极低脂蛋白(a)水平与新发糖尿病和非酒精性肝病风险的关系

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE Atherosclerosis plus Pub Date : 2024-07-11 DOI:10.1016/j.athplu.2024.07.001
Ming Wai Yeung , M. Abdullah Said , Yordi J. van de Vegte , Niek Verweij , Robin P.F. Dullaart , Pim van der Harst
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引用次数: 0

摘要

背景和目的我们的目的是在英国生物库这一大型前瞻性人群队列中研究血清脂蛋白(a)[Lp(a)]浓度极低与他汀类药物使用情况下新发 2 型糖尿病(T2D)和非酒精性肝病(NAFLD)的关系。方法我们利用扩展的生物标志物数据集,从总共 451,479 名参与者中识别出了 47,362 名脂蛋白(a)浓度极低(3.8 nmol/L)的参与者。中位随访时间为 12.3 年,我们采用 Cox 比例危险模型评估了按他汀类药物使用情况分层的参与者中新发心脏代谢疾病的风险。结果以脂蛋白(a)在可报告范围内的参与者为参照组,脂蛋白(a)极低(<3.8 nmol/L)的参与者患 T2D 的危险比(HR)为 1.07(95 % 置信区间,CI 1.01-1.13),患非酒精性脂肪肝的危险比(HR)为 1.30(95 % 置信区间,CI 1.20-1.41)。使用他汀类药物的参与者新发 T2D 的风险更高(调整后 HR 1.15;95 % CI 1.05-1.27)。在按他汀类药物使用情况进行的分层分析中,新发非酒精性脂肪肝的风险估计值相当。结论在英国生物库的前瞻性分析中,超低脂蛋白(a)与较高的T2D和NAFLD风险相关。与 T2D 的关系受降脂药物使用情况的影响。磁共振分析不支持这些反向关联的因果关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Associations of very low Lipoprotein(a) levels with risks of new-onset diabetes and non-alcoholic liver disease

Background and aims

We aimed to study the association of very low serum Lipoprotein(a) [Lp(a)] concentrations with new-onset type 2 diabetes (T2D) and non-alcoholic liver disease (NAFLD) in the context of statin usage in the UK Biobank, a large prospective population cohort.

Methods

Using an extended biomarker dataset, we identified 47,362 participants with very low Lp(a) concentrations (<3.8 nmol/L) from a total of 451,479 participants. With a median follow-up of 12.3 years, we assessed the risk of new-onset cardiometabolic diseases in participants stratified by statin usage with Cox proportional hazards models. We performed two-sample Mendelian randomization MR analyses to test causal relationship between genetically predicted Lp(a) and T2D and NAFLD.

Results

Taking the participants with Lp(a) within reportable range as the reference group, the hazard ratios (HR) for T2D were 1.07 (95 % confidence interval, CI 1.01–1.13) and for NAFLD 1.30 (95 % CI 1.20–1.41) respectively for participants with very low Lp(a) (<3.8 nmol/L). The risk for new-onset T2D was higher in participants using statins (adjusted HR 1.15; 95 % CI 1.05–1.27). The risk estimates for new-onset NAFLD were comparable in the analysis stratified by statin use. There was no evidence for causal links between genetically predicted Lp(a) and T2D nor NAFLD in two-sample MR analyses.

Conclusions

Very low Lp(a) was associated with higher risks of T2D and NAFLD in a prospective analysis of the UK Biobank. The association with T2D was influenced by lipid lowering medication usage. MR analyses did not support causality for these inverse associations.

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来源期刊
Atherosclerosis plus
Atherosclerosis plus Cardiology and Cardiovascular Medicine
CiteScore
2.60
自引率
0.00%
发文量
0
审稿时长
66 days
期刊最新文献
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