Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Big Data Center, China Medical University Hospital and College of Medicine, Taichung, Taiwan.
Nutr Metab Cardiovasc Dis. 2022 Aug;32(8):1944-1954. doi: 10.1016/j.numecd.2022.05.006. Epub 2022 May 19.
The associations between dyslipidemia and coronary artery calcium (CAC) are controversial. We investigated their cross-sectional relationships and developed a predictive scoring system for prognostically significant coronary calcification (PSCC).
This study evaluated the lipid profiles and the CAC score (CACS) measured through multidetector computed tomography (MDCT) among Taiwanese adult patients in a tertiary hospital between 2011 and 2016. Patients with CACS higher than 100 were classified as having PSCC. Dyslipidemia for each lipid component was defined based on the clinical cutoffs or the use of the lipid-lowering agents. Multivariable logistic regression was used to assess the association between dyslipidemia and PSCC and the model performance was assessed using calibration plot, discrimination, and a decision curve analysis. Of the 3586 eligible patients, 364 (10.2%) had PSCC. Increased age, male sex, higher body mass index (BMI), and higher level of triglyceride (TG) were associated with PSCC. The adjusted odds ratios (95% confidence intervals) of PSCC was 1.15 (0.90-1.47) for dyslipidemia defined by total cholesterol (TC) ≥200 mg/dL, 1.06 (0.83-1.35) for low-density-lipoprotein-cholesterol (LDL-C) ≥130 mg/dL, and 1.36 (1.06-1.75) for TG ≥ 200 mg/dL. The positive association between TG ≥ 200 mg/dL and PSCC was not modified by sex. Incorporating hypertriglyceridemia did not significantly improve the predictive performance of the base model comprising of age, sex, BMI, smoking, hypertension, diabetes, estimated glomerular filtration rate, and fasting glucose.
Hypertriglyceridemia was significantly associated with the prevalent odds of PSCC. Our proposed predictive model may be a useful screening tool for PSCC.
血脂异常与冠状动脉钙（CAC）之间的关联存在争议。我们研究了它们的横断面关系，并建立了一个预测有意义的冠状动脉钙化（PSCC）的预测评分系统。
本研究评估了 2011 年至 2016 年间在一家三级医院接受多层螺旋 CT（MDCT）测量的血脂谱和 CAC 评分（CACS）的台湾成年患者。CAC 高于 100 的患者被归类为有 PSCC。根据临床临界值或使用降脂药物，定义每个脂质成分的血脂异常。多变量逻辑回归用于评估血脂异常与 PSCC 的相关性，校准图、判别力和决策曲线分析用于评估模型性能。在 3586 名合格患者中，有 364 名（10.2%）有 PSCC。年龄增长、男性、较高的体重指数（BMI）和较高的甘油三酯（TG）水平与 PSCC 相关。PSCC 的调整比值比（95%置信区间）为：TC≥200mg/dL 定义的血脂异常为 1.15（0.90-1.47），LDL-C≥130mg/dL 为 1.06（0.83-1.35），TG≥200mg/dL 为 1.36（1.06-1.75）。TG≥200mg/dL 与 PSCC 之间的正相关关系不受性别影响。纳入高甘油三酯血症并不能显著提高包含年龄、性别、BMI、吸烟、高血压、糖尿病、估计肾小球滤过率和空腹血糖的基础模型的预测性能。
高甘油三酯血症与 PSCC 的患病率显著相关。我们提出的预测模型可能是 PSCC 的有用筛查工具。
