Abstract：
BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) are highly correlated measures of atherogenic lipoproteins.
OBJECTIVE: The study investigators hypothesized that excess apoB is associated with an increased risk of myocardial infarction (MI), atherosclerotic cardiovascular disease (ASCVD), and all-cause mortality.
METHODS: The study included 53,484 women and 41,624 men not taking statins from the Copenhagen General Population Study. Associations of excess apoB with the risk of MI, ASCVD, and all-cause mortality were estimated by Cox proportional hazards regressions with 95% CIs. Excess apoB was defined as measured levels of apoB minus expected levels of apoB from LDL-C alone; expected levels were defined by linear regressions of LDL-C levels vs apoB levels in individuals with triglycerides ≤1 mmol/L (89 mg/dL).
RESULTS: During a median follow-up of 9.6 years, 2,048 MIs, 4,282 ASCVD events, and 8,873 deaths occurred. There was a dose-dependent association between excess apoB and the risk of MI and ASCVD in both women and men, as well as an association with the risk of all-cause mortality in women. For ASCVD in women compared with those with excess apoB <11 mg/dL, the multivariable adjusted HR was 1.08 (95% CI: 0.97-1.21) for excess apoB 11 to 25 mg/dL, 1.30 (95% CI: 1.14-1.48) for 26 to 45 mg/dL, 1.34 (95% CI: 1.14-1.58) for 46 to 100 mg/dL, and 1.75 (95% CI: 1.08-2.83) for excess apoB >100 mg/dL. Corresponding HRs in men were 1.14 (95% CI: 1.02-1.26), 1.41 (95% CI: 1.26-1.57), 1.41 (95% CI: 1.25-1.60), and 1.52 (95% CI: 1.13-2.05), respectively. Results were robust across the entire LDL-C spectrum.
CONCLUSIONS: Excess apoB (ie, the value of apoB above that contributed by LDL-C levels alone) is associated dose-dependently with an increased risk of MI and ASCVD in women and men. This finding demonstrates that apoB provides important predictive value beyond LDL-C across the entire LDL-C spectrum.
OBJECTIVE: The study investigators hypothesized that excess apoB is associated with an increased risk of myocardial infarction (MI), atherosclerotic cardiovascular disease (ASCVD), and all-cause mortality.
METHODS: The study included 53,484 women and 41,624 men not taking statins from the Copenhagen General Population Study. Associations of excess apoB with the risk of MI, ASCVD, and all-cause mortality were estimated by Cox proportional hazards regressions with 95% CIs. Excess apoB was defined as measured levels of apoB minus expected levels of apoB from LDL-C alone; expected levels were defined by linear regressions of LDL-C levels vs apoB levels in individuals with triglycerides ≤1 mmol/L (89 mg/dL).
RESULTS: During a median follow-up of 9.6 years, 2,048 MIs, 4,282 ASCVD events, and 8,873 deaths occurred. There was a dose-dependent association between excess apoB and the risk of MI and ASCVD in both women and men, as well as an association with the risk of all-cause mortality in women. For ASCVD in women compared with those with excess apoB <11 mg/dL, the multivariable adjusted HR was 1.08 (95% CI: 0.97-1.21) for excess apoB 11 to 25 mg/dL, 1.30 (95% CI: 1.14-1.48) for 26 to 45 mg/dL, 1.34 (95% CI: 1.14-1.58) for 46 to 100 mg/dL, and 1.75 (95% CI: 1.08-2.83) for excess apoB >100 mg/dL. Corresponding HRs in men were 1.14 (95% CI: 1.02-1.26), 1.41 (95% CI: 1.26-1.57), 1.41 (95% CI: 1.25-1.60), and 1.52 (95% CI: 1.13-2.05), respectively. Results were robust across the entire LDL-C spectrum.
