脂蛋白和脂蛋白脂质组成与血糖异常阶段和亚临床冠状动脉粥样硬化有关。

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2024-11-03 DOI:10.1016/j.ijcard.2024.132698

Bruna Gigante , Qiaosen Chen , Harry Björkbacka , Elias Björnson , Jonas Brinck , Elin Chorell , Demir Djekic , Andreas Edsfeldt , Gunnar Engström , Jan W. Eriksson , Anders Gottsäter , Anders Gummesson , Emil Hagström , Ulf Hedin , Tomas Jernberg , Nina Johnston , Lennart Nilsson , Fredrik Nyström , Julia Otten , Annika Rosengren , Carl Johan Östgren

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引用次数: 0

摘要

背景：糖尿病患者的血脂异常会增加动脉粥样硬化性心血管疾病的风险。我们旨在确定与血糖异常和亚临床冠状动脉粥样硬化相关的血脂异常特征：研究参与者（n = 5050）被分为三组：正常血糖、糖尿病前期和糖尿病。冠状动脉钙化评分（CACS）大于 0 则定义为亚临床冠状动脉粥样硬化。在 225 种血脂生物标志物中，我们采用了两种独立的方法来确定与糖尿病前期和糖尿病相关的生物标志物，并通过与 CACS 和 CACS 负荷（CACS>0）的零膨胀泊松回归进一步检验其相关性：进一步研究了与糖尿病前期和糖尿病相关的 32 种生物标志物与 CACS 的关系。高密度脂蛋白直径[多重调整 OR 为 0.85，95 %CI (0.78-0.92)]以及超大型高密度脂蛋白中的游离胆固醇、磷脂和总脂类与 CACS 呈反向关系。小高密度脂蛋白和配发的降脂药物与 CACS 之间存在近似显著的交互作用，多重调整 OR 为 0.53，95 %CI 为（0.36-0.77）。非高密度脂蛋白与 CACS 之间没有发现一致的关联：结论：高密度脂蛋白成分和相对浓度的变化与血糖异常和亚临床冠状动脉粥样硬化有关。使用降脂药物治疗可能有助于降低与高循环小高密度脂蛋白水平相关的风险。

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Lipoproteins and lipoprotein lipid composition are associated with stages of dysglycemia and subclinical coronary atherosclerosis

Background

Dyslipidaemia in patients with diabetes contributes to the risk of atherosclerotic cardiovascular disease. We aimed to identify a dyslipidemic profile associated with both dysglycemia and subclinical coronary atherosclerosis.

Methods

Study participants (n = 5050) were classified in three groups: normoglycemia, pre-diabetes, and diabetes. A coronary artery calcium score (CACS) > 0 defined subclinical coronary atherosclerosis. Two independent methods were used to identify, among 225 lipid biomarkers, those that were associated with pre-diabetes and diabetes and were further tested for association by zero inflated Poisson regression with CACS and with CACS burden in study participants with CACS>0. Estimates were adjusted for cardiovascular risk factors with an interaction term for dispensed lipid lowering drugs.

Results

Thirty-two biomarkers associated with prediabetes and diabetes were further investigated for association with CACS. HDL diameter [multi-adjusted OR of 0.85 and 95 %CI (0.78–0.92)] as well as free cholesterol, phospholipids and total lipids in extra large HDL were inversely associated with CACS. There was a borderline significant interaction between small HDL and dispensed lipid lowering drugs on the presence of CACS, with and multi-adjusted OR of 0.53 and 95 %CI (0.36–0.77). None of the 32 glycemic profile-related lipid biomarkers associated with the relative increase of CACS in those with CACS>0. No consistent association was observed between non-HDL lipoproteins and CACS.

Conclusions

Changes in composition and relative concentration of HDL associated with both dysglycemia and subclinical coronary atherosclerosis. Treatment with lipid lowering drugs may contribute to reduce the risk associated with high circulating levels of small HDL.

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.