无症状人群中血清脂蛋白a与冠状动脉钙化相关性的研究

Correlation between serum lipoprotein(a)and coronary calcification in asymptomatic population

目的:探究在无任何症状人群中血清脂蛋白a[LP(a)]与冠状动脉钙化的关系。方法:纳入首都医科大学附属北京安贞医院健康体检中心,就诊的无任何症状个体,患者行冠状动脉CTA检查,收集影响患者钙化的各项生化检查(包括LP(a)),同时收集患者钙化积分情况,依据钙化和LP(a)水平将患者进行分组,并用Logistic回归分析LP(a)和冠状动脉钙化的关系。结果:共纳入412例患者,其中钙化患者150例,无钙化患者262例,钙化患者在年龄、男性比例、Scr、UA、BMI、FGB、吸烟比例、高血压、糖尿病、脂蛋白a方面高于无钙化患者,在HDL-C、eGFR方面低于无钙化组。调整上述危险因素后发现LP(a)水平升高与冠状动脉钙化相关,随着LP(a)升高,OR值和95%CI依次为[2.322(1.144〜4.715),P<0.05;3.690(1.811〜7.519),P<0.05;4.191(2.039〜8.617),P<0.05]。结论:LP(a)水平和冠状动脉钙化风险以及钙化程度相关,LP(a)的升高可能意味着更高的心血管疾病发生风险。

Objective:To investigate the relationship between serum lipoprotein(a)[LP(a)]and coronary calcification in asymptomatic population.Methods:Asymptomatic individuals in Beijing Anzhen Hos-pital,Capital Medical University were enrolled in this study.Each patient had a test of coronary artery computed tomography.All biochemical examinations(including lipoprotein A)affecting the calcification of the patients were collected,and the calcification scores of the patients were collected.The patients were divided into groups according to the calcification and lipoprotein A levels,and the relationship between lipoprotein A and coronary calcification was analyzed by logistic regression.Results:We included 412 patients with 150 cases patients with calcification,262 cases of patients with no calcification.The patients who had coronary artery calcification are higher in age,male,creatinine,uric acid level,BMI,FGB smoking,high blood pressure,diabetes and lipo-protein(a),lower in HDL-C and eGFR than those without calcification.By adjusting for the above risk factors,it was found that increased LP(a)level was associated with coronary calcification,and the OR value and 95%CI were separately 2.322(1.144-4.715),P<0.05;3.690(1.811-7.519),P<0.05;4.191(2.039-8.617),P<0.05,with the increase of Lp(a).Conclusions:LP(a)levels are associated with the risk and degree of coronary artery calcification,and an increase in LP(a)may indicate a higher risk of cardiovascular disease.