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居住在美国的西班牙裔或拉丁裔个体中载脂蛋白B水平的异质性。

Heterogeneity of Apolipoprotein B Levels Among Hispanic or Latino Individuals Residing in the US.

作者信息

Slipczuk Leandro, Kuno Toshiki, Marcovina Santica, Swett Katrina, Orroth Kate K, López J Antonio G, Kent Shia T, Booth John N, Kaplan Robert, Sotres-Alvarez Daniela, Thyagarajan Bharat, Sofer Tamar, Daviglus Martha L, Talavera Gregory A, Joshi Parag H, Rodriguez Carlos J

机构信息

Cardiology Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

出版信息

JAMA Cardiol. 2025 Feb 1;10(2):164-169. doi: 10.1001/jamacardio.2024.4789.

Abstract

IMPORTANCE

Apolipoprotein B (apoB) distribution and its implications as an atherosclerotic cardiovascular disease (ASCVD) risk-enhancing factor among individuals of diverse Hispanic or Latino backgrounds have not been described.

OBJECTIVE

To describe the distribution of apoB in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) cohort and to characterize associations of baseline sociodemographic and clinical variables with apoB and self-identified Hispanic or Latino background.

DESIGN, SETTING, AND PARTICIPANTS: The HCHS/SOL was a prospective, population-based cohort study of diverse Hispanic or Latino adults living in the US who were recruited and screened between March 2008 and June 2011. Sampling weights were used to generate a population-based sample of Hispanic or Latino participants aged 18 to 74 years who resided in 4 US metropolitan areas (Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California). ApoB concentration was measured in participants from the HCHS/SOL, and apoB tertiles were compared across demographic groups, including self-identified Hispanic or Latino background. Median percentage continental genetic ancestry (West African, Amerindian, and European) was compared across apoB tertiles.

EXPOSURE

ApoB measured in mg/dL from serum or plasma using an immunoturbidimetric assay.

MAIN OUTCOMES AND MEASURES

ApoB tertiles were determined, and traditional lipids were evaluated across apoB tertiles. ApoB and traditional lipid measurements were assessed across ASCVD risk categories. Additionally, scatterplots were created to observe correlations between apoB and low-density lipoprotein cholesterol or non-high-density lipoprotein cholesterol.

RESULTS

Overall mean (SD) apoB concentration was 99.8 (0.4) mg/dL, with male participants displaying significantly higher mean levels than female participants (102.4 vs 97.4 mg/dL, respectively). Mean (SD) participant age was 41.1 (0.8) years, and 8376 participants (51.9%) were female. ApoB levels were higher among older age groups. There was significant heterogeneity in mean apoB concentrations across self-identified Hispanic or Latino background groups, ranging from 95.1 mg/dL in Dominican individuals to 104.8 mg/dL in Cuban individuals. The prevalence of elevated apoB (≥130 mg/dL) was greater across higher predicted ASCVD risk categories. Among participants with a 10-year predicted ASCVD risk of 7.5% or higher, 26.5% had an elevated apoB. Median West African ancestry was lower across higher tertiles of apoB.

CONCLUSIONS AND RELEVANCE

In this cohort study among participants from the HCHS/SOL, elevated apoB was present in one-quarter of a diverse cohort study of Hispanic or Latino individuals who were at intermediate or high predicted ASCVD risk. Differences in apoB distribution among Hispanic or Latino individuals may have important implications for apoB's use in ASCVD risk assessment.

摘要

重要性

载脂蛋白B(apoB)的分布情况及其作为动脉粥样硬化性心血管疾病(ASCVD)风险增强因素在不同西班牙裔或拉丁裔背景个体中的影响尚未得到描述。

目的

描述西班牙裔社区健康研究/拉丁裔研究(HCHS/SOL)队列中apoB的分布情况,并确定基线社会人口统计学和临床变量与apoB以及自我认定的西班牙裔或拉丁裔背景之间的关联。

设计、设置和参与者:HCHS/SOL是一项基于人群的前瞻性队列研究,研究对象为居住在美国的不同西班牙裔或拉丁裔成年人,于2008年3月至2011年6月期间招募并进行筛查。采用抽样权重生成一个基于人群的样本,样本包含居住在美国4个大都市地区(纽约布朗克斯区、伊利诺伊州芝加哥市、佛罗里达州迈阿密市和加利福尼亚州圣地亚哥市)、年龄在18至74岁之间的西班牙裔或拉丁裔参与者。对HCHS/SOL的参与者测量apoB浓度,并比较不同人口统计学组(包括自我认定的西班牙裔或拉丁裔背景)之间的apoB三分位数。比较了apoB三分位数之间的大陆遗传血统中位数百分比(西非、美洲印第安人和欧洲)。

暴露因素

使用免疫比浊法从血清或血浆中测量的以mg/dL为单位的apoB。

主要结局和测量指标

确定apoB三分位数,并评估不同apoB三分位数之间的传统血脂指标。在不同的ASCVD风险类别中评估apoB和传统血脂测量值。此外,绘制散点图以观察apoB与低密度脂蛋白胆固醇或非高密度脂蛋白胆固醇之间的相关性。

结果

总体平均(标准差)apoB浓度为99.8(0.4)mg/dL,男性参与者的平均水平显著高于女性参与者(分别为102.4和97.4 mg/dL)。参与者的平均(标准差)年龄为41.1(0.8)岁,8376名参与者(51.9%)为女性。apoB水平在年龄较大的组中较高。在自我认定的西班牙裔或拉丁裔背景组中,平均apoB浓度存在显著异质性,从多米尼加人的95.1 mg/dL到古巴人的104.8 mg/dL不等。在预测的ASCVD风险较高的类别中,apoB升高(≥130 mg/dL)的患病率更高。在预测10年ASCVD风险为7.5%或更高的参与者中,26.5%的人apoB升高。apoB三分位数越高,西非血统的中位数越低。

结论和相关性

在这项来自HCHS/SOL参与者的队列研究中,在预测ASCVD风险为中度或高度的不同西班牙裔或拉丁裔个体队列研究中,四分之一的个体存在apoB升高。西班牙裔或拉丁裔个体中apoB分布的差异可能对apoB在ASCVD风险评估中的应用具有重要意义。

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Apolipoprotein B: Bridging the Gap Between Evidence and Clinical Practice.载脂蛋白 B:弥合证据与临床实践之间的差距。
Circulation. 2024 Jul 2;150(1):62-79. doi: 10.1161/CIRCULATIONAHA.124.068885. Epub 2024 Jul 1.

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