献血者甘油三酯筛查试点研究

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2024-07-01 DOI:10.1016/j.jacl.2024.04.056

Stephen Eason MBA, Frances Compton MD, Merlyn Sayers MB ChB, Amit Khera MD, Zahid Ahmad MD, Caroline Abe MD

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引用次数: 0

摘要

研究经费Ionis 青年研究者奖背景/简介很少有人尝试在社区筛查甘油三酯水平，而这有可能识别心血管疾病和急性高甘油三酯性胰腺炎的高危人群。目标/目的展示测量献血者非空腹甘油三酯水平的可行性。方法我们在 2023 年 12 月至 2024 年 1 月的 3 周时间里，对北德州卡特血液护理中心的志愿献血者进行了非空腹甘油三酯水平（加利福尼亚州贝克曼库尔特检测法）的前瞻性测量。献血者自我报告的人口统计学数据包括年龄、性别、民族/种族和体重指数。根据卡特血液护理中心的常规协议，对血压和总胆固醇水平进行了检查。根据 2021 年 ACC 高甘油三酯血症管理专家共识，将非空腹甘油三酯水平分为正常<175 mg/dL、中度 175-499 mg/dL 和重度>500 mg/dL 高甘油三酯血症。结果10175 名献血者测量了甘油三酯水平[35.2% 女性，年龄 53 岁（42-62），体重指数 29.4（26-33），71.6% 白人]。此外，98 人多次捐献[第一次甘油三酯 141 mg/dL (99-198)，第二次甘油三酯 142 mg/dL (103-205)，甘油三酯人际绝对变化 +/- 39.5 mg/dL (17-86)]。在唯一的捐献者中，甘油三酯水平介于 23-2342 mg/dL 之间（中位数为 154 mg/dL，平均值为 185 mg/dL）。值得注意的是，7 名捐献者的甘油三酯为 1000 毫克/分升（最低 1051 毫克/分升，最高 2342 毫克/分升）。总体而言，58.4% 的捐献者甘油三酯正常[甘油三酯 111 mg/dL (84-140)，41.6% 女性，年龄 52 岁 (40-62)，体重指数 28.4 (25-32)，71.7% 白人；16.9% 血压升高，总胆固醇 169 mg/dL (146-193)]；39.2% 患有中度高甘油三酯血症[甘油三酯 243 mg/dL (204-309)，26.8% 女性，年龄 53 岁 (43-61)，体重指数 30.5（27.4-34.2），71.8%为白人，21.9%血压升高，总胆固醇 181 mg/dL (156-206)]；2.4%为重度高甘油三酯血症[甘油三酯 582（539-705），17%为女性，年龄 52 岁（44-59），体重指数 30.9（28-35），67.5%为白人，27.6%血压升高，总胆固醇 209 mg/dL (178-235)]。甘油三酯水平与男性（p <0.001）、高血压（p <0.001）、高胆固醇（p <0.001）和西班牙裔（p <0.001）有关。结论我们的试点研究证明了在志愿献血者中开展非空腹社区高甘油三酯血症筛查的可行性。此类工作可快速筛查许多人的甘油三酯。此外，这种筛查还有可能识别出心血管疾病（中度高甘油三酯血症）和急性胰腺炎（重度高甘油三酯血症）的高危人群。未来的工作将探讨捐献者对甘油三酯的理解、确定其患高甘油三酯血症的风险因素，以及教育的必要性和护理途径。

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†A Pilot Study of Triglyceride Screening in Blood Donors

Study Funding

Ionis Young Investigators Award.

Background/Synopsis

Few attempts at community-based screening have been made for triglyceride levels, which has the potential to identify individuals at risk for cardiovascular disease as well as acute hypertriglyceridemic pancreatitis. One opportunity for such screening is among blood donors.

Objective/Purpose

Demonstrate feasibility of measuring non-fasting triglyceride level in blood donors.

Methods

We prospectively measured non-fasting triglyceride levels (Beckman Coulter assay, California) among volunteer blood donors at Carter BloodCare North Texas over 3 weeks from December 2023 to January 2024. Donor self-reported demographic data included age, gender, ethnicity/race and BMI. Blood pressure and total cholesterol level were checked per routine protocol at Carter BloodCare. Per the 2021 ACC expert consensus on management of hypertriglyceridemia, non-fasting triglyceride levels were stratified into normal <175 mg/dL, moderate 175-499 mg/dL, and severe >500 mg/dL hypertriglyceridemia. Results reported as median (IQR).

Results

10,175 unique blood donors had a triglyceride level measured [35.2% female, age 53 years (42-62), BMI 29.4 (26-33), 71.6% White]. Additionally, 98 individuals donated multiple times [first triglyceride 141 mg/dL (99-198), second triglyceride 142 mg/dL (103-205), interpersonal absolute change in triglyceride +/- 39.5 mg/dL (17-86)]. Among unique donors, triglyceride levels ranged from 23-2342 mg/dL (median 154 mg/dL, mean 185 mg/dL). Of note, 7 donors had triglycerides >1000 mg/dL (min 1051- max 2342). Overall, 58.4% had normal triglycerides [triglyceride 111 mg/dL (84-140), 41.6% female, age 52 years (40-62), BMI 28.4 (25-32), 71.7% White; 16.9% elevated blood pressure, total cholesterol 169 mg/dL (146-193)]; 39.2% had moderate hypertriglyceridemia [triglyceride 243 mg/dL (204-309), 26.8% female, age 53 years (43-61), BMI 30.5 (27.4-34.2), 71.8% White, 21.9% elevated blood pressure, total cholesterol 181 mg/dL (156-206)]; 2.4% severe hypertriglyceridemia [triglyceride 582 (539-705), 17% female, age 52 years (44-59), BMI 30.9 (28-35), 67.5% White, 27.6% elevated blood pressure, total cholesterol 209 mg/dL (178-235)]. Triglyceride levels were associated with male gender (p < 0.001), high blood pressure (p < 0.001), high cholesterol (p < 0.001), and Hispanic ethnicity (p<0.001).

Conclusions

Our pilot study demonstrates the feasibility of non-fasting community-based screening for hypertriglyceridemia among volunteer blood donors. Such efforts can rapidly screen triglycerides in many individuals. Furthermore, such screening has the potential to identify individuals at risk for cardiovascular disease (moderate hypertriglyceridemia) and acute pancreatitis (severe hypertriglyceridemia). Future efforts will explore donors’ understanding of triglycerides, identification of their risk factors for hypertriglyceridemia, along with the need for education and a pathway for their care.

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.