摘要
目的:探讨非高密度脂蛋白胆固醇(non-HDL-C)水平对绝经后女性心血管疾病(CVD)的影响。方法:采用前瞻性队列研究方法,选取2006~2018年参加开滦集团职工健康体检中总胆固醇、高密度脂蛋白胆固醇资料完整且无CVD病史的8893例已绝经女性为研究对象,以发生CVD、死亡或2021年12月31日随访结束为随访终点。根据《中国血脂管理指南(2023年)》,将研究对象分为non-HDL-C<4.1 mmol/L组(n=6079)、4.1 mmol/L≤non-HDL-C<4.9 mmol/L组(n=1824)和non-HDL-C≥4.9 mmol/L组(n=990)。用Kaplan-Meier法计算不同non-HDL-C水平分组的CVD累积发病率,并以log-rank进行检验。采用多因素Cox回归模型分析不同non-HDL-C水平对CVD的影响。结果:平均随访(10.78±4.48)年期间,non-HDL-C<4.1 mmol/L组、4.1 mmol/L≤non-HDL-C<4.9 mmol/L组和non-HDL-C≥4.9 mmol/L组的CVD累积发病率分别为1.82%、3.24%、2.89%,Kaplan-Meier生存曲线分析显示,三组累积发病率差异有统计学意义(log-rank P<0.0001)。Cox回归分析结果显示,校正年龄、性别等混杂因素后,与non-HDL-C<4.1 mmol/L组相比,4.1 mmol/L≤non-HDL-C<4.9 mmol/L组与non-HDL-C≥4.9 mmol/L组发生CVD的HR(95%CI)值分别为1.40(1.13~1.74)、1.35(1.03~1.78)。结论:高non-HDL-C水平是绝经后女性发生CVD的独立危险因素。
Objectives:To investigate the impact of baseline non-high-density lipoprotein cholesterol(non-HDL-C)levels on new-onset cardiovascular disease(CVD)in postmenopausal women.Methods:This prospective cohort study selected 8893 postmenopausal women who participated from 2006 to 2018 employee health examination of Kailuan Group and had complete total cholesterol(TC)and HDL-C data and no history of CVD.Participants were followed up to 31 December,2021.The primary endpoint was the occurrence of CVD or death.According to the Chinese Lipid Management Guidelines(2023),the participants were divided into non-HDL-C<4.1 mmol/L group(n=6079),4.1 mmol/L≤non-HDL-C<4.9 mmol/L group(n=1824)and non-HDL-C≥4.9 mmol/L group(n=990).The cumulative incidence of CVD in different groups of non-HDL-C levels was calculated using the Kaplan-Meier method and tested by log-rank analysis.Multivariate Cox regression model was used to analyze the effects of different non-HDL-C levels on CVD.Results:The mean follow-up time was(10.78±4.48)years,the cumulative incidence of CVD in different non-HDL-C level groups was 1.82%,3.24%and 2.89%,respectively.Kaplan-Meier survival curve showed a statistically significant difference in cumulative incidence among the three groups(log-rank P<0.0001).The results of Cox regression analysis showed that after adjusting for confounding factors such as age and sex,the HR(95%CI)values for CVD in the 4.1≤non-HDL-C<4.9 mmol/L group and the non-HDL-C≥4.9 mmol/L group were 1.40(1.13-1.74)and 1.35(1.03-1.78),respectively.Conclusions:High non-HDL-C levels are an independent risk factor for new-onset CVD in postmenopausal women.
作者
张丽沙
吴寿岭
邵郅强
郭佳
王健
许文奇
郭路
李文娟
陈朔华
高义军
ZHANG Lisha;WU Shouling;SHAO Zhiqiang;GUO Jia;WANG Jian;XU Wenqi;GUO Lu;LI Wenjuan;CHEN Shuohua;GAO Yijun(Department of Gynecology and Obstetrics,Kailuan General Hospital,Tangshan 063000,China;Graduate School,North China University of Science and Technology,Tangshan 063210,China;Laboratory of Cardiology,Kailuan General Hospital,Tangshan 063000,China;School of Public Health,North China University of Science and Technology,Tangshan 063210,China)
出处
《中国循环杂志》
CSCD
北大核心
2024年第1期61-67,共7页
Chinese Circulation Journal
