采用逆概率加权法分析日本中年工人的低密度脂蛋白胆固醇与冠心病和脑卒中风险的关系。

Association of Low-Density Lipoprotein Cholesterol with Risk of Coronary Heart Disease and Stroke among Middle-Aged Japanese Workers: An Analysis using Inverse Probability Weighting.

机构信息

Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine.

Department of Public Health, Fujita Health University School of Medicine.

出版信息

J Atheroscler Thromb. 2023 May 1;30(5):455-466. doi: 10.5551/jat.63519. Epub 2022 Jul 13.

Abstract

AIMS

The associations between low-density lipoprotein cholesterol (LDL-C) and the risk of cardiovascular disease (CVD) subtypes are not well established among the Japanese population. This study used longitudinal data from the Aichi Workers' Cohort Study to explore the association between LDL-C levels and the risk of coronary heart disease (CHD) and stroke subtypes.

METHODS

Pooled data of 8966 adults (7093men and 1903 women) who were recruited between (2002) and (2008) were used for the current analysis. Propensity scores for the LDL-C categories were generated using multinomial logistic regression. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from the inverse probability weighted Cox proportional hazards model for LDL-C category associations with risks of CHD, stroke subtypes, and CVD.

RESULTS

During a median follow-up of 12 years, 122 strokes (57 ischemic strokes, 25 intracerebral hemorrhage, and 40 unknown subtypes) and 82 cases of CHD were observed. LDL-C 160- mg/dL compared to LDL-C 100-119 mg/dL was positively and significantly associated with the risk of CHD (HR: 4.56; 95% CI: 1.91-10.9) but not with ischemic stroke (HR: 0.99; 95% CI: 0.44-2.22). LDL-C was inversely associated with the risk of intracerebral hemorrhage (P for trend=0.009).

CONCLUSION

In middle-aged Japanese workers, LDL-C was significantly and positively associated with CHD, but not with ischemic stroke. LDL-C was inversely significantly associated with intracerebral hemorrhage.

摘要

目的

在日本人群中,低密度脂蛋白胆固醇(LDL-C)与心血管疾病(CVD)亚型风险之间的关联尚未得到充分证实。本研究使用来自爱知工作者队列研究的纵向数据,探讨 LDL-C 水平与冠心病(CHD)和中风亚型风险之间的关系。

方法

本研究共纳入了 8966 名成年人(7093 名男性和 1903 名女性)的数据,这些参与者于(2002 年)至(2008 年)期间被招募。使用多项逻辑回归生成 LDL-C 类别的倾向评分。使用逆概率加权 Cox 比例风险模型估计 LDL-C 类别与 CHD、中风亚型和 CVD 风险之间的风险比(HR)和 95%置信区间(CI)。

结果

在中位数为 12 年的随访期间,观察到 122 例中风(57 例缺血性中风、25 例颅内出血和 40 例未知亚型)和 82 例 CHD。与 LDL-C 100-119mg/dL 相比,LDL-C 160mg/dL 与 CHD 风险呈正相关且显著相关(HR:4.56;95%CI:1.91-10.9),但与缺血性中风无关(HR:0.99;95%CI:0.44-2.22)。LDL-C 与颅内出血风险呈负相关(趋势 P 值=0.009)。

结论

在日本中年工人中,LDL-C 与 CHD 显著正相关,但与缺血性中风无关。LDL-C 与颅内出血显著负相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c1e/10164596/0910766f81d4/30_63519_1.jpg

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