Burzyńska Monika, Jankowski Piotr, Babicki Mateusz, Banach Maciej, Chudzik Michał
Department of Epidemiology and Biostatistics, Division of Social and Preventive Medicine, Medical University of Lodz, Łódź, Poland; Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, Warszawa, Poland.
Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, Warszawa, Poland
Pol Arch Intern Med. 2024 Nov 28;134(11). doi: 10.20452/pamw.16860. Epub 2024 Oct 1.
Elevated levels of lipoprotein(a) [Lp(a)] are independently associated with an increased risk of cardiovascular disease (CVD).
We aimed to evaluate the levels of Lp(a) among patients of European ancestry referred to outpatient cardiology clinics.
We analyzed 2475 consecutive patients referred to 2 outpatient cardiology clinics between March 2022 and January 2024. Individuals with atherosclerotic CVD, heart failure, significant valve disease, and aortic aneurysm were excluded.
A majority of the study population were women (n = 1724 [69.7%]). The median (interquartile range) age of the participants was 66 (53-73) years. An Lp(a) level greater than or equal to 30 mg/dl (≥75 nmol/l) was recorded in 21.5% and a level greater than or equal to 50 mg/dl (≥125 nmol/l) was recorded in 13.5% of the patients. In univariable analysis, the Lp(a) level was significantly associated with hypertension, sleep apnea, migraine, polycystic ovary syndrome, physical activity level, as well as fasting blood glucose, glycated hemoglobin A1c (HbA1c), low‑density lipoprotein cholesterol (LDL‑C), and non-high‑density lipoprotein cholesterol concentrations. Female sex (β [SE] = 0.06 [0.02]), atrial fibrillation (β [SE] = 0.05 [0.02]), and the levels of HbA1c (β [SE] = 0.14 [0.02]) and LDL‑C (β [SE] = 0.09 [0.02]) were independently related to the level of Lp(a). Atrial fibrillation (odds ratio [OR], 1.8; 95% CI, 1.01-3.19), migraine (OR, 0.51; 95% CI, 0.32-0.83), and hyperlipidemia (OR, 1.56; 95% CI, 1.22-1.99) were related to the Lp(a) level of 30 mg/dl or above (≥75 nmol/l), while female sex (OR, 1.46; 95% CI, 1.10-1.92), hyperlipidemia (OR, 1.49; 95% CI, 1.12-1.97), hypertension (OR, 1.42; 95% CI, 1.1-1.84) and HbA1c concentration (OR, 0.84; 95% CI, 0.72-0.96) were significantly associated with the Lp(a) level greater than or equal to 50 mg/dl (≥125 nmol/l).
The observed prevalence of increased Lp(a) concentration among patients of European ancestry treated at outpatient cardiology clinics was 21.5%. Female sex, hypertension, atrial fibrillation, migraine, and concentrations of LDL‑C and HbA1c were independently related to the level of Lp(a) in this population.
脂蛋白(a)[Lp(a)]水平升高与心血管疾病(CVD)风险增加独立相关。
我们旨在评估转诊至门诊心脏病诊所的欧洲血统患者的Lp(a)水平。
我们分析了2022年3月至2024年1月期间转诊至两家门诊心脏病诊所的2475例连续患者。排除患有动脉粥样硬化性CVD、心力衰竭、严重瓣膜病和主动脉瘤的个体。
研究人群中大多数为女性(n = 1724[69.7%])。参与者的年龄中位数(四分位间距)为66(53 - 73)岁。21.5%的患者Lp(a)水平大于或等于30 mg/dl(≥75 nmol/l)，13.5%的患者Lp(a)水平大于或等于50 mg/dl(≥125 nmol/l)。在单变量分析中，Lp(a)水平与高血压、睡眠呼吸暂停、偏头痛、多囊卵巢综合征、身体活动水平以及空腹血糖、糖化血红蛋白A1c(HbA1c)、低密度脂蛋白胆固醇(LDL-C)和非高密度脂蛋白胆固醇浓度显著相关。女性(β[标准误]= 0.06[0.02])、心房颤动(β[标准误]= 0.05[0.02])以及HbA1c(β[标准误]= 0.14[0.02])和LDL-C(β[标准误]= 0.09[0.02])水平与Lp(a)水平独立相关。心房颤动(比值比[OR]，1.8；95%置信区间，1.01 - 3.19)、偏头痛(OR，0.51；95%置信区间，0.32 - 0.83)和高脂血症(OR, 1.56；95%置信区间，1.22 - 1.99)与Lp(a)水平30 mg/dl及以上(≥75 nmol/l)相关，而女性(OR, 1.46；95%置信区间，1.10 - 1.92)、高脂血症(OR, 1.49；95%置信区间，1.12 - 1.97)、高血压(OR, 1.42；95%置信区间，1.1 - 1.84)和HbA1c浓度(OR, 0.84；95%置信区间，0.72 - 0.96)与Lp(a)水平大于或等于50 mg/dl(≥125 nmol/l)显著相关。
在门诊心脏病诊所接受治疗的欧洲血统患者中，观察到的Lp(a)浓度升高的患病率为21.5%。在该人群中，女性、高血压、心房颤动、偏头痛以及LDL-C和HbA1c浓度与Lp(a)水平独立相关。
