背景:在种族和地理上不同的人群中,全面的血液脂蛋白谱及其与冠心病(CHD)的关系仍未得到充分研究。
结果:我们在3438名个体(1719对)中进行了冠心病的巢式病例对照研究,包括1084名美国白人(542对),1244美国黑人(622对),和1110名中国成年人(555对)。我们检查了36种血浆脂质,脂蛋白,和载脂蛋白,核磁共振波谱测量,根据人口统计学,所有参与者和亚组中的冠心病事件,生活方式,和代谢健康状况,使用条件或无条件逻辑回归校正潜在的混杂因素。常规测量血脂,也就是说,总胆固醇,甘油三酯,低密度脂蛋白胆固醇,高密度脂蛋白胆固醇,每个都与冠心病相关,所有参与者的比值比(ORs)分别为1.33、1.32、1.24和0.79/1-SD.17种脂蛋白生物标志物显示出数字上比常规脂质更强的关联,所有参与者中每1-SD的ORs范围为1.35至1.57,OR为阴性0.78(所有错误发现率<0.05),包括载脂蛋白B100与载脂蛋白A1的比率(OR,1.57[95%CI,1.45-1.7]),低密度脂蛋白甘油三酯(OR,1.55[95%CI,1.43-1.69]),和载脂蛋白B(OR,1.49[95%CI,1.37-1.62])。所有这些关联在种族群体和其他按年龄定义的亚组之间是显著和一致的,性别,吸烟,肥胖,和代谢健康状况,包括常规测量的脂质水平正常的个体。
结论:我们的研究强调了几种脂蛋白生物标志物,包括载脂蛋白B/载脂蛋白A1比率,载脂蛋白B,和低密度脂蛋白甘油三酯,与冠心病事件密切相关。我们的结果表明,全面的脂蛋白测量可以补充标准脂质面板,以告知不同人群的CHD风险。
BACKGROUND: Comprehensive blood lipoprotein profiles and their association with incident coronary heart disease (CHD) among racially and geographically diverse populations remain understudied.
RESULTS: We conducted nested case-control studies of CHD among 3438 individuals (1719 pairs), including 1084 White Americans (542 pairs), 1244 Black Americans (622 pairs), and 1110 Chinese adults (555 pairs). We examined 36 plasma lipids, lipoproteins, and apolipoproteins, measured by nuclear magnetic resonance spectroscopy, with incident CHD among all participants and subgroups by demographics, lifestyle, and metabolic health status using conditional or unconditional logistic regression adjusted for potential confounders. Conventionally measured blood lipids, that is, total cholesterol, triglycerides, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol, were each associated with incident CHD, with odds ratios (ORs) being 1.33, 1.32, 1.24, and 0.79 per 1-SD increase among all participants. Seventeen lipoprotein biomarkers showed numerically stronger associations than conventional lipids, with ORs per 1-SD among all participants ranging from 1.35 to 1.57 and a negative OR of 0.78 (all false discovery rate <0.05), including apolipoprotein B100 to apolipoprotein A1 ratio (OR, 1.57 [95% CI, 1.45-1.7]), low-density lipoprotein-triglycerides (OR, 1.55 [95% CI, 1.43-1.69]), and apolipoprotein B (OR, 1.49 [95% CI, 1.37-1.62]). All these associations were significant and consistent across racial groups and other subgroups defined by age, sex, smoking, obesity, and metabolic health status, including individuals with normal levels of conventionally measured lipids.
CONCLUSIONS: Our study highlighted several lipoprotein biomarkers, including apolipoprotein B/ apolipoprotein A1 ratio, apolipoprotein B, and low-density lipoprotein-triglycerides, strongly and consistently associated with incident CHD. Our results suggest that comprehensive lipoprotein measures may complement the standard lipid panel to inform CHD risk among diverse populations.