Wadström Benjamin N, Wulff Anders B, Pedersen Kasper M, Nordestgaard Børge G
Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.
The Copenhagen General Population Study, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.
Clin Chem. 2025 Apr 3;71(4):463-473. doi: 10.1093/clinchem/hvae222.
Small remnants may penetrate the arterial intima more efficiently compared to large triglyceride-rich lipoproteins (TGRL). We tested the hypothesis that the importance of remnant cholesterol for the risk of atherosclerotic cardiovascular disease (ASCVD) may depend on the size of the remnants and TGRL carrying cholesterol.
The cholesterol content of small remnants and large TGRL were measured in 25 572 individuals from the Copenhagen General Population Study (2003-2015) and in 222 721 individuals from the UK Biobank (2006-2010) using nuclear magnetic resonance spectroscopy. In the Copenhagen cohort during up to 15 years of follow-up and in the UK Biobank cohort during up to 16 years of follow-up, the numbers of individuals diagnosed with ASCVD (=myocardial infarction, ischemic stroke, and peripheral artery disease) in national health registries were 3869 and 11 424, respectively.
Compared to individuals with low cholesterol content in both small remnants and large TGRL (cutpoints were median cholesterol content), multivariable-adjusted hazard ratios for risk of ASCVD were 1.21 (95% confidence interval: 1.07-1.37) for individuals with high cholesterol content in small remnants only and 0.94 (0.83-1.07) for individuals with high cholesterol content in large TGRL only; the multivariable-adjusted hazard ratio for risk of ASCVD per 10 percentile-units higher cholesterol content in small remnants vs that in large TGRL was 1.04 (1.01-1.07). In the UK Biobank cohort, corresponding hazard ratios were 1.11 (1.03-1.20), 1.01 (0.93-1.09), and 1.05 (1.04-1.07), respectively.
The importance of remnant cholesterol for the risk of ASCVD may depend on the size of the TGRL and remnants carrying cholesterol.
与富含甘油三酯的大脂蛋白（TGRL）相比，小残余颗粒可能更有效地穿透动脉内膜。我们检验了以下假设：残余胆固醇对动脉粥样硬化性心血管疾病（ASCVD）风险的重要性可能取决于残余颗粒和携带胆固醇的TGRL的大小。
使用核磁共振波谱法，在哥本哈根一般人群研究（2003 - 2015年）的25572名个体以及英国生物银行（2006 - 2010年）的222721名个体中，测量小残余颗粒和大TGRL的胆固醇含量。在哥本哈根队列长达15年的随访期间以及英国生物银行队列长达16年的随访期间，国家健康登记处诊断为ASCVD（=心肌梗死、缺血性中风和外周动脉疾病）的个体数量分别为3869例和11424例。
与小残余颗粒和大TGRL中胆固醇含量均低的个体（切点为胆固醇含量中位数）相比，仅小残余颗粒中胆固醇含量高的个体发生ASCVD风险的多变量调整风险比为1.21（95%置信区间：1.07 - 1.37），仅大TGRL中胆固醇含量高的个体为0.94（0.83 - 1.07）；小残余颗粒中胆固醇含量每升高10个百分位数单位相对于大TGRL中胆固醇含量升高时，发生ASCVD风险的多变量调整风险比为1.04（1.01 - 1.07）。在英国生物银行队列中，相应的风险比分别为1.11（1.03 - 1.20）、1.01（0.93 - 1.09）和1.05（1.04 - 1.07）。
残余胆固醇对ASCVD风险的重要性可能取决于携带胆固醇的TGRL和残余颗粒的大小。
