基于社区的日本男性人群中血清前蛋白转化酶枯草溶菌素/柯萨奇蛋白酶 9 浓度与冠状动脉钙患病率之间的关系。

Relationship between Serum Proprotein Convertase Subtilisin/Kexin Type 9 Concentration and Prevalence of Coronary Artery Calcium in a Community-Based Sample of Japanese Men.

机构信息

Department of Public Health, Shiga University of Medical Science.

Department of Cardiology, Kobe Rosai Hospital.

出版信息

J Atheroscler Thromb. 2023 Jul 1;30(7):767-777. doi: 10.5551/jat.63549. Epub 2022 Sep 17.

DOI:10.5551/jat.63549

PMID:36123046

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10322734/

Abstract

AIMS

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising new target for reducing low-density lipoprotein cholesterol (LDL-C) and cardiovascular events in high-risk patients. However, the influence of circulating PCSK9 concentration on atherosclerotic plaque formation in the general population remains unknown. We assessed the relationship between serum PCSK9 concentration and coronary artery calcium (CAC) prevalence in the general population.

METHODS

Community-dwelling Japanese men (n=622) aged 46-82 years without a history of cardiovascular disease and lipid-lowering medications were included. Serum PCSK9 concentration and CAC score were measured using the Agatston method, and the multivariable analysis was used to assess their association. CAC was defined as an Agatston score of ＞10. We conducted further analysis stratified by age (＜60, 60-69, and ≥ 70 years).

RESULTS

The average age, LDL-C, and median serum PCSK9 concentration were 68 years, 122 mg/dL, and 240 ng/mL, respectively. After multivariable adjustment for traditional cardiovascular risk factors, no significant association was observed between serum PCSK9 concentration and CAC prevalence (adjusted relative risk [aRR] 1.05, 95% confidence interval [CI] 0.97-1.13). With age stratification, serum PCSK9 concentration was significantly associated with CAC prevalence in men aged ＜60 years (aRR 1.38, 95% CI 1.01-1.88) but not in men aged 60-69 years (aRR 0.96, 95% CI 0.85-1.10) or ≥ 70 years (aRR 1.08, 95% CI 0.99-1.19).

CONCLUSIONS

A higher serum PCSK9 concentration was associated with a higher CAC prevalence in men aged ＜60 years, which was independent of traditional cardiovascular risk factors.

摘要

目的

前蛋白转化酶枯草溶菌素 9（PCSK9）是降低高危患者的低密度脂蛋白胆固醇（LDL-C）和心血管事件的有前途的新靶点。然而，循环 PCSK9 浓度对普通人群中动脉粥样硬化斑块形成的影响尚不清楚。我们评估了普通人群中血清 PCSK9 浓度与冠状动脉钙（CAC）患病率之间的关系。

方法

纳入 622 名年龄在 46-82 岁、无心血管疾病和降脂药物史的社区居住的日本男性。使用 Agatston 法测量血清 PCSK9 浓度和 CAC 评分，并使用多变量分析评估它们之间的关联。CAC 定义为 Agatston 评分＞10。我们根据年龄（＜60、60-69 和≥70 岁）进行了进一步的分层分析。

结果

平均年龄、LDL-C 和中位数血清 PCSK9 浓度分别为 68 岁、122mg/dL 和 240ng/mL。对传统心血管危险因素进行多变量调整后，血清 PCSK9 浓度与 CAC 患病率之间无显著关联（调整后的相对风险[aRR]1.05，95%置信区间[CI]0.97-1.13）。按年龄分层，血清 PCSK9 浓度与＜60 岁男性的 CAC 患病率显著相关（aRR 1.38，95%CI 1.01-1.88），但与 60-69 岁男性（aRR 0.96，95%CI 0.85-1.10）或≥70 岁男性（aRR 1.08，95%CI 0.99-1.19）无关。