载脂蛋白B改变脂蛋白(a)与ASCVD风险之间的关系

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal Pub Date : 2024-12-05 DOI:10.1016/j.ahj.2024.11.014

Yuhui Lai MD , Shaozhao Zhang PhD , Yue Guo PhD , Chaoguang Xu MD , Mengting Huang MD , Rongjian Zhan MD , Menghui Liu PhD , Zhenyu Xiong PhD , Yiquan Huang MD , Xinxue Liao PhD , Yuedong Ma PhD , Xiaodong Zhuang PhD , Jingzhou Jiang PhD , Xing Wu PhD

{"title":"载脂蛋白B改变脂蛋白(a)与ASCVD风险之间的关系","authors":"Yuhui Lai MD , Shaozhao Zhang PhD , Yue Guo PhD , Chaoguang Xu MD , Mengting Huang MD , Rongjian Zhan MD , Menghui Liu PhD , Zhenyu Xiong PhD , Yiquan Huang MD , Xinxue Liao PhD , Yuedong Ma PhD , Xiaodong Zhuang PhD , Jingzhou Jiang PhD , Xing Wu PhD","doi":"10.1016/j.ahj.2024.11.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Elevated lipoprotein(a) (Lp[a]) and apolipoprotein B (apoB) are individually associated with the risk of atherosclerotic cardiovascular disease (ASCVD). Moreover, previous basic research has implicated the potential interaction between apoB and Lp(a) in the atherogenic process. We aimed to determine whether apoB levels significantly modulate ASCVD risk associated with Lp(a) in a large community-based population without baseline cardiovascular disease.</div></div><div><h3>Methods</h3><div>Plasma Lp(a) and apoB were measured in the Atherosclerosis Risk in Communities (ARIC) study. Elevated Lp(a) was defined as the highest race-specific quintile, and elevated apoB was defined as ≥89 mg/dl (median value). The modifying effect of apoB on the Lp(a)-related risk of ASCVD and coronary heart disease (CHD) was determined using Cox regression models adjusted for cardiovascular risk factors.</div></div><div><h3>Results</h3><div>Among 12,988 ARIC participants, 3,888 ASCVD events and 1754 CHD events were observed. Elevated apoB (≥89 mg/dl) and elevated Lp(a) (race-specific quintile 5) were independently associated with ASCVD (hazard ratio [HR]: 1.19; 95% CI: 1.08-1.30; P <0.001; HR: 1.27; 95% CI: 1.16-1.40; <em>P</em> < .001, respectively). Lp(a)-by-apoB interaction was noted [Lp(a) (quintile 1-4 or quintile 5) * apoB (<89 or ≥89 mg/dl) = 0.002]. Compared to the concordantly low Lp(a) group, the individuals with high Lp(a) had a greater ASCVD risk only when apoB was elevated (HR: 1.48; 95% CI: 1.34-1.63; <em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>In the context of primary prevention, ASCVD risk associated with Lp(a) was observed only when apoB was elevated. The measurement of apoB can further refine and contextualize the ASCVD risk associated with Lp(a).</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"281 ","pages":"Pages 157-167"},"PeriodicalIF":3.7000,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Apolipoprotein B modifies the association between lipoprotein(a) and ASCVD risk\",\"authors\":\"Yuhui Lai MD , Shaozhao Zhang PhD , Yue Guo PhD , Chaoguang Xu MD , Mengting Huang MD , Rongjian Zhan MD , Menghui Liu PhD , Zhenyu Xiong PhD , Yiquan Huang MD , Xinxue Liao PhD , Yuedong Ma PhD , Xiaodong Zhuang PhD , Jingzhou Jiang PhD , Xing Wu PhD\",\"doi\":\"10.1016/j.ahj.2024.11.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Elevated lipoprotein(a) (Lp[a]) and apolipoprotein B (apoB) are individually associated with the risk of atherosclerotic cardiovascular disease (ASCVD). Moreover, previous basic research has implicated the potential interaction between apoB and Lp(a) in the atherogenic process. We aimed to determine whether apoB levels significantly modulate ASCVD risk associated with Lp(a) in a large community-based population without baseline cardiovascular disease.</div></div><div><h3>Methods</h3><div>Plasma Lp(a) and apoB were measured in the Atherosclerosis Risk in Communities (ARIC) study. Elevated Lp(a) was defined as the highest race-specific quintile, and elevated apoB was defined as ≥89 mg/dl (median value). The modifying effect of apoB on the Lp(a)-related risk of ASCVD and coronary heart disease (CHD) was determined using Cox regression models adjusted for cardiovascular risk factors.</div></div><div><h3>Results</h3><div>Among 12,988 ARIC participants, 3,888 ASCVD events and 1754 CHD events were observed. Elevated apoB (≥89 mg/dl) and elevated Lp(a) (race-specific quintile 5) were independently associated with ASCVD (hazard ratio [HR]: 1.19; 95% CI: 1.08-1.30; P <0.001; HR: 1.27; 95% CI: 1.16-1.40; <em>P</em> < .001, respectively). Lp(a)-by-apoB interaction was noted [Lp(a) (quintile 1-4 or quintile 5) * apoB (<89 or ≥89 mg/dl) = 0.002]. Compared to the concordantly low Lp(a) group, the individuals with high Lp(a) had a greater ASCVD risk only when apoB was elevated (HR: 1.48; 95% CI: 1.34-1.63; <em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>In the context of primary prevention, ASCVD risk associated with Lp(a) was observed only when apoB was elevated. The measurement of apoB can further refine and contextualize the ASCVD risk associated with Lp(a).</div></div>\",\"PeriodicalId\":7868,\"journal\":{\"name\":\"American heart journal\",\"volume\":\"281 \",\"pages\":\"Pages 157-167\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-12-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American heart journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S000287032400320X\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American heart journal","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S000287032400320X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

