Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, Turku University, Turku, Finland.
Department of Clinical Chemistry, Laboratory Division, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland.
Clin Chem. 2022 Dec 6;68(12):1502-1508. doi: 10.1093/clinchem/hvac158.
The ceramide- and phospholipid-based cardiovascular risk score (CERT2) has been found to predict the risk for cardiovascular disease (CVD) events, especially cardiovascular mortality. In the present study, our aim was to estimate the predictive ability of CERT2 for mortality of CVD, coronary artery disease (CAD), and stroke in the elderly and to compare these results with those of conventional lipids.
We conducted a prospective study with an 18-year follow-up period that included a total of 1260 participants ages ≥64 years. Ceramides and phosphatidylcholines were analyzed using a LC-MS. Total cholesterol and triglycerides were performed by enzymatic methods and HDL cholesterol was determined by a direct enzymatic method. Concentrations of LDL-cholesterol were calculated according to the Friedewald formula.
A higher score of CERT2 was significantly associated with higher CVD, CAD, and stroke mortality during the 18-year follow-up both in unadjusted and adjusted Cox regression models. The unadjusted hazard ratios (HRs) of CERT2 (95% CI) per SD for CVD, CAD, and stroke were 1.72 (1.52-1.96), 1.76 (1.52-2.04), and 1.63 (1.27-2.10), respectively, and the corresponding adjusted HRs (95% CI) per SD for CERT2 were 1.48 (1.29-1.69), 1.50 (1.28-1.75), and 1.41 (1.09-1.83). For conventional lipids, HRs per SD were lower than for CERT2.
The risk score CERT2 associated strongly with CVD, CAD, and stroke mortality in the elderly, while the association between these events and conventional lipids was weak.
已发现神经酰胺和磷脂为基础的心血管风险评分（CERT2）可预测心血管疾病（CVD）事件的风险，尤其是心血管死亡率。在本研究中，我们旨在评估 CERT2 对老年人 CVD、冠心病（CAD）和中风死亡率的预测能力，并将这些结果与常规脂质进行比较。
我们进行了一项前瞻性研究，随访时间为 18 年，共纳入了 1260 名年龄≥64 岁的参与者。使用 LC-MS 分析神经酰胺和磷脂。采用酶法测定总胆固醇和甘油三酯，用直接酶法测定高密度脂蛋白胆固醇。根据 Friedewald 公式计算 LDL-胆固醇的浓度。
在未调整和调整后的 Cox 回归模型中，CERT2 评分较高与 18 年随访期间 CVD、CAD 和中风死亡率显著相关。CERT2 每标准差的未调整危险比（HR）（95%CI）分别为 CVD、CAD 和中风为 1.72（1.52-1.96）、1.76（1.52-2.04）和 1.63（1.27-2.10），相应的调整后 HR（95%CI）分别为 1.48（1.29-1.69）、1.50（1.28-1.75）和 1.41（1.09-1.83）。对于常规脂质，每标准差的 HR 低于 CERT2。
CERT2 风险评分与老年人 CVD、CAD 和中风死亡率密切相关，而这些事件与常规脂质之间的关联较弱。
