Graduate School, Beijing University of Chinese Medicine, Beijing, China.
National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Front Endocrinol (Lausanne). 2023 Sep 29;14:1260764. doi: 10.3389/fendo.2023.1260764. eCollection 2023.
Previous findings have indicated that elevated low-density lipoprotein cholesterol (LDL-C) and remnant cholesterol (RC) are associated with hypertension. We aim to explore whether higher RC levels may be associated with hypertension beyond LDL-C in the general US adult population.
This study included 10,842 adults from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Weighted multivariable logistic regression models were used to estimate the odds ratios (ORs) of hypertension for LDL-C and RC. We also performed analyses examining the association between hypertension and LDL-C vs. RC concordant/discordant groups.
A total of 4,963 (41.54%, weighted) individuals had hypertension. The weighted median levels were LDL-C: 118mg/dL, RC: 20mg/dL. At lower LDL-C clinical cut-point, the proportion of discordantly high RC dramatically increased. After multivariable adjustment, log RC was associated with higher prevalence of hypertension [OR 2.54, 95% confidence interval (CI) 2.17-2.99]. Participants with the highest tertile of RC were more likely to have hypertension (OR 2.18; 95% CI 1.89-2.52) compared with those with the lowest tertile of RC. This association remained marked after including body mass index (BMI), LDL-C, high-density lipoprotein cholesterol (HDL-C) or triglycerides. The association between LDL-C and hypertension was absent after adjusting for BMI, RC or triglycerides. Compared with low LDL-C/low RC group, the discordant low LDL-C/high RC group was associated with hypertension (OR 2.04; 95% CI 1.72-2.42), whereas the high LDL-C/low RC group was not, regardless of BMI, HDL-C or triglycerides. Similar results were observed when examining discordance among different clinical cut-points, except for the cut-point of LDL-C 70 mg/dL and RC 13 mg/dL. To better understand the association, we performed an additional analysis, which showed that among participants with apolipoprotein B < median (92mg/dL), those with discordant RC ≥ median (20mg/dL) had significantly higher odds of having hypertension (OR 1.73; 95% CI 1.38-2.17).
RC was associated with hypertension beyond LDL-C in the general US adult population. This association went beyond increased triglycerides levels, and lipoproteins other than apoB may be involved.
先前的研究结果表明，升高的低密度脂蛋白胆固醇（LDL-C）和残余胆固醇（RC）与高血压有关。我们旨在探讨在一般美国成年人群中，RC 水平升高是否与 LDL-C 以外的高血压有关。
本研究纳入了 1999 年至 2018 年国家健康和营养检查调查（NHANES）中的 10842 名成年人。使用加权多变量逻辑回归模型估计 LDL-C 和 RC 与高血压的比值比（OR）。我们还进行了分析，以检查高血压与 LDL-C 与 RC 一致/不一致组之间的关联。
共有 4963 名（加权的 41.54%）个体患有高血压。加权中位数水平为 LDL-C：118mg/dL，RC：20mg/dL。在 LDL-C 的较低临床切点下，RC 不一致升高的比例明显增加。在多变量调整后，log RC 与高血压的患病率呈正相关[OR 2.54，95%置信区间（CI）2.17-2.99]。与 RC 最低三分位组相比，RC 最高三分位组更有可能患有高血压（OR 2.18；95%CI 1.89-2.52）。即使包括体重指数（BMI）、LDL-C、高密度脂蛋白胆固醇（HDL-C）或甘油三酯后，这种关联仍然显著。在调整 BMI、RC 或甘油三酯后，LDL-C 与高血压之间的关联消失。与低 LDL-C/低 RC 组相比，LDL-C 不一致低/RC 高的组与高血压相关（OR 2.04；95%CI 1.72-2.42），而高 LDL-C/低 RC 组则没有，无论 BMI、HDL-C 或甘油三酯如何。当检查不同临床切点之间的差异时，除了 LDL-C 70mg/dL 和 RC 13mg/dL 的切点外，观察到了类似的结果。为了更好地理解这种关联，我们进行了一项额外的分析，结果表明，在载脂蛋白 B<中位数（92mg/dL）的参与者中，RC 不一致≥中位数（20mg/dL）的参与者发生高血压的几率明显更高（OR 1.73；95%CI 1.38-2.17）。
RC 与美国成年人群中 LDL-C 以外的高血压有关。这种关联超出了甘油三酯水平的升高，并且除了载脂蛋白 B 以外的脂蛋白可能参与其中。
