Zhang Yan, Song Kexin, Bi Shuli, Li Mingyang, Yao Zhuhua
Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China.
Department of Internal Medicine, Graduate School of Hebei Medical University, Shijiazhuang, China.
Front Endocrinol (Lausanne). 2024 Dec 9;15:1475933. doi: 10.3389/fendo.2024.1475933. eCollection 2024.
Postmenopausal women represent the demographic increasingly susceptible to cardiovascular and metabolic diseases. Elevated levels of remnant cholesterol (RC) have been implicated in atherosclerosis and insulin resistance.
This study aimed to investigate the relationship between RC and the prevalence of coronary heart disease (CHD), diabetes, and CHD combined with diabetes in a nationally representative sample of US postmenopausal women using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Multivariate logistic regression models were employed to evaluate the association between RC and the outcomes of interest. Nonlinear associations were assessed using restricted cubic splines (RCS), and subgroup analyses, along with interaction tests, were performed.
A total of 1611 participants were included in the final analysis. Higher RC levels were significantly associated with increased risks of CHD [OR=1.67, 95%CI (1.02, 2.74)], diabetes [OR=1.77, 95%CI (1.22, 2.58)], and CHD combined with diabetes [OR=2.28, 95%CI (1.17, 4.42)] (all P<0.05). Compared to the lowest RC quartile (Q1), the highest quartile (Q4) demonstrated elevated incidences of CHD [OR=1.76, 95%CI (1.04, 2.98)], diabetes [OR=1.81, 95%CI (1.30, 2.53)], and CHD combined with diabetes [OR=3.08, 95%CI (1.29, 7.37)] (all P<0.05). RCS curves indicated a nearly linear relationship between RC and the risks of CHD, diabetes, and CHD combined with diabetes.
Our study reveals a significant positive correlation between RC levels and the prevalence of CHD, diabetes, and CHD combined with diabetes among postmenopausal women. Understanding these associations could potentially inform targeted prevention and management strategies tailored to this vulnerable population.
绝经后女性是越来越易患心血管疾病和代谢性疾病的人群。残余胆固醇（RC）水平升高与动脉粥样硬化和胰岛素抵抗有关。
本研究旨在利用2007 - 2018年美国国家健康与营养检查调查（NHANES）的数据，调查美国绝经后女性的全国代表性样本中RC与冠心病（CHD）、糖尿病以及CHD合并糖尿病患病率之间的关系。采用多变量逻辑回归模型评估RC与感兴趣结局之间的关联。使用受限立方样条（RCS）评估非线性关联，并进行亚组分析和交互作用检验。
最终分析共纳入1611名参与者。较高的RC水平与CHD风险增加显著相关[比值比（OR）=1.67，95%置信区间（CI）（1.02，2.74）]、糖尿病[OR=1.77，95%CI（1.22，2.58）]以及CHD合并糖尿病[OR=2.28，95%CI（1.17，4.42）]（均P<0.05）。与最低RC四分位数（Q1）相比，最高四分位数（Q4）的CHD发病率升高[OR=1.76，95%CI（1.04，2.98）]、糖尿病[OR=1.81，95%CI（1.30，2.53）]以及CHD合并糖尿病[OR=3.08，95%CI（1.29，7.37）]（均P<0.05）。RCS曲线表明RC与CHD、糖尿病以及CHD合并糖尿病风险之间存在近乎线性的关系。
我们的研究揭示了绝经后女性中RC水平与CHD、糖尿病以及CHD合并糖尿病患病率之间存在显著正相关。了解这些关联可能为针对这一脆弱人群的针对性预防和管理策略提供依据。
