VLDL triglycerides and cholesterol in non-alcoholic fatty liver disease and myocardial infarction.

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Atherosclerosis Pub Date : 2024-12-15 DOI:10.1016/j.atherosclerosis.2024.119094

Lærke Kristine Kyhl, Børge Grønne Nordestgaard, Anne Tybjærg-Hansen, George Davey Smith, Sune Fallgaard Nielsen

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引用次数: 0

Abstract

Background and aims: Myocardial infarction is a leading cause of death in individuals with non-alcoholic fatty liver disease (NAFLD). The two diseases share elevated very low-density lipoproteins (VLDL) carrying both triglycerides and cholesterol; however, in NAFLD mainly triglycerides accumulate in liver cells while in myocardial infarction mainly cholesterol accumulates in the atherosclerotic plaque. We hypothesized that VLDL triglycerides preferentially associate with risk of NAFLD, while VLDL cholesterol preferentially associates with risk of myocardial infarction.

Methods: We examined 25,428 individuals without clinically diagnosed NAFLD or myocardial infarction at baseline, nested within 109,776 individuals from the prospective Copenhagen General Population Study and followed these individuals for a mean of 10 years. VLDL triglycerides, VLDL cholesterol, and low-density lipoprotein (LDL) cholesterol were determined using nuclear magnetic resonance spectrometry.

Results: Continuously higher VLDL triglycerides were associated with continuously higher risk of NAFLD; however, this was not the case for VLDL cholesterol, LDL cholesterol, or apolipoprotein B. In contrast, continuously higher VLDL cholesterol, LDL cholesterol, and plasma apolipoprotein B were all associated with continuously higher risk of myocardial infarction. Compared to individuals with both VLDL triglycerides and VLDL cholesterol ≤66th percentile, the hazard ratios for NAFLD in individuals with VLDL triglycerides >66th percentile were 1.61(95 % confidence intervals:1.25-2.06) at high VLDL cholesterol and 1.41(0.90-2.21) at low VLDL cholesterol. Corresponding hazard ratios for myocardial infarction in individuals with VLDL cholesterol >66th percentile were 1.51(1.36-1.67) at high VLDL triglycerides and 1.42(1.18-1.69) at low VLDL triglycerides.

Conclusions: VLDL triglycerides predominated in NAFLD while VLDL cholesterol predominated in myocardial infarction; however, VLDL cholesterol was also elevated slightly in NAFLD while VLDL triglycerides was also elevated in myocardial infarction.

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VLDL甘油三酯和胆固醇在非酒精性脂肪性肝病和心肌梗死中的作用

背景和目的：心肌梗死是非酒精性脂肪性肝病（NAFLD）患者死亡的主要原因。这两种疾病的共同特点是携带甘油三酯和胆固醇的极低密度脂蛋白（VLDL）升高；然而，在NAFLD中，甘油三酯主要积聚在肝细胞中，而在心肌梗死中，胆固醇主要积聚在动脉粥样硬化斑块中。我们假设VLDL甘油三酯优先与NAFLD风险相关，而VLDL胆固醇优先与心肌梗死风险相关。方法：我们检查了25,428名基线时没有临床诊断为NAFLD或心肌梗死的个体，将其纳入前瞻性哥本哈根普通人群研究的109,776名个体中，并对这些个体进行了平均10年的随访。采用核磁共振光谱法测定VLDL甘油三酯、VLDL胆固醇和低密度脂蛋白（LDL）胆固醇。结果：持续升高的VLDL甘油三酯与持续升高的NAFLD风险相关；然而，VLDL胆固醇、LDL胆固醇或载脂蛋白B的情况并非如此。相反，持续升高的VLDL胆固醇、LDL胆固醇和血浆载脂蛋白B均与持续升高的心肌梗死风险相关。与VLDL甘油三酯和VLDL胆固醇均≤66百分位的个体相比，VLDL甘油三酯≤66百分位的个体NAFLD的风险比在高VLDL胆固醇组为1.61(95%可信区间：1.25-2.06)，在低VLDL胆固醇组为1.41（0.90-2.21）。VLDL胆固醇水平高的人群心肌梗死的相应风险比为1.51(1.36-1.67)，而VLDL甘油三酯水平低的人群心肌梗死的相应风险比为1.42（1.18-1.69）。结论：在NAFLD中以VLDL甘油三酯为主，在心肌梗死中以VLDL胆固醇为主；然而，VLDL胆固醇在NAFLD中也有轻微升高，而VLDL甘油三酯在心肌梗死中也有升高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.