Department of Laboratory Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University.
Department of Medicine, King Chulalongkorn Memorial Hospital.
J Atheroscler Thromb. 2023 Dec 1;30(12):1803-1816. doi: 10.5551/jat.64081. Epub 2023 May 18.
Familial hypercholesterolemia (FH) is currently underdiagnosed and undertreated. The establishment of a FH registry could facilitate a deeper understanding of this disease. We described the clinical characteristics of subjects with FH from the Thai FH Registry, compared our data with the regional and global data, and identified gaps in the care of these subjects.
A multicenter, nationwide prospective FH registry was established in Thailand. Our data were compared with those of the European Atherosclerosis Society-FH Studies Collaboration. Multiple logistic regression analyses were performed for variables associated with lipid-lowering medication (LLM) use and the attainment of low-density lipoprotein-cholesterol (LDL-C) goal.
The study includes 472 subjects with FH (mean age at FH diagnosis: 46±12 years, 61.4% women). A history of premature coronary artery disease was found in 12%. The percentage of LLM use in subjects with a Dutch Lipid Clinic Network score of ≥ 6 (probable or definite FH) in our registry (64%) was slightly lower than the regional data but higher than the global data. Among those who received statins, 25.2% and 6.4% achieved LDL-C levels of ＜100 mg/dL and ＜70 mg/dL, respectively. Women with FH were less likely to achieve LDL-C ＜70 mg/dL (adjusted odds ratio: 0.22, 95% confidence interval: 0.06-0.71, p=0.012).
FH in Thailand was diagnosed late, and treatment was inadequate for the majority of subjects. Women with FH were less likely to achieve LDL-C goals. Our insights could potentially help raise awareness and narrow the gap in patient care.
家族性高胆固醇血症（FH）目前诊断不足且治疗不足。建立 FH 登记处可以帮助我们更深入地了解这种疾病。我们描述了来自泰国 FH 登记处的 FH 患者的临床特征，将我们的数据与区域和全球数据进行了比较，并确定了这些患者护理中的差距。
在泰国建立了一个多中心、全国性的 FH 前瞻性登记处。我们的数据与欧洲动脉粥样硬化学会 FH 研究合作的数据进行了比较。对与降脂药物（LLM）使用和达到低密度脂蛋白胆固醇（LDL-C）目标相关的变量进行了多变量逻辑回归分析。
该研究共纳入 472 例 FH 患者（FH 诊断时的平均年龄为 46±12 岁，61.4%为女性）。12%的患者有早发冠心病史。我们登记处中荷兰脂质诊所网络评分≥6（可能或明确的 FH）的患者中 LLM 的使用率（64%）略低于区域数据，但高于全球数据。在接受他汀类药物治疗的患者中，分别有 25.2%和 6.4%的患者 LDL-C 水平达到＜100mg/dL 和＜70mg/dL。FH 女性患者达到 LDL-C＜70mg/dL 的可能性较低（调整后的优势比：0.22，95%置信区间：0.06-0.71，p=0.012）。
泰国的 FH 诊断较晚，大多数患者的治疗不足。FH 女性患者达到 LDL-C 目标的可能性较低。我们的见解可能有助于提高认识并缩小患者护理差距。
