测量脂蛋白颗粒大小和数量对心血管风险预测的益处:一项系统综述和荟萃分析

IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Clinica e Investigacion en Arteriosclerosis Pub Date : 2023-07-01 DOI:10.1016/j.arteri.2022.11.001
Jose A. Quesada , Vicente Bertomeu-González , Domingo Orozco-Beltrán , Alberto Cordero , Vicente F. Gil-Guillén , Adriana López-Pineda , Rauf Nouni-García , Concepción Carratalá-Munuera
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引用次数: 1

摘要

心血管风险(CVR)通常通过测量高密度脂蛋白(HDL)和低密度脂蛋白的总胆固醇含量来计算。本系统综述的目的是评估通过核磁共振(NMR)光谱测定的与LDL和HDL颗粒大小和数量相关的CVR。材料和方法使用电子数据库MEDLINE和Scopus进行文献检索。2019年1月1日之前发表的所有符合以下纳入标准的队列和病例对照研究均被纳入:通过NMR光谱测量的HDL-P、LDL-P、HDL-Z和/或LDL-Z;心血管事件作为结果变量;以比值比或危险比表示的心血管事件风险;仅限成年患者。对每个暴露变量(低密度脂蛋白4个,高密度脂蛋白5个)和每个暴露测量(最高和最低四分位数和1个标准差增量)进行荟萃分析。结果本综述包括24项研究。LDL颗粒的数量与CVR直接相关:每增加一个标准差,风险就会增加28%。LDL颗粒大小与CVR呈反比且显著相关:每增加一个标准差,风险就会降低8%。小LDL颗粒数量每增加一个标准偏差,CVR就会增加12%。HD、颗粒数量和大小与CVR呈负相关。结论较大的颗粒大小提供了更大的保护,尽管研究之间的这种关系不一致。LDL颗粒数量越大,LDL颗粒尺寸越小,CVR越高。风险随着高密度脂蛋白颗粒数量和大小的增加而降低。
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The benefits of measuring the size and number of lipoprotein particles for cardiovascular risk prediction: A systematic review and meta-analysis

Objective

Cardiovascular risk (CVR) is conventionally calculated by measuring the total cholesterol content of high-density lipoproteins (HDL) and low-density lipoproteins (LDL). The purpose of this systematic review was to assess the CVR associated with LDL and HDL particle size and number as determined by nuclear magnetic resonance (NMR) spectroscopy.

Material and methods

A literature search was performed using the electronic databases MEDLINE and Scopus. All cohort and case–control studies published before January 1, 2019 that met the following inclusion criteria were included: HDL-P, LDL-P, HDL-Z and/or LDL-Z measured by NMR spectroscopy; cardiovascular event as an outcome variable; risk of cardiovascular events expressed as odds ratios or hazard ratios; only adult patients. A meta-analysis was performed for each exposure variable (4 for LDL and 5 for HDL) and for each exposure measure (highest versus lowest quartile and 1-standard deviation increment).

Results

This review included 24 studies. Number of LDL particles was directly associated with CVR: risk increased by 28% with each standard deviation increment. LDL particle size was inversely and significantly associated with CVR: each standard deviation increment corresponded to an 8% risk reduction. CVR increased by 12% with each standard deviation increase in number of small LDL particles. HD, particle number and size were inversely associated with CVR.

Conclusion

Larger particle size provided greater protection, although this relationship was inconsistent between studies. Larger number of LDL particles and smaller LDL particle size are associated with increased CVR. Risk decreases with increasing number and size of HDL particles.

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来源期刊
Clinica e Investigacion en Arteriosclerosis
Clinica e Investigacion en Arteriosclerosis PERIPHERAL VASCULAR DISEASE-
CiteScore
3.20
自引率
6.20%
发文量
44
审稿时长
40 days
期刊介绍: La publicación idónea para acceder tanto a los últimos originales de investigación como a formación médica continuada sobre la arteriosclerosis y su etiología, epidemiología, fisiopatología, diagnóstico y tratamiento. Además, es la publicación oficial de la Sociedad Española de Arteriosclerosis.
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