Urbonas Gediminas, Šileikienė Lolita, Valius Leonas, Grigalė Evelina, Kaupas Vilius, Juška Tautvydas, Vėbraitė Gabrielė, Grabauskytė Ingrida
Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania.
Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50103 Kaunas, Lithuania.
Medicina (Kaunas). 2024 Nov 28;60(12):1963. doi: 10.3390/medicina60121963.
: Low-density lipoprotein cholesterol (LDL-C) is a marker of cardiovascular risk and its management. This study evaluated LDL-C control trends in patients treated at a primary healthcare center in Lithuania. : Five-year (2019-2023) data on patients aged 40 years or older diagnosed with dyslipidemia were extracted from a real-world data and analytics platform, TriNetX. Patients were grouped into three groups: patients with dyslipidemia only (control group), patients with dyslipidemia and diabetes, and patients with dyslipidemia and cardiovascular disease (CVD). The following LDL-C goals were used for analysis: <1.4 mmol/L (a goal for very-high-risk patients in primary or secondary prevention), <1.8 mmol/L (a goal for high-risk patients), and <3.0 mmol/L (a goal for low-risk patients). : There were 18,646 patients with dyslipidemia. Of them, 8.9% of patients had diabetes, and 3.1% of patients had CVD. The median LDL-C concentration was significantly lower in patients with diabetes (2.82 mmol/L, < 0.05) and in patients with CVD (2.45 mmol/L, < 0.05) than in the control group (3.35 mmol/L). A trend of decreasing median LDL-C over the years was observed in all groups, with the lowest median values in 2023. The proportion of patients with LDL-C levels < 3 mmol/L increased from 32.0% in 2019 to 41.5% in 2023. The proportion of diabetic patients achieving LDL-C < 1.8 mmol/L increased from 7.4% to 25.9%, and those achieving LDL-C < 1.4 mmol/L increased from 3.1% to 10.6%. The proportion of patients with CVD achieving LDL-C < 1.8 mmol/L increased from 14.2% to 36.6%, and those achieving LDL-C < 1.4 mmol/L increased from 3.0% to 14.0%. : Trends in the control of LDL-C levels are positive over 5 years, but a significant proportion of patients still did not reach the recommended target levels.
低密度脂蛋白胆固醇（LDL-C）是心血管疾病风险及其管理的一个指标。本研究评估了立陶宛一家初级医疗中心接受治疗的患者的LDL-C控制趋势。：从真实世界数据与分析平台TriNetX中提取了2019年至2023年期间40岁及以上被诊断为血脂异常患者的五年数据。患者被分为三组：仅患有血脂异常的患者（对照组）、患有血脂异常和糖尿病的患者以及患有血脂异常和心血管疾病（CVD）的患者。以下LDL-C目标用于分析：<1.4 mmol/L（一级或二级预防中极高风险患者的目标）、<1.8 mmol/L（高风险患者的目标）和<3.0 mmol/L（低风险患者的目标）。：共有18646名血脂异常患者。其中，8.9%的患者患有糖尿病，3.1%的患者患有CVD。糖尿病患者（2.82 mmol/L，<0.05）和CVD患者（2.45 mmol/L，<0.05）的LDL-C浓度中位数显著低于对照组（3.35 mmol/L）。所有组均观察到多年来LDL-C中位数呈下降趋势，2023年中位数最低。LDL-C水平<3 mmol/L的患者比例从2019年的32.0%增至2023年的41.5%。实现LDL-C<1.8 mmol/L的糖尿病患者比例从7.4%增至25.9%，实现LDL-C<1.4 mmol/L的患者比例从3.1%增至10.6%。实现LDL-C<1.8 mmol/L的CVD患者比例从14.2%增至36.6%，实现LDL-C<1.4 mmol/L的患者比例从3.0%增至14.0%。：LDL-C水平的控制趋势在5年期间呈积极态势，但仍有相当比例的患者未达到推荐的目标水平。
