富含甘油三酯的脂蛋白中的胆固醇对心血管疾病及全因死亡的影响  

Impact of Triglyceride-rich Lipoprotein-cholesterol on Cardiovascular Disease and All-cause Mortality

作　　者：李旭阳 杨爽 郭子墨 王桂萍 于佳新[1] 李金峰[3] 阮春雨[3] 吴寿岭[3] 刘晓堃[1] LI Xuyang;YANG Shuang;GUO Zimo;WANG Guiping;YU Jiaxin;LI Jinfeng;RUAN Chunyu;WU Shouling;LIU Xiaokun(Department of Cardiology,Tangshan Workers’Hospital,Tangshan(063000),Hebei,China)

机构地区：[1]唐山市工人医院心内科,河北省063000 [2]华北理工大学研究生学院 [3]开滦总医院心内科

出　　处：《中国循环杂志》2022年第9期920-927,共8页Chinese Circulation Journal

摘　　要：目的:探究富含甘油三酯的脂蛋白中的胆固醇(TRL-C)对心血管疾病(CVD)及全因死亡的影响。方法:本研究采用前瞻性队列研究方法,选取在2006年度完成开滦研究健康体检的101510例参与者为观察对象,依据TRL-C水平四分位数分为TRL-C1组、TRL-C2组、TRL-C3组和TRL-C4组。计算四组中CVD累积发病率和累积全因死亡率,并采用多因素Cox回归模型分析TRL-C对CVD及全因死亡风险的影响。结果:最终纳入统计分析者94110例,TRL-C1组~TRL-C4组分别有23547例、23508例、23546例和23509例。CVD中位随访时间为12.99(12.60,13.18)年,TRL-C1组~TRL-C4组的CVD累积发病率分别为6.08%、7.74%、9.04%、10.63%。全因死亡中位随访时间为13.02(12.70,13.20)年,累积全因死亡率分别为10.80%、11.78%、11.95%、11.71%。校正多因素Cox回归分析结果显示:与TRL-C1组相比,TRL-C2组~TRL-C4组发生CVD的HR(95%CI)分别为1.12(1.04~1.21)、1.22(1.14~1.32)、1.35(1.25~1.45),全因死亡的HR(95%CI)分别为1.02(0.97~1.08)、1.02(0.96~1.08)、1.06(1.00~1.13);心肌梗死的HR(95%CI)分别为1.22(1.03~1.46)、1.55(1.31~1.83)、1.99(1.69~2.35);脑卒中的HR(95%CI)分别为1.09(1.01~1.19)、1.14(1.05~1.24)、1.20(1.11~1.31)。当以缺血性脑卒中为结局事件时,结果与以上结果类似,但以出血性脑卒中为结局事件时,并未发现以上关联。结论:高TRL-C与CVD及全因死亡风险增加有关,而且在CVD中这种风险主要见于心肌梗死和缺血性脑卒中。Objectives:To explore the impact of triglyceride-rich lipoprotein cholesterol(TRL-C)on cardiovascular disease(CVD)and all-cause death.Methods:In this prospective cohort study,101510 participants who completed health checkup of the Kailuan study in 2006 were selected and grouped according to TRL-C quartiles:TRL-C1 group,TRL-C2 group,TRL-C3 group and TRL-C4group.The cumulative incidence of CVD and cumulative all-cause mortality in the four groups were calculated,and the impact of TRL-C on the risk of CVD and all-cause mortality was analyzed using a multivariate Cox regression model.Results:A total of 94110 participants were finally included in the statistical analysis,with 23547,23508,23546,and 23509 cases in the TRL-C1 group to TRL-C4 group,respectively.The median follow-up time for CVD was 12.99(12.60,13.18)years,and the cumulative incidence of CVD in the TRL-C1 group to TRL-C4 group was 6.08%,7.74%,9.04%,and 10.63%,respectively.The median follow-up time for all-cause mortality was 13.02(12.70,13.20)years,and the cumulative all-cause mortality rates were 10.80%,11.78%,11.95%,and 11.71%,respectively.The results of the adjusted multivariate Cox regression model analysis showed that compared with the TRL-C1 group,the HR(95%CI)for the occurrence of CVD in the TRL-C2 group to TRL-C4 group was 1.12(1.04-1.21),1.22(1.14-1.32),and 1.35(1.25-1.45),respectively,and the HR(95%CI)for all-cause mortality was 1.02(0.97-1.08),1.02(0.96-1.08),and 1.06(1.00-1.13),respectively;HR(95%CI)for myocardial infarction was 1.22(1.03-1.46),1.55(1.31-1.83),and 1.99(1.69-2.35),respectively;HR(95%CI)for stroke was 1.09(1.01-1.19),1.14(1.05-1.24),and 1.20(1.11-1.31),respectively.The results were similar to the above results when ischemic stroke was used as the outcome event,but the above association was not found when hemorrhagic stroke was used as the outcome event.Conclusions:High TRL-C is associated with an increased risk of CVD,and all-cause death,and the increased risk is mainly related to myocardial infarction and ischemic stroke in term

关 键 词：富含甘油三酯的脂蛋白中的胆固醇 心血管疾病 全因死亡 前瞻性队列研究 

分 类 号：R54[医药卫生—心血管疾病]