Xiaoqing Zhu, Weihao Xu, Benchuan Hao, Qi Chen, Zhenyu Xiong, Qingsong Wang, Xiaofei Hou, Yundai Chen, Jun Guo, Tao Chen
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引用次数: 0
Abstract
Aim: Remnant cholesterol (RC) has been recognized as a modifiable risk factor for cardiovascular disease (CVD). However, the association between long-term changes in RC during follow-up and incident CVD remains underexplored, with most research focusing on baseline RC levels.
Methods: Data for this prospective cohort study were derived from the China Health and Retirement Longitudinal Study (CHARLS). RC levels were calculated using the Friedewald equation. Changes in RC, cumulative RC, and the change in RC (ΔRC) were assessed by comparing RC levels at Waves 1 and 3. Cox proportional hazard models, adjusted for potential confounders, were used to evaluate the impact of baseline and dynamic RC levels on incident CVD risk.
Results: Among 3,866 participants (46.23% male, mean age: 57.50 years) followed for 5.0 years, participants with initially high RC who decreased to low levels showed reduced CVD risk (HR 0.71, 95% CI 0.54-0.94). Those with low baseline RC escalating to high levels showed similar risk (HR 0.85, 95% CI 0.68-1.06) compared to consistently high RC levels. Highest tertile cumulative RC significantly increased CVD risk (HR 1.37, 95% CI 1.11-1.69). Among high baseline RC participants, those in the lowest ΔRC tertile had reduced CVD risk (HR 0.68, 95% CI 0.52-0.89).
Conclusions: Longitudinal RC increases were associated with higher CVD risks, while RC reductions were associated with decreased risks. RC monitoring and management may contribute to CVD risk assessment and prevention, though further research with direct RC measurement and clinically validated outcomes is needed.
目的：残余胆固醇（RC）已被认为是心血管疾病（CVD）的可改变危险因素。然而，随访期间RC的长期变化与CVD事件之间的关系仍未得到充分探讨，大多数研究集中在基线RC水平上。方法：这项前瞻性队列研究的数据来自中国健康与退休纵向研究（CHARLS）。RC水平用Friedewald方程计算。通过比较第1波和第3波的RC水平来评估RC变化、累积RC变化和RC变化（ΔRC）。Cox比例风险模型对潜在混杂因素进行了调整，用于评估基线和动态RC水平对突发心血管疾病风险的影响。结果：在随访5.0年的3866名参与者中（46.23%为男性，平均年龄57.50岁），最初RC高的参与者降低到低水平后心血管疾病风险降低（HR 0.71, 95% CI 0.54-0.94）。基线低的RC升高到高水平的患者与持续高RC水平的患者相比具有相似的风险（HR 0.85, 95% CI 0.68-1.06）。最高分位数累积RC显著增加心血管疾病风险（HR 1.37, 95% CI 1.11-1.69）。在高基线RC参与者中，最低ΔRC tertile的参与者心血管疾病风险降低（HR 0.68, 95% CI 0.52-0.89）。结论：纵向RC升高与CVD风险升高相关，而RC降低与风险降低相关。RC监测和管理可能有助于心血管疾病的风险评估和预防，但需要进一步研究直接的RC测量和临床验证结果。
期刊介绍：
European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.
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