PDF(Pubmed)
Abstract：
BACKGROUND: Dyslipidemia frequently coexists with hypertension in the population. Apolipoprotein B (ApoB) is increasingly considered a more potent predictor of cardiovascular disease (CVD). Abnormal levels of serum ApoB can potentially impact the mortality risk.
METHODS: The prospective cohort study employed data from the National Health and Nutrition Examination Survey (NHANES), which was performed between 2005 and 2016, with follow-ups extended until December 2019. Serum ApoB concentrations were quantified using nephelometry. In line with the NHANES descriptions and recommendations, the reference ranges for ApoB concentrations are 55-140 and 55-125 mg/dL for men and women, respectively. Participants were categorized into low, normal, and high ApoB levels. The low and high groups were combined into the abnormal group. In this study, all-cause mortality (ACM) and CVD mortality (CVM) were the endpoints. Survey-weighted cox hazards models were used for evaluating the correlation between serum ApoB levels and ACM and CVM. A generalized additive model (GAM) was employed to examine the dose-dependent relationship between ApoB levels and mortality risk.
RESULTS: After a median of 95 (interquartile range: 62-135) months of follow-up, 986 all-cause and 286 CVD deaths were recorded. The abnormal ApoB group exhibited a trend toward an elevated risk of ACM in relative to the normal group (HR 1.22, 95% CI: 0.96-1.53). The risk of CVM was elevated by 76% in the ApoB abnormal group (HR 1.76, 95% CI: 1.28-2.42). According to the GAM, there existed a nonlinear association between serum ApoB levels and ACM (P = 0.005) and CVM (P = 0.009).
CONCLUSIONS: In the US hypertensive population, serum Apo B levels were U-shaped and correlated with ACM and CVM risk, with the lowest risk at 100 mg/dL. Importantly, abnormal Apo B levels were related to an elevated risk of ACM and CVM. These risks were especially high at lower Apo B levels. The obtained findings emphasize the importance of maintaining appropriate Apo B levels to prevent adverse outcomes in hypertensive individuals.
METHODS: The prospective cohort study employed data from the National Health and Nutrition Examination Survey (NHANES), which was performed between 2005 and 2016, with follow-ups extended until December 2019. Serum ApoB concentrations were quantified using nephelometry. In line with the NHANES descriptions and recommendations, the reference ranges for ApoB concentrations are 55-140 and 55-125 mg/dL for men and women, respectively. Participants were categorized into low, normal, and high ApoB levels. The low and high groups were combined into the abnormal group. In this study, all-cause mortality (ACM) and CVD mortality (CVM) were the endpoints. Survey-weighted cox hazards models were used for evaluating the correlation between serum ApoB levels and ACM and CVM. A generalized additive model (GAM) was employed to examine the dose-dependent relationship between ApoB levels and mortality risk.
RESULTS: After a median of 95 (interquartile range: 62-135) months of follow-up, 986 all-cause and 286 CVD deaths were recorded. The abnormal ApoB group exhibited a trend toward an elevated risk of ACM in relative to the normal group (HR 1.22, 95% CI: 0.96-1.53). The risk of CVM was elevated by 76% in the ApoB abnormal group (HR 1.76, 95% CI: 1.28-2.42). According to the GAM, there existed a nonlinear association between serum ApoB levels and ACM (P = 0.005) and CVM (P = 0.009).
CONCLUSIONS: In the US hypertensive population, serum Apo B levels were U-shaped and correlated with ACM and CVM risk, with the lowest risk at 100 mg/dL. Importantly, abnormal Apo B levels were related to an elevated risk of ACM and CVM. These risks were especially high at lower Apo B levels. The obtained findings emphasize the importance of maintaining appropriate Apo B levels to prevent adverse outcomes in hypertensive individuals.
摘要：
背景：在人群中，血脂异常常与高血压并存。载脂蛋白B（ApoB）越来越被认为是心血管疾病（CVD）的更有效预测因子。血清ApoB水平异常可能影响死亡风险。
方法：前瞻性队列研究采用了国家健康与营养调查（NHANES）的数据，在2005年至2016年期间进行，随访时间延长至2019年12月。使用比浊法定量血清ApoB浓度。根据NHANES的描述和建议，男性和女性的ApoB浓度参考范围为55-140和55-125mg/dL，分别。参与者被归类为低，正常,和高ApoB水平。将低和高组合并为异常组。在这项研究中,全因死亡率(ACM)和CVD死亡率(CVM)为终点.使用调查加权Cox风险模型评估血清ApoB水平与ACM和CVM之间的相关性。采用广义累加模型（GAM）来检查ApoB水平与死亡风险之间的剂量依赖性关系。
结果：在中位随访95（四分位距：62-135）个月后，记录了986例全因死亡和286例CVD死亡。相对于正常组，异常ApoB组表现出ACM风险升高的趋势（HR1.22，95％CI：0.96-1.53）。ApoB异常组CVM风险升高76%(HR1.76,95%CI:1.28-2.42)。根据GAM的说法,血清ApoB水平与ACM（P=0.005）和CVM（P=0.009）之间存在非线性关联。
结论：在美国高血压人群中，血清载脂蛋白B水平呈U型，与ACM和CVM风险相关，100mg/dL时风险最低。重要的是,ApoB水平异常与ACM和CVM风险升高相关。在较低的ApoB水平下，这些风险尤其高。获得的发现强调了维持适当的ApoB水平以预防高血压个体的不良后果的重要性。
方法：前瞻性队列研究采用了国家健康与营养调查（NHANES）的数据，在2005年至2016年期间进行，随访时间延长至2019年12月。使用比浊法定量血清ApoB浓度。根据NHANES的描述和建议，男性和女性的ApoB浓度参考范围为55-140和55-125mg/dL，分别。参与者被归类为低，正常,和高ApoB水平。将低和高组合并为异常组。在这项研究中,全因死亡率(ACM)和CVD死亡率(CVM)为终点.使用调查加权Cox风险模型评估血清ApoB水平与ACM和CVM之间的相关性。采用广义累加模型（GAM）来检查ApoB水平与死亡风险之间的剂量依赖性关系。
结果：在中位随访95（四分位距：62-135）个月后，记录了986例全因死亡和286例CVD死亡。相对于正常组，异常ApoB组表现出ACM风险升高的趋势（HR1.22，95％CI：0.96-1.53）。ApoB异常组CVM风险升高76%(HR1.76,95%CI:1.28-2.42)。根据GAM的说法,血清ApoB水平与ACM（P=0.005）和CVM（P=0.009）之间存在非线性关联。
结论：在美国高血压人群中，血清载脂蛋白B水平呈U型，与ACM和CVM风险相关，100mg/dL时风险最低。重要的是,ApoB水平异常与ACM和CVM风险升高相关。在较低的ApoB水平下，这些风险尤其高。获得的发现强调了维持适当的ApoB水平以预防高血压个体的不良后果的重要性。
