PDF(Pubmed)
Abstract：
UNASSIGNED: Despite reducing low-density lipoprotein cholesterol (LDL-C) to the normal range, residual cardiovascular risk remain. Remnant cholesterol (RC) exerts a potential residual risk for cardiovascular disease (CVD) prevention, and the long-term longitudinal association between RC and mortality has yet to be well elucidated.
UNASSIGNED: This study examined a nationally representative sample of 13,383 adults aged 20 years or older (mean age 45.7 and 52% women) who participated in the NHANES III (from1988 to1994). Causes of death were ascertained by linkage to death records through December 31, 2019. The relations of RC with all-cause and CVD mortality were tested using weighted Cox proportional hazard models.
UNASSIGNED: Through a median follow-up of 26.6 years, 5,044 deaths were reported, comprising 1,741 deaths of CVD [1,409 deaths of ischemic heart disease (IHD) and 332 deaths of stroke] and 1,126 of cancer. Compared to those with RC <14.26 mg/dl (lowest quartile), participants with RC ≥29.80 mg/dl (highest quartile) had multivariable-adjusted HRs of 1.23 (95% CI: 1.07-1.42) for all-cause mortality, 1.22 (95% CI: 0.97-1.53) for CVD mortality, and 1.32 (95% CI: 1.03-1.69) for IHD mortality, and 0.89 (95% CI: 0.55-1.43) for stroke mortality, and 1.17 (95% CI 0.90-1.52) for cancer mortality. We observed that elevated RC levels increased CVD risk and IHD mortality despite LDL-C being in the normal range.
UNASSIGNED: Elevated blood RC was associated with an increased long-term risk of all-cause, CVD, and IHD mortality. These associations were independent of socioeconomic factors, lifestyles, and history of diseases, and remained robust across the LDL-C stratum. Measuring RC levels might favor clinical assessment of early CVD risk. Further investigation is needed to elucidate the optimal range of RC levels for cardiovascular disease health in the general population.
UNASSIGNED: This study examined a nationally representative sample of 13,383 adults aged 20 years or older (mean age 45.7 and 52% women) who participated in the NHANES III (from1988 to1994). Causes of death were ascertained by linkage to death records through December 31, 2019. The relations of RC with all-cause and CVD mortality were tested using weighted Cox proportional hazard models.
UNASSIGNED: Through a median follow-up of 26.6 years, 5,044 deaths were reported, comprising 1,741 deaths of CVD [1,409 deaths of ischemic heart disease (IHD) and 332 deaths of stroke] and 1,126 of cancer. Compared to those with RC <14.26 mg/dl (lowest quartile), participants with RC ≥29.80 mg/dl (highest quartile) had multivariable-adjusted HRs of 1.23 (95% CI: 1.07-1.42) for all-cause mortality, 1.22 (95% CI: 0.97-1.53) for CVD mortality, and 1.32 (95% CI: 1.03-1.69) for IHD mortality, and 0.89 (95% CI: 0.55-1.43) for stroke mortality, and 1.17 (95% CI 0.90-1.52) for cancer mortality. We observed that elevated RC levels increased CVD risk and IHD mortality despite LDL-C being in the normal range.
UNASSIGNED: Elevated blood RC was associated with an increased long-term risk of all-cause, CVD, and IHD mortality. These associations were independent of socioeconomic factors, lifestyles, and history of diseases, and remained robust across the LDL-C stratum. Measuring RC levels might favor clinical assessment of early CVD risk. Further investigation is needed to elucidate the optimal range of RC levels for cardiovascular disease health in the general population.
摘要：
■尽管将低密度脂蛋白胆固醇（LDL-C）降低到正常范围，残余的心血管风险仍然存在。残余胆固醇（RC）对心血管疾病（CVD）预防具有潜在的残余风险，RC和死亡率之间的长期纵向关联尚未得到很好的阐明。
这项研究调查了一个全国代表性的样本13,383名20岁或以上的成年人（平均年龄45.7岁和52%的女性）参加了NHANESIII（从1988年到1994年）。死亡原因是通过与2019年12月31日之前的死亡记录联系来确定的。使用加权Cox比例风险模型测试RC与全因和CVD死亡率的关系。
■经过26.6年的中位随访，报告了5,044人死亡，包括1,741例CVD死亡[1,409例缺血性心脏病（IHD）死亡和332例中风死亡]和1,126例癌症。与RC<14.26mg/dl（最低四分位数）相比，RC≥29.80mg/dl（最高四分位数）的参与者的全因死亡率的多变量校正HR为1.23（95％CI：1.07-1.42），1.22（95%CI：0.97-1.53）的CVD死亡率，IHD死亡率为1.32（95%CI：1.03-1.69），卒中死亡率为0.89（95%CI：0.55-1.43），癌症死亡率为1.17（95%CI0.90-1.52）。我们观察到，尽管LDL-C在正常范围内，但RC水平升高会增加CVD风险和IHD死亡率。
■血液RC升高与全因长期风险增加有关，CVD,和IHD死亡率。这些关联独立于社会经济因素，生活方式,和疾病史，并在整个LDL-C层中保持稳健。测量RC水平可能有利于早期CVD风险的临床评估。需要进一步研究以阐明一般人群中心血管疾病健康的RC水平的最佳范围。
这项研究调查了一个全国代表性的样本13,383名20岁或以上的成年人（平均年龄45.7岁和52%的女性）参加了NHANESIII（从1988年到1994年）。死亡原因是通过与2019年12月31日之前的死亡记录联系来确定的。使用加权Cox比例风险模型测试RC与全因和CVD死亡率的关系。
■经过26.6年的中位随访，报告了5,044人死亡，包括1,741例CVD死亡[1,409例缺血性心脏病（IHD）死亡和332例中风死亡]和1,126例癌症。与RC<14.26mg/dl（最低四分位数）相比，RC≥29.80mg/dl（最高四分位数）的参与者的全因死亡率的多变量校正HR为1.23（95％CI：1.07-1.42），1.22（95%CI：0.97-1.53）的CVD死亡率，IHD死亡率为1.32（95%CI：1.03-1.69），卒中死亡率为0.89（95%CI：0.55-1.43），癌症死亡率为1.17（95%CI0.90-1.52）。我们观察到，尽管LDL-C在正常范围内，但RC水平升高会增加CVD风险和IHD死亡率。
■血液RC升高与全因长期风险增加有关，CVD,和IHD死亡率。这些关联独立于社会经济因素，生活方式,和疾病史，并在整个LDL-C层中保持稳健。测量RC水平可能有利于早期CVD风险的临床评估。需要进一步研究以阐明一般人群中心血管疾病健康的RC水平的最佳范围。
