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在普通中国人群中,残胆固醇与动脉僵硬度的相关性比传统脂质和脂质比值更强。

Remnant Cholesterol is More Strongly Associated with Arterial Stiffness than Traditional Lipids and Lipid Ratios in the General Chinese Population.

机构信息

School of Medicine, Nankai University.

Department of Endocrinology, First medical center of PLA General Hospital.

出版信息

J Atheroscler Thromb. 2024 May 1;31(5):587-602. doi: 10.5551/jat.64146. Epub 2024 Jan 10.

Abstract

AIM

Studies on the relationship between remnant cholesterol (RC) and arterial stiffness (AS) are limited. This study aims to investigate the relationship between RC and AS and to explore RC, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), non-HDL-C, LDL-C/HDL-C, TG/HDL-C, lipoprotein combine index (LCI), and TC/HDL-C, which are lipid parameters most strongly associated with AS.

METHODS

A total of 4653 participants from the REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals) study were recruited. AS was defined as a brachial-ankle pulse wave velocity of ≥ 1400 cm/s. Multiple logistic regression analyses were performed to detect its association with lipid parameters (RC, TG, TC, HDL-C, LDL-C, non-HDL-C, LDL-C/HDL-C, TG/HDL-C, LCI, and TC/HDL-C).

RESULTS

Logistic regression analysis showed that compared with other traditional or non-traditional lipid parameters, the association between RC and AS was the strongest (odds ratio (OR) 1.59, 95% confidence interval (CI) 1.30-1.95, P<0.001). In the stratified analysis, RC was significantly associated with AS in both sexes and at any age, as well as blood glucose, blood pressure, and body mass index levels. Besides, RC and AS were still significantly associated when TG<1.7 mmol/L (OR:1.58, 95% CI: 1.02-2.45, P=0.04), LDL-C <3.4 mmol/L (OR:1.32, 95% CI: 1.01-1.73, P=0.041), HDL-C ≥ 1.0 mmol/L (OR:1.67, 95% CI: 1.34-2.08, P<0.001), or non-HDL-C<4.1 mmol/L (OR: 1.42, 95% CI: 1.10-1.82, P=0.007) are controlled within the appropriate range.

CONCLUSION

In conclusion, compared with traditional lipids and lipid ratios, RC is more strongly associated with AS. The association between RC and AS remains significant even when TG, LDL-C, HDL-C, or non-HDL-C levels are controlled within the appropriate range.

摘要

目的

关于残余胆固醇(RC)与动脉僵硬度(AS)之间关系的研究有限。本研究旨在探讨 RC 与 AS 之间的关系,并探讨 RC、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、非高密度脂蛋白胆固醇(non-HDL-C)、LDL-C/HDL-C、TG/HDL-C、脂蛋白综合指数(LCI)以及 TC/HDL-C,这些是与 AS 关系最密切的脂质参数。

方法

共纳入来自 REACTION(中国糖尿病个体癌症风险评估)研究的 4653 名参与者。AS 定义为肱踝脉搏波速度≥1400cm/s。采用多因素逻辑回归分析检测脂质参数(RC、TG、TC、HDL-C、LDL-C、non-HDL-C、LDL-C/HDL-C、TG/HDL-C、LCI 和 TC/HDL-C)与 AS 的相关性。

结果

逻辑回归分析显示,与其他传统或非传统脂质参数相比,RC 与 AS 的相关性最强(比值比(OR)为 1.59,95%置信区间(CI)为 1.30-1.95,P<0.001)。在分层分析中,RC 与两性以及任何年龄段的 AS 均显著相关,且与血糖、血压和体重指数水平相关。此外,当 TG<1.7mmol/L(OR:1.58,95%CI:1.02-2.45,P=0.04)、LDL-C<3.4mmol/L(OR:1.32,95%CI:1.01-1.73,P=0.041)、HDL-C≥1.0mmol/L(OR:1.67,95%CI:1.34-2.08,P<0.001)或 non-HDL-C<4.1mmol/L(OR:1.42,95%CI:1.10-1.82,P=0.007)在合适范围内时,RC 与 AS 仍显著相关。

结论

与传统脂质和脂质比值相比,RC 与 AS 的相关性更强。即使在 TG、LDL-C、HDL-C 或 non-HDL-C 水平控制在合适范围内时,RC 与 AS 之间的关联仍然显著。

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