中国非动脉硬化性心血管疾病人群脂蛋白(a)水平分布特征及影响因素
Distribution and influencing factors of lipoprotein(a)levels in non-arteriosclerotic cardiovascular disease population in China
柯雅蕾 1潘烺 2吕筠 3孙点剑一 3裴培 2陈怡平 4杨玲 4杜怀东 4Robert Clarke 4陈君石 5陈铮鸣 4章晓 6陈婷 6李润琴 6齐丽彤 7李立明 3余灿清 3代表中国慢性病前瞻性研究项目协作组
作者信息
- 1. 北京大学公共卫生学院流行病与卫生统计学系,北京 100191
- 2. 北京大学公众健康与重大疫情防控战略研究中心,北京 100191
- 3. 北京大学公共卫生学院流行病与卫生统计学系,北京 100191;北京大学公众健康与重大疫情防控战略研究中心,北京 100191;重大疾病流行病学教育部重点实验室(北京大学),北京 100191
- 4. 牛津大学临床与流行病学研究中心纳菲尔德人群健康系,牛津OX3 7LF
- 5. 国家食品安全风险评估中心,北京 100022
- 6. 北京诺华制药有限公司,北京 102200
- 7. 北京大学第一医院心内科,北京 100034
- 折叠
摘要
目的 描述中国非动脉硬化性心血管疾病(ASCVD)人群脂蛋白(a)[Lp(a)]的分布并分析其影响因素.方法 基于中国慢性病前瞻性研究项目的一项巢式病例对照研究,选取其中进行了血液生化指标检测的对照人群进行分析,使用参比实验室检定的多克隆抗体比浊法测定Lp(a)水平,≥75.0 nmol/L定义为高Lp(a).采用多因素logistic回归模型分析Lp(a)水平的影响因素.结果 在纳入研究的5 870名非ASCVD人群中,Lp(a)水平呈正偏态分布,M(Q,,Q3)为17.5(8.8,43.5)nmol/L.多因素logistic回归分析结果显示,女性与高Lp(a)相关(OR=1.23,95％CI:1.05～1.43),中心性肥胖者的高Lp(a)风险降低(OR=0.68,95％CI:0.52～0.89).随TC、LDL-C、载脂蛋白A1(ApoA1)和载脂蛋白B(ApoB)水平升高,高Lp(a)风险增加,各升高组的OR值(95％CI)分别为2.40(1.76～3.24)、2.68(1.36～4.93)、1.29(1.03～1.61)和 1.65(1.27～2.13);HDL-C 降低组高 Lp(a)风险降低,OR值(95％CI)为0.76(0.61～0.94);而TG、ApoA1与ApoB的比值(ApoA1/B)与高Lp(a)风险呈负相关,TG升高组的OR值(95％CI)为 0.73(0.60～0.89),Apo A1/B 升高组的 OR值(95％CI)为 0.60(0.50～0.72);Lp(a)水平与血脂指标(除Apo A1外)的相关性均存在线性趋势(线性趋势检验P≤0.001).未发现行为生活方式因素如饮食、吸烟、体力活动水平与Lp(a)水平存在统计学关联.结论 Lp(a)水平与性别及中心性肥胖有关,但受行为生活方式因素影响较小.
Abstract
Objective To describe the distribution of lipoprotein(a)[Lp(a)]levels in non-arteriosclerotic cardiovascular disease(ASCVD)population in China and explore its influencing factors.Methods This study was based on a nested case-control study in the CKB study measured plasma biomarkers.Lp(a)levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a).Multiple logistic regression model was used to examine the factors related to Lp(a)levels.Results Among the 5 870 non-ASCVD population included in the analysis,Lp(a)levels showed a right-skewed distribution,with a M(Q1,Q3)of 17.5(8.8,43.5)nmol/L.The multiple logistic regression analysis found that female was associated with high Lp(a)(OR=1.23,95％CI:1.05-1.43).The risk of increased Lp(a)levels in subjects with abdominal obesity was significantly reduced(OR=0.68,95％CI:0.52-0.89).As TC,LDL-C,apolipoprotein A1(Apo A1),and apolipoprotein B(Apo B)levels increased,the risk of high Lp(a)increased,with OR(95％CI)for each elevated group was 2.40(1.76-3.24),2.68(1.36-4.93),1.29(1.03-1.61),and 1.65(1.27-2.13),respectively.The risk of high Lp(a)was reduced in the HDL-C lowering group with an OR(95％CI)of 0.76(0.61-0.94).In contrast,an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B)was negatively correlated with the risk of high Lp(a),with OR(95％CI)of 0.73(0.60-0.89)for elevated triglyceride group,and OR(95％CI)of 0.60(0.50-0.72)for the Apo A1/B ratio increase group(linear trend test P≤0.001 except for Apo A1).However,no correlation was found between Lp(a)levels and lifestyle factors such as diet,smoking,and physical activity.Conclusions Lp(a)levels were associated with sex and abdominal obesity,but less with lifestyle behaviors.
关键词
脂蛋白(a)/非动脉硬化性心血管疾病人群/分布/影响因素Key words
Lipoprotein(a)/Non-arteriosclerotic cardiovascular disease population/Distribution/Influencing factor引用本文复制引用
基金项目
国家自然科学基金(82192904)
国家自然科学基金(82192901)
国家自然科学基金(82192900)
国家重点研发计划重点专项(2016YFC0900500)
中国香港 Kadoorie Charitable基金()
出版年
2024
NETL
NSTL
万方数据