高密度脂蛋白亚型与心脑血管病发生风险相关性的Meta分析

Meta-analysis of the correlation between high-density lipoprotein subfractions and the risk of cardio-cerebrovascular diseases

目的系统评价高密度脂蛋白(HDL)亚型与心脑血管病发病风险的相关性。方法检索PubMed、Embase、Cochrane Library、中国期刊全文数据库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)从建库至2019年7月有关HDL亚型与心脑血管病关系的文献。严格按照纳入和排除标准筛选文献和提取资料。采用stata 12.0及Review Manager 5.3软件进行Meta分析。结果磁共振法分类的HDL颗粒(HDLp)[RR=0.82,95%CI(0.77,0.87),P<0.00001]及其亚型较HDL胆固醇(HDL-C)[RR=0.93,95%CI(0.87,1.00),P=0.05]能更好地反映与心脑血管病的相关性;对不同结局事件进行分析,HDL-C[RR=0.96,95%CI(0.91,1.01),P=0.16],HDLp[RR=0.97,95%CI(0.82,1.15),P=0.74]及其亚型与脑卒中无明显相关性。超速离心法所分类的HDL2[RR=0.95,95%CI(0.87,1.04),P=0.27]及HDL3[RR=0.89,95%CI(0.79,1.01),P=0.06]与冠心病发生风险无明显相关性。结论磁共振法所分得HDLp及其亚型较HDL-C能更好地反映冠心病发生风险,HDL-C、HDLp及HDLp亚型均与脑卒中无明显相关性。超速离心法分类的HDL亚型不能很好地反映冠心病发生风险。

Objective To systematically evaluate the correlation between high-density lipoprotein(HDL)subfractions and the risk of cardio-cerebrovascular diseases.Methods The literatures related to the relationship between HDL subfractions and cardio-cerebrovascular diseases published on PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Database and Chinese Biomedical Literature Database(CBM)from the establishment of the database to July 2019 were searched.The inclusion and exclusion criteria were strictly followed.The stata 12.0 and Review Manager 5.3 software were used for Meta-analysis.Results HDL particle(HDLp)(RR=0.82,95%CI[0.77,0.87],P<0.00001)and its subfractions defined by nuclear magnetic resonance were shown superior correlation with cardio-cerebrovascular disease to HDL cholesterol(HDL-C)(RR=0.93,95%CI[0.87,1.00],P=0.05).Within each individual ending events,HDL-C(RR=0.96,95%CI[0.91,1.01],P=0.16),HDLp(RR=0.97,95%CI[0.82,1.15],P=0.74)and its subfractions showed no correlation with the incidence of stroke.No correlation was observed between coronary artery disease and HDL2(RR=0.95,95%CI[0.87,1.04],P=0.27)or HDL3(RR=0.89,95%CI[0.79,1.01],P=0.06)defined by ultracentrifugation.Conclusion HDLp and its subfractions defined by nuclear magnetic resonance are better indicators for risk of coronary artery diseases than HDL-C.There are no associations between HDL-C,HDLp and HDLp subfractions and stroke.HDL subfractions defined by ultracentrifugation are not good predictors of the risk of coronary artery diseases.