载脂蛋白A1和低密度脂蛋白及同型半胱氨酸水平与世居高原藏族青年发生冠心病的关系

Relationship between apolipoprotein A1,low-density lipoprotein,homocysteine levels and coronary atherosclerotic heart disease in young Tibetans living on the plateau for generations

目的探讨血清载脂蛋白A1、低密度脂蛋白(LDL)、同型半胱氨酸(Hcy)水平与世居高原藏族青年发生冠心病(冠状动脉粥样硬化性心脏病)的相关性。方法选取2018年4月至2020年4月于青海省心脑血管病专科医院经冠状动脉造影确诊的80例世居高原藏族青年冠心病患者为观察组,另选取同期于本院体检健康经冠状动脉造影检查结果阴性的80例世居高原藏族青年作为对照组。比较2组一般资料及血清载脂蛋白A1、LDL、Hcy水平。采用Logistic回归方法分析世居高原藏族青年发生冠心病的独立危险因素;采用受试者工作特征(ROC)曲线分析各因素对世居高原藏族青年发生冠心病的预测价值。结果 2组年龄、男性比例、高血压病、糖尿病、体重指数、吸烟史、饮酒史比较差异均无统计学意义(均P>0.05)。观察组载脂蛋白A1水平低于对照组,LDL和Hcy水平均高于对照组[(0.7±0.3) g/L比(1.5±0.6) g/L、(3.5±1.2) mmol/L比(3.0±0.8) mmol/L、(27.5±14.5)μmol/L比(9.4±1.6)μmol/L],差异均有统计学意义(均P <0.05)。Logistic回归分析结果显示,血清载脂蛋白A1、LDL、Hcy均为世居高原藏族青年发生冠心病的独立危险因素(均P=0.01);ROC曲线分析结果显示,血清载脂蛋白A1、LDL、Hcy联合预测世居高原藏族青年发生冠心病的曲线下面积高于三者单独检测。结论对于世居高原藏族青年,载脂蛋白A1偏低及LDL、Hcy偏高是发生冠心病的危险因素。

Objective To investigate the correlation between serum apolipoprotein A1(Apo A1),low-density lipoprotein(LDL),homocysteine(Hcy)levels and coronary atherosclerotic heart disease(CHD)in young Tibetans living on the plateau for generations.Methods From April 2018 to April 2020,80 young Tibetans living on the plateau for generations with CHD diagnosed by coronary artery angiography in Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital were selected as observation group,and other80 healthy young Tibetans living on the plateau for generations in the same period who underwent physical examination with negative result of coronary artery angiography in the hospital were selected as the control group.The general data and serum levels of Apo A1,LDL and Hcy were compared between the two groups.Logistic regression method was used to analyze independent risk factors of CHD in young Tibetans living on the plateau for generations.Receiver operating characteristic(ROC)curve was used to analyze the predicted value of factors in young Tibetans living on the plateau for generations.Results There were no significant differences in age,male rate,hypertension,diabetes mellitus,body mass index,somking history,and drinking history between the two groups(all P>0.05).The serum level of Apo A1 in observation group was lower than that in control group,and LDL and Hcy levels in observation group were higher than those in control group[(0.7±0.3)g/L vs(1.5±0.6)g/L,(3.5±1.2)mmol/L vs(3.0±0.8)mmol/L,(27.5±14.5)μmol/L vs(9.4±1.6)μmol/L](all P<0.05).Logistic regression analysis showed that serum Apo A1,LDL and Hcy were independent risk factors for CHD in young Tibetans living on the plateau for generations(all P=0.01).ROC curve analysis showed that the area under the curve of serum Apo A1,LDL and Hcy combined detection were higher than those of the three indexes detection alone.Conclusion For young Tibetan living on the plateau for generations,low Apo A1 and high LDL and Hcy levels are risk factors for CHD.