■脂蛋白(a)[Lp(a)]是动脉粥样硬化性心血管疾病(ASCVD)的因果危险因素。
■作者通过分类种族评估了Lp(a)测试和水平的差异,种族,ASCVD风险。
■这是2010年至2021年对来自加利福尼亚大型医疗保健系统的患者进行的回顾性队列研究。符合条件的个人年龄≥18岁,≥2次初级保健就诊,以及接受Lp(a)测试的完整种族和种族数据。种族和种族自我报告并分类如下:非西班牙裔(NH)白人,NH-Black,西班牙裔(墨西哥人,波多黎各人,其他),NH-亚洲人(亚洲印第安人,中文,菲律宾人,日本人,韩语,越南人,其他)。Logistic回归模型测试了Lp(a)升高(≥50mg/dL)与种族之间的关联,种族,ASCVD风险。
■13,689人(0.9%)接受Lp(a)测试,平均年龄54.6±13.8岁,49%是女性,28.8%NH亚洲。超过三分之一的受测者Lp(a)水平≥50mg/dL,范围从30.7%的墨西哥患者到62.6%的NH-Black患者。接受测试的人的ASCVD风险因种族而异:73.6%的亚裔印度人10年风险<5%,而27.2%的NH-Black建立了ASCVD。Lp(a)患病率≥50mg/dL在整个ASCVD风险谱中增加。调整后,西班牙裔(OR:0.76[95%CI:0.66-0.88])和亚洲裔(OR:0.88[95%CI:0.81-0.96])的Lp(a)≥50mg/dL的几率较低,而黑人个体的几率更高(OR:2.46[95%CI:1.97-3.07])。
■不经常进行Lp(a)测试。在那些测试中,Lp(a)水平经常升高,并且在分类的种族和种族群体中差异显着。Lp(a)升高的患病率随着ASCVD风险的增加而增加,因种族和民族而异。
UNASSIGNED: Lipoprotein(a) [Lp(a)] is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD).
UNASSIGNED: The authors assessed differences in Lp(a)
testing and levels by disaggregated race, ethnicity, and ASCVD risk.
UNASSIGNED: This was a retrospective cohort study of patients from a large California health care system from 2010 to 2021. Eligible individuals were ≥18 years old, with ≥2 primary care visits, and complete race and ethnicity data who underwent Lp(a)
testing. Race and ethnicity were self-reported and categorized as follows: non-Hispanic (NH) White, NH-Black, Hispanic (Mexican, Puerto Rican, other), NH-Asian (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, other). Logistic regression models tested associations between elevated Lp(a) (≥50 mg/dL) and race, ethnicity, and ASCVD risk.
UNASSIGNED: 13,689 (0.9%) individuals underwent Lp(a)
testing with a mean age of 54.6 ± 13.8 years, 49% female, 28.8% NH Asian. Over one-third of those tested had Lp(a) levels ≥50 mg/dL, ranging from 30.7% of Mexican patients to 62.6% of NH-Black patients. The ASCVD risk of those tested varied by race: 73.6% of Asian Indian individuals had <5% 10-year risk, whereas 27.2% of NH-Black had established ASCVD. Lp(a) prevalence ≥50 mg/dL increased across the ASCVD risk spectrum. After adjustment, Hispanic (OR: 0.76 [95% CI: 0.66-0.88]) and Asian (OR: 0.88 [95% CI: 0.81-0.96]) had lower odds of Lp(a) ≥50 mg/dL, whereas Black individuals had higher odds (OR: 2.46 [95% CI: 1.97-3.07]).
UNASSIGNED: Lp(a)
testing is performed infrequently. Of those tested, Lp(a) levels were frequently elevated and differed significantly across disaggregated race and ethnicity groups. The prevalence of elevated Lp(a) increased with increasing ASCVD risk, with significant variation by race and ethnicity.