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低密度脂蛋白胆固醇水平与颅内动脉粥样硬化狭窄风险的关系:APAC 研究结果。

Association Between Low-Density Lipoprotein-Cholesterol Level and Risk of Intracranial Atherosclerotic Stenosis: Results From the APAC Study.

机构信息

Department of Neurology, Beijing Tiantan Hospital.

China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders.

出版信息

Neurologist. 2023 Sep 1;28(5):300-303. doi: 10.1097/NRL.0000000000000488.

Abstract

BACKGROUND

It is unknown whether plasma low-density lipoprotein-cholesterol level (LDL-C) can predict the occurrence of intracranial atherosclerotic stenosis (ICAS), especially asymptomatic (A)ICAS. This study investigated whether LDL-C level is independently associated with AICAS.

METHODS

The Asymptomatic Polyvascular Abnormalities Community study is an ongoing community-based, prospective, long-term follow-up observational study with 3387 participants. AICAS was diagnosed by transcranial Doppler ultrasonography. The participants were divided into 3 groups based on LDL-C level. Cox regression was used to evaluate the association between LDL-C level and incidence of AICAS.

RESULTS

During 2 years of follow-up, 9.98% of participants were diagnosed with AICAS. The incidence of AICAS (person-years with 95% CI) was 4.99% (4.48%-5.50%). AICAS incidence did not increase with increasing LDL-C level. Compared with the <2.6 mmol/l subgroup, the incidence of asymptomatic ICAS was not significantly higher in the 2.6 to 3.4 and >3.4 mmol/l subgroups after adjusting for confounding factors (hazard ratio=0.95, 95% CI: 0.86-1.03 and hazard ratio=0.96, 95% CI: 0.84-1.10, respectively).

CONCLUSIONS

LDL-C is not an independent predictor of AICAS incidence in the Chinese population.

摘要

背景

目前尚不清楚血浆低密度脂蛋白胆固醇(LDL-C)水平是否可以预测颅内动脉粥样硬化性狭窄(ICAS)的发生,尤其是无症状性(A)ICAS。本研究旨在探讨 LDL-C 水平是否与 AICAS 的发生存在独立相关性。

方法

无症状性多血管异常社区研究(Asymptomatic Polyvascular Abnormalities Community study)是一项正在进行的基于社区的、前瞻性、长期随访观察性研究,共纳入 3387 名参与者。通过经颅多普勒超声检查诊断 AICAS。根据 LDL-C 水平将参与者分为 3 组。采用 Cox 回归评估 LDL-C 水平与 AICAS 发生率之间的关系。

结果

在 2 年的随访期间,有 9.98%的参与者被诊断为 AICAS。AICAS 的发生率(人年及 95%可信区间)为 4.99%(4.48%-5.50%)。随着 LDL-C 水平的升高,AICAS 的发生率并未增加。在校正混杂因素后,与<2.6mmol/l 亚组相比,2.6-3.4mmol/l 和>3.4mmol/l 亚组的无症状性 ICAS 发生率并无显著升高(风险比=0.95,95%可信区间:0.86-1.03 和风险比=0.96,95%可信区间:0.84-1.10)。

结论

在中国人群中,LDL-C 不是 AICAS 发生率的独立预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f54/10521774/c9dd509cd3ae/nrl-28-300-g001.jpg

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