载脂蛋白B和脂质生物标志物在预测20年动脉粥样硬化性心血管疾病风险中的一致性-不一致性:ATTICA研究(2002-2022)。

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Sofia-Panagiota Giannakopoulou, Smaragdi Antonopoulou, Fotios Barkas, Evangelos Liberopoulos, Christina Chrysohoou, Petros P Sfikakis, Christos Pitsavos, Costas Tsioufis, Demosthenes Panagiotakos
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引用次数: 0

摘要

背景:低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)和载脂蛋白B100 (apoB)之间存在很强的相关性。然而,有证据表明LDL-C和非hdl - c可能低估了载脂蛋白ob,潜在地模糊了剩余的心血管风险。此外,载脂蛋白ob和脂蛋白(a)之间的相互作用与动脉粥样硬化有关。本研究旨在确定在一组表面健康的成年人中,载脂蛋白ob、LDL-C、非hdl - c或脂蛋白(a)之间的不一致是否与20年动脉粥样硬化性心血管疾病(ASCVD)风险相关。方法:2002年在希腊大雅典招募了3042名无心血管疾病的成年人。2022年进行了为期20年的随访,包括n = 2169名参与者,其中n = 1988名具有心血管疾病发病率的完整数据。生物标志物之间的不一致是根据推荐的脂质阈值来定义的。Cox比例风险模型用于评估不一致/一致生物标志物对与20年ASCVD风险之间的关系。结果:载脂蛋白ob与LDL-C和非hdl - c密切相关,但一致性有限。随着载脂蛋白ob水平升高,超过LDL-C、非hdl - c和脂蛋白水平,20年ASCVD累积发病率增加(a)。不一致分析显示,无论非hdl - c和脂蛋白(a)如何,载脂蛋白ob升高独立预测20年ASCVD风险增加。然而,这种影响仅在伴随LDL-C水平升高的情况下观察到。将载脂蛋白ob纳入传统可改变风险因素的评估中,阐明了先前20年残余ASCVD风险的一部分,特别是在LDL-C、非hdl - c或脂蛋白(a)水平升高的个体中。结论:载脂蛋白ob可能是评估长期ASCVD风险的优越生物标志物,表明载脂蛋白ob含有的脂蛋白颗粒数量,而不是胆固醇含量,是ASCVD风险更可靠的预测因子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Concordance-discordance between apolipoprotein B and lipid biomarkers in predicting 20-year atherosclerotic cardiovascular disease risk: The ATTICA study (2002-2022).

Background: A strong correlation exists between low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B100 (apoB). However, evidence suggests that LDL-C and non-HDL-C may underestimate apoB, potentially obscuring residual cardiovascular risk. Furthermore, interactions between apoB and lipoprotein(a) are implicated in atherogenesis. This study sought to determine whether discordance between apoB, LDL-C, non-HDL-C, or lipoprotein(a) is associated with 20-year atherosclerotic cardiovascular disease (ASCVD) risk within a cohort of apparently healthy adults.

Methods: A cohort of 3042 CVD-free adults residing in greater Athens, Greece, was recruited in 2002. A 20-year follow-up was conducted in 2022, comprising n = 2169 participants, of which n = 1988 had complete data for cardiovascular disease incidence. Discordance between biomarkers was defined based on recommended lipid thresholds. Cox proportional hazards models were used to assess the association between discordant/concordant biomarker pairs and 20-year ASCVD risk.

Results: ApoB strongly correlated with LDL-C and non-HDL-C, though concordance was limited. Increased 20-year ASCVD cumulative incidence with elevated apoB levels, beyond LDL-C, non-HDL-C, and lipoprotein(a). Discordance analysis revealed that elevated apoB independently predicted increased 20-year ASCVD risk, regardless of non-HDL-C and lipoprotein(a). However, this effect was observed only on concomitantly elevated LDL-C levels. Incorporating apoB into the assessment of traditional modifiable risk factors elucidated part of the previously residual 20-year ASCVD risk, especially in individuals with elevated LDL-C, non-HDL-C, or lipoprotein(a) levels.

Conclusions: ApoB may be a superior biomarker for assessing long-term ASCVD risk, indicating that apoB-containing lipoprotein particle number, rather than cholesterol content, is a more robust predictor of ASCVD risk.

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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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