CONCLUSIONS: Excess apoB (ie, the value of apoB above that contributed by LDL-C levels alone) is associated dose-dependently with an increased risk of MI and ASCVD in women and men. This finding demonstrates that apoB provides important predictive value beyond LDL-C across the entire LDL-C spectrum.
摘要：
背景：低密度脂蛋白胆固醇（LDL-C）和载脂蛋白B（apoB）是动脉粥样硬化脂蛋白的高度相关指标。
目的：研究人员假设过量的apoB与心肌梗死（MI）的风险增加有关，动脉粥样硬化性心血管疾病（ASCVD），和全因死亡率。
方法：该研究包括53,484名女性和41,624名男性，他们没有从哥本哈根普通人群研究中服用他汀类药物。过量apoB与MI风险的关联，ASCVD,全因死亡率通过Cox比例风险回归与95%CI估计.过量apoB被定义为apoB的测量水平减去单独来自LDL-C的apoB的预期水平；预期水平通过甘油三酯≤1mmol/L（89mg/dL）的个体中LDL-C水平与apoB水平的线性回归来定义。
结果：在9.6年的中位随访中，2,048MIs，4,282个ASCVD事件，发生了8,873人死亡。在女性和男性中，过量的apoB与MI和ASCVD的风险之间存在剂量依赖性关联。以及与女性全因死亡风险的关联。对于ASCVD的女性，与过量apoB<11mg/dL的女性相比，过量apoB11至25mg/dL的多变量校正HR为1.08(95%CI:0.97-1.21)，1.30（95％CI：1.14-1.48），对于26至45mg/dL，1.34（95％CI：1.14-1.58），用于46至100mg/dL，对于过量的apoB>100mg/dL，则为1.75（95％CI：1.08-2.83）。男性对应的HR为1.14（95%CI：1.02-1.26），1.41（95%CI：1.26-1.57），1.41（95%CI：1.25-1.60），和1.52（95%CI：1.13-2.05），分别。结果在整个LDL-C谱上是稳健的。
结论：过量apoB（即，apoB高于仅由LDL-C水平贡献的值)与女性和男性MI和ASCVD风险增加呈剂量依赖性相关。该发现表明,apoB在整个LDL-C谱中提供超过LDL-C的重要预测值。
目的：研究人员假设过量的apoB与心肌梗死（MI）的风险增加有关，动脉粥样硬化性心血管疾病（ASCVD），和全因死亡率。
方法：该研究包括53,484名女性和41,624名男性，他们没有从哥本哈根普通人群研究中服用他汀类药物。过量apoB与MI风险的关联，ASCVD,全因死亡率通过Cox比例风险回归与95%CI估计.过量apoB被定义为apoB的测量水平减去单独来自LDL-C的apoB的预期水平；预期水平通过甘油三酯≤1mmol/L（89mg/dL）的个体中LDL-C水平与apoB水平的线性回归来定义。
结果：在9.6年的中位随访中，2,048MIs，4,282个ASCVD事件，发生了8,873人死亡。在女性和男性中，过量的apoB与MI和ASCVD的风险之间存在剂量依赖性关联。以及与女性全因死亡风险的关联。对于ASCVD的女性，与过量apoB<11mg/dL的女性相比，过量apoB11至25mg/dL的多变量校正HR为1.08(95%CI:0.97-1.21)，1.30（95％CI：1.14-1.48），对于26至45mg/dL，1.34（95％CI：1.14-1.58），用于46至100mg/dL，对于过量的apoB>100mg/dL，则为1.75（95％CI：1.08-2.83）。男性对应的HR为1.14（95%CI：1.02-1.26），1.41（95%CI：1.26-1.57），1.41（95%CI：1.25-1.60），和1.52（95%CI：1.13-2.05），分别。结果在整个LDL-C谱上是稳健的。
结论：过量apoB（即，apoB高于仅由LDL-C水平贡献的值)与女性和男性MI和ASCVD风险增加呈剂量依赖性相关。该发现表明,apoB在整个LDL-C谱中提供超过LDL-C的重要预测值。
