残余胆固醇与高密度脂蛋白胆固醇比值对首次发生动脉粥样硬化性心血管疾病风险的影响：开滦前瞻性队列研究

Impact of remnant cholesterol to high-density lipoprotein cholesterol ratio on risk of incident ASCVD: the Kailuan prospective cohort study.

作者信息

Tan Yizhen, Chen Shuohua, Huang Zhe, Lu Xiangfeng, Li Jianxin, Wang Youxin, Wu Shouling, Wu Ying, Wu Yuntao, Li Yun

机构信息

Department of Preventive Medicine, School of Public Health, North China University of Science and Technology, Tangshan, 063210, China.

Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China.

出版信息

Nutr Metab (Lond). 2025 May 26;22(1):51. doi: 10.1186/s12986-025-00948-7.

DOI:10.1186/s12986-025-00948-7

PMID:40420165

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12105187/

Abstract

BACKGROUND

The study utilized the remnant cholesterol (RC) to high-density lipoprotein cholesterol (HDL-C) ratio as a lipidemia indicator. Assessing its long-term impact on cardiovascular disease (ASCVD) is crucial for primary prevention.

METHODS

84,380 participants were enrolled in the prospective cohort. Participants were classified into low, medium, and high levels based on baseline RC/HDL-C levels at the 50th percentile and 90th percentile. Participants were followed until December 31, 2023. Calculate the incidence density of ASCVD for each group. The time-dependent Cox proportional hazards model was utilized to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for ASCVD risk among different groups.

RESULTS

The study included 42,181, 33,739, and 8460 participants in the low, medium, and high levels respectively. A median follow-up of 16.92 years, 8397 ASCVD cases were identified. The 1000 person-years incidence density and 95% CIs for ASCVD were 5.86 (5.67, 6.05) in the low level, 6.92 (6.70, 7.15) in the medium level, and 8.85 (8.35, 9.39) in the high level. Compared to the low level, the Cox model showed that the HRs and 95% CIs for ASCVD were 1.09 (1.04, 1.14) and 1.23 (1.15, 1.32), respectively in medium and high levels.

CONCLUSION

Higher RC/HDL-C level was significantly associated with an increased risk of ASCVD. Including the RC/HDL-C in lipid evaluation can reduce the onset of ASCVD.

CLINICAL TRIAL REGISTRATION NUMBER

ChiCTR2000029767.

摘要

背景

本研究采用残余胆固醇（RC）与高密度脂蛋白胆固醇（HDL-C）的比值作为血脂异常指标。评估其对心血管疾病（ASCVD）的长期影响对于一级预防至关重要。

方法

84380名参与者被纳入前瞻性队列研究。根据第50百分位数和第90百分位数的基线RC/HDL-C水平，将参与者分为低、中、高三个水平组。对参与者进行随访直至2023年12月31日。计算每组ASCVD的发病密度。采用时间依赖性Cox比例风险模型计算不同组间ASCVD风险的风险比（HRs）和95%置信区间（CIs）。

结果

该研究分别纳入低、中、高三个水平组的参与者42181名、33739名和8460名。中位随访时间为16.92年，共识别出8397例ASCVD病例。低水平组、中等水平组和高水平组ASCVD的每1000人年发病密度及95%CI分别为5.86（5.67，6.05）、6.92（6.70，7.15）和8.85（8.35，9.39）。与低水平组相比，Cox模型显示中等水平组和高水平组ASCVD的HRs及95%CI分别为1.09（1.04，1.14）和1.23（1.15，1.32）。