongyan, Wei Ran, Zhang Yi, Xu Min, Xu Yu, Wang Tiange, Zhao Zhiyun, Chen Yuhong, Li Mian, Wang Weiqing, Bi Yufang, Lu Jieli
Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor-State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2022 May 18;9:906396. doi: 10.3389/fcvm.2022.906396. eCollection 2022.
Apolipoprotein B (apoB) and non-high-density lipoprotein cholesterol (non-HDL-C) have been shown to predict cardiovascular disease (CVD) even in the case of low levels of low-density lipoprotein cholesterol (LDL-C). We aimed to investigate whether the discordance between LDL-C and apoB or non-HDL-C was associated with arterial stiffness and elevated carotid intima-media thickness (CIMT) in middle-aged and elderly adults.
A total of 5,279 Chinese adults free of CVD at baseline were included and followed with a mean follow-up of 4.3 years. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV) and pulse pressure (PP). The associations of apoB, non-HDL-C, and LDL-C with arterial stiffness or elevated CIMT were examined with logistic regression models using either continuous scales by restricted cubic splines or categories of concordant and discordant values defined by medians.
High apoB but not LDL-C was associated with elevated baPWV or PP. High apoB, non-HDL-C, and LDL-C were all associated with elevated CIMT ( < 0.05). Individuals with low levels of LDL-C and discordantly high apoB or non-HDL-C compared to those with concordantly low apoB or non-HDL-C demonstrated higher risks of elevated baPWV [ORs (95% CI) of 1.40 (1.03-1.91) and 1.56 (1.12-2.18), respectively] and elevated PP [ORs (95% CI) of 1.61 (1.19-2.18) and 1.55 (1.12-2.15), respectively]. While, discordant high LDL-C with low apoB was associated with an increased risk of elevated CIMT (OR, 1.74; 95% CI, 1.13-2.69).
Discordance analysis revealed that elevated apoB or non-HDL-C was a better predictor of risk of arterial stiffness, whereas LDL-C for elevated CIMT.
载脂蛋白B（apoB）和非高密度脂蛋白胆固醇（non-HDL-C）已被证明即使在低密度脂蛋白胆固醇（LDL-C）水平较低的情况下也能预测心血管疾病（CVD）。我们旨在研究LDL-C与apoB或non-HDL-C之间的不一致是否与中老年成年人的动脉僵硬度和颈动脉内膜中层厚度（CIMT）升高有关。
纳入5279名基线时无CVD的中国成年人，平均随访4.3年。通过臂踝脉搏波速度（baPWV）和脉压（PP）测量动脉僵硬度。使用限制立方样条的连续量表或由中位数定义的一致和不一致值类别，通过逻辑回归模型检查apoB、non-HDL-C和LDL-C与动脉僵硬度或CIMT升高的关联。
高apoB而非LDL-C与baPWV或PP升高相关。高apoB、non-HDL-C和LDL-C均与CIMT升高相关（<0.05）。与apoB或non-HDL-C一致较低的个体相比，LDL-C水平较低且apoB或non-HDL-C不一致较高的个体表现出baPWV升高的风险更高[比值比（95%可信区间）分别为1.40（1.03-1.91）和1.56（1.12-2.18）]和PP升高[比值比（95%可信区间）分别为1.61（1.19-2.18）和1.55（1.12-2.15）]。而apoB低时LDL-C不一致高与CIMT升高风险增加相关（比值比，1.74；95%可信区间，1.13-2.69）。
不一致性分析显示，apoB或non-HDL-C升高是动脉僵硬度风险的更好预测指标，而LDL-C是CIMT升高的更好预测指标。
