School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Nutr Metab Cardiovasc Dis. 2023 Nov;33(11):2055-2066. doi: 10.1016/j.numecd.2023.07.015. Epub 2023 Jul 14.
Studies have indicated inconsistent results regarding the association between plasma levels of Lipoprotein(a) [Lp(a)] and coronary artery calcification (CAC). We performed a systematic review and meta-analysis to investigate the association between elevated levels of Lp(a) and risk of CAC in populations free of cardiovascular disease (CVD) symptoms.
PubMed, Web of Science, Embase, and Scopus were searched up to July 2022 and the methodological quality was assessed using Newcastle-Ottawa Scale (NOS) scale. Random-effects meta-analysis was used to estimate pooled odds ratio (OR) and 95% confidence interval. Out of 298 studies, data from 8 cross-sectional (n = 18,668) and 4 cohort (n = 15,355) studies were used in meta-analysis. Cohort studies demonstrated a positive significant association between Lp(a) and CAC, so that individuals with Lp(a)≥30-50 exposed to about 60% risk of CAC incidence compared to those with lower Lp(a) concentrations in asymptomatic CVD subjects (OR, 1.58; 95% CI, 1.38-1.80; l, 0.0%; P, 0.483); Subgroup analysis showed that a cut-off level for Lp(a) measurement could not statistically affect the association, but race significantly affected the relationship between Lp(a) and CAC (OR,1.60; 95% CI, 1.41-1.81). Analyses also revealed that both men and women with higher Lp(a) concentrations are at the same risk for increased CAC.
Blood Lp(a) level was significantly associated with CAC incidence in asymptomatic populations with CVD, indicating that measuring Lp(a) may be a useful biomarker for diagnosing subclinical atherosclerosis in individuals at higher risk of CAC score.
CRD42022350297.
研究表明，脂蛋白(a) [Lp(a)] 血浆水平与冠状动脉钙化 (CAC) 之间的关联结果不一致。我们进行了系统评价和荟萃分析，以调查无心血管疾病 (CVD) 症状人群中 Lp(a) 水平升高与 CAC 风险之间的关系。
截至 2022 年 7 月，检索了 PubMed、Web of Science、Embase 和 Scopus，并使用纽卡斯尔-渥太华量表 (NOS) 评估方法学质量。使用随机效应荟萃分析估计合并优势比 (OR) 和 95%置信区间。在 298 项研究中，共有 8 项横断面 (n=18668) 和 4 项队列研究 (n=15355) 的数据用于荟萃分析。队列研究表明 Lp(a) 与 CAC 之间存在正显著关联，因此在无症状 CVD 患者中，与 Lp(a) 浓度较低的个体相比，Lp(a)≥30-50 的个体 CAC 发生率的风险增加约 60%（OR，1.58；95%CI，1.38-1.80；I2，0.0%；P=0.483）；亚组分析表明，Lp(a) 测量的截止值不能在统计学上影响关联，但种族显著影响 Lp(a) 与 CAC 之间的关系（OR，1.60；95%CI，1.41-1.81）。分析还表明，Lp(a) 浓度较高的男性和女性发生 CAC 的风险相同。
在无症状 CVD 人群中，血液 Lp(a) 水平与 CAC 发生率显著相关，表明测量 Lp(a) 可能是诊断 CAC 评分较高个体亚临床动脉粥样硬化的有用生物标志物。
CRD42022350297。