背景：脂蛋白(a) （Lp[a]）和载脂蛋白B （apoB）升高与动脉粥样硬化性心血管疾病（ASCVD）的风险单独相关。此外，先前的基础研究表明载脂蛋白ob和Lp(a)在动脉粥样硬化过程中可能存在相互作用。我们的目的是确定载脂蛋白ob水平是否显著调节与Lp(a)相关的ASCVD风险，在一个没有基线心血管疾病的大型社区人群中。方法：在社区动脉粥样硬化风险（ARIC）研究中测量血浆Lp(a)和载脂蛋白ob。Lp(a)升高被定义为最高的种族特异性五分位数，apoB升高被定义为≥89 mg/dl（中位数）。采用校正心血管危险因素的Cox回归模型，确定载脂蛋白ob对ASCVD和冠心病（CHD）的Lp(a)相关风险的调节作用。结果：在12988名ARIC参与者中，观察到3888例ASCVD事件和1754例冠心病事件。apoB升高（≥89 mg/dl）和Lp(a)升高（种族特异性五分位数5）与ASCVD独立相关(危险比[HR]: 1.19；95% ci: 1.08-1.30；结论：在一级预防的背景下，只有当载脂蛋白ob升高时，ASCVD风险与Lp(a)相关。载脂蛋白ob的测量可以进一步完善和了解与Lp相关的ASCVD风险(a)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Apolipoprotein B modifies the association between lipoprotein(a) and ASCVD risk

Background

Elevated lipoprotein(a) (Lp[a]) and apolipoprotein B (apoB) are individually associated with the risk of atherosclerotic cardiovascular disease (ASCVD). Moreover, previous basic research has implicated the potential interaction between apoB and Lp(a) in the atherogenic process. We aimed to determine whether apoB levels significantly modulate ASCVD risk associated with Lp(a) in a large community-based population without baseline cardiovascular disease.

Methods

Plasma Lp(a) and apoB were measured in the Atherosclerosis Risk in Communities (ARIC) study. Elevated Lp(a) was defined as the highest race-specific quintile, and elevated apoB was defined as ≥89 mg/dl (median value). The modifying effect of apoB on the Lp(a)-related risk of ASCVD and coronary heart disease (CHD) was determined using Cox regression models adjusted for cardiovascular risk factors.

Results

Among 12,988 ARIC participants, 3,888 ASCVD events and 1754 CHD events were observed. Elevated apoB (≥89 mg/dl) and elevated Lp(a) (race-specific quintile 5) were independently associated with ASCVD (hazard ratio [HR]: 1.19; 95% CI: 1.08-1.30; P <0.001; HR: 1.27; 95% CI: 1.16-1.40; P < .001, respectively). Lp(a)-by-apoB interaction was noted [Lp(a) (quintile 1-4 or quintile 5) * apoB (<89 or ≥89 mg/dl) = 0.002]. Compared to the concordantly low Lp(a) group, the individuals with high Lp(a) had a greater ASCVD risk only when apoB was elevated (HR: 1.48; 95% CI: 1.34-1.63; P < .001).

Conclusions

In the context of primary prevention, ASCVD risk associated with Lp(a) was observed only when apoB was elevated. The measurement of apoB can further refine and contextualize the ASCVD risk associated with Lp(a).

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

American heart journal 医学-心血管系统

CiteScore

8.20

自引率

2.10%

发文量

214

审稿时长

38 days

期刊介绍： The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.