小高密度脂蛋白颗粒水平较低与传染病发病率和死亡率增加相关：一项基于人群的 30195 例个体的队列研究。

Lower levels of small HDL particles associated with increased infectious disease morbidity and mortality: a population-based cohort study of 30 195 individuals.

机构信息

Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 73, DK-2730 Herlev, Denmark.

The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 73, DK-2730 Herlev, Denmark.

出版信息

Cardiovasc Res. 2023 May 2;119(4):957-968. doi: 10.1093/cvr/cvac194.

DOI:10.1093/cvr/cvac194

PMID:36537045

Abstract

AIMS

Low levels of HDL cholesterol have been associated with increased risk of infectious disease morbidity and mortality. Nuclear magnetic resonance (NMR) spectroscopy permits the measurement of HDL particle count and allows further subclassification according to particle size. We tested the hypothesis that low number of different HDL subfractions is associated with increased infectious disease morbidity and mortality.

METHODS AND RESULTS

HDL particle counts were measured using NMR spectroscopy in 30 195 individuals aged 22-99 years from the Copenhagen General Population Study. Using multiple-event Cox regression and cause-specific hazard models, we assessed risk of hospitalizations due to infection and infectious disease-related death, from 2003 through 2018. During follow-up, 9303 individuals had one or more infectious disease events, and 1558 experienced infectious disease-related death. In multifactorial adjusted analyses, low number of small and medium HDL particles was associated with increased risk of any infection and infectious disease-related death, whereas low number of large and extra-large HDL particles was not. A very high number of small and medium HDL particles was also associated with increased risk of any infection, but not with infectious disease-related death. For small and medium HDL particles and compared to individuals in the 91-95th percentile, hazard ratios (HRs) in individuals in the lowest percentile were 2.31 (95% confidence interval: 1.75, 3.05) for any infection and 3.23 (2.08, 5.02) for infectious disease-related death. For the highest percentile, corresponding HRs were 1.36 (1.07, 1.74) and 1.06 (0.57, 1.98), respectively. Individuals in the lowest percentile had increased risk of pneumonia (HR: 1.86; 95% confidence interval: 1.30, 2.65), sepsis (2.17; 1.37, 3.35), urinary tract infection (1.76; 1.17, 2.63), skin infection (1.87; 1.24, 2.81), gastroenteritis (1.78; 1.01, 3.16), and other infections (2.57; 1.28, 5.16).

CONCLUSION

Low number of the small HDL particles was associated with increased infectious disease morbidity and mortality.

摘要

目的

低水平的高密度脂蛋白胆固醇（HDL 胆固醇）与感染性疾病发病率和死亡率的增加有关。核磁共振（NMR）光谱允许测量 HDL 颗粒计数，并允许根据颗粒大小进一步进行亚分类。我们检验了这样一个假设，即不同 HDL 亚组分数量较少与感染性疾病发病率和死亡率的增加有关。

方法和结果

在哥本哈根普通人群研究中，对 30195 名年龄在 22-99 岁的个体进行了 NMR 光谱测量，以测量 HDL 颗粒计数。使用多事件 Cox 回归和病因特异性危险模型，我们评估了 2003 年至 2018 年期间因感染导致的住院和感染性疾病相关死亡的风险。在随访期间，9303 人发生了一次或多次感染性疾病事件，1558 人发生了感染性疾病相关死亡。在多因素调整分析中，小而中等 HDL 颗粒数量较少与任何感染和感染性疾病相关死亡的风险增加有关，而大而超大 HDL 颗粒数量较少则没有。非常多的小而中等 HDL 颗粒也与任何感染的风险增加有关，但与感染性疾病相关的死亡无关。对于小而中等 HDL 颗粒，与处于第 91-95 百分位的个体相比，处于最低百分位的个体的危险比（HR）分别为 2.31（95%置信区间：1.75，3.05）的任何感染和 3.23（2.08，5.02）的感染性疾病相关死亡。对于最高百分位，相应的 HR 分别为 1.36（1.07，1.74）和 1.06（0.57，1.98）。处于最低百分位的个体患肺炎（HR：1.86；95%置信区间：1.30，2.65）、败血症（2.17；1.37，3.35）、尿路感染（1.76；1.17，2.63）、皮肤感染（1.87；1.24，2.81）、肠胃炎（1.78；1.01，3.16）和其他感染（2.57；1.28，5.16）的风险增加。