Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Diabetes Metab J. 2023 Jan;47(1):59-71. doi: 10.4093/dmj.2021.0320. Epub 2023 Jan 26.
To validate the treatment target of low-density lipoprotein cholesterol (LDL-C) level according to the cardiovascular disease (CVD) risk which was recommended by Korean dyslipidemia guideline.
We used the Korean National Health Insurance Service database which included 3,958,048 people aged 20 to 89 years who underwent regular health screening. The primary outcome was incident CVD, defined as a composite of myocardial infarction and stroke during the follow-up period from 2009 to 2018.
The risk of CVD increased from LDL-C level of 70 mg/dL in very high-risk and high-risk groups and from 130 mg/dL in moderate-risk and low-risk groups. Adjusted hazard ratios (HRs) of LDL-C ranges 70-99, 100-129, 130-159, 160-189, and ≥190 mg/dL were 1.20 (95% confidence interval [CI], 1.08-1.33), 1.27 (1.15-1.42), 1.39 (1.23-1.56), 1.69 (1.45-1.96), and 1.84 (1.49- 2.27) in very high-risk group, and 1.07 (1.02-1.13), 1.16 (1.10-1.21), 1.29 (1.22-1.36), 1.45 (1.36-1.55), and 1.73 (1.58-1.90) in high-risk group. Adjusted HRs (95% CI) of LDL-C ranges 130-159, 160-189, and ≥190 mg/dL were 1.15 (1.11-1.20), 1.28 (1.22- 1.34), and 1.45 (1.36-1.54) in moderate-risk group and 1.07 (1.02-1.13), 1.20 (1.13-1.26), and 1.47 (1.37-1.57) in low-risk group.
We confirmed the incidence of CVD was increased in higher LDL-C range. The risk of CVD increased from ≥70 mg/dL of LDL-C in very high-risk and high-risk groups, and from ≥130 mg/dL of LDL-C in moderate-risk and low-risk groups in Korean adults.
验证根据韩国血脂异常指南推荐的心血管疾病（CVD）风险确定的低密度脂蛋白胆固醇（LDL-C）治疗目标。
我们使用了韩国国民健康保险服务数据库，其中包括 3958048 名年龄在 20 至 89 岁之间接受定期健康检查的人群。主要结局是 CVD 事件，定义为随访期间（2009 年至 2018 年）心肌梗死和中风的复合事件。
极高危和高危人群的 LDL-C 水平为 70mg/dL 时，以及中危和低危人群的 LDL-C 水平为 130mg/dL 时，CVD 的风险增加。LDL-C 范围为 70-99、100-129、130-159、160-189 和≥190mg/dL 的调整后的危险比（HR）分别为 1.20（95%置信区间[CI]，1.08-1.33）、1.27（1.15-1.42）、1.39（1.23-1.56）、1.69（1.45-1.96）和 1.84（1.49-2.27），极高危人群为 1.07（1.02-1.13）、1.16（1.10-1.21）、1.29（1.22-1.36）、1.45（1.36-1.55）和 1.73（1.58-1.90）。中危人群的 LDL-C 范围为 130-159、160-189 和≥190mg/dL 的调整 HR（95%CI）分别为 1.15（1.11-1.20）、1.28（1.22-1.34）和 1.45（1.36-1.54），而低危人群的调整 HR 为 1.07（1.02-1.13）、1.20（1.13-1.26）和 1.47（1.37-1.57）。
我们证实 LDL-C 水平较高时 CVD 的发生率增加。在韩国成年人中，极高危和高危人群的 LDL-C 水平从≥70mg/dL 开始，中危和低危人群的 LDL-C 水平从≥130mg/dL 开始，CVD 的风险增加。
