小而密低密度脂蛋白胆固醇与颈动脉斑块面积的相关性分析

The Correlation Between Small and Dense Low-density LipoproteinCholesterol and Carotid Plaque Area

目的 探讨小而密低密度脂蛋白胆固醇(small dense low-density lipoprotein cholesterol, sdLDL-C)与颈动脉斑块(carotid artery plaque, CAP)的关系。方法 收集2016年至2017年数据库的体检人群1 345例,根据颈动脉超声结果分为两组:颈动脉内膜中层厚度(CIMT≤1.5mm)正常组1 089例(男性586例,女性503例);颈动脉内膜中层厚度(CIMT≥1.5mm)斑块组256例(男性191例,女性65例)。采用多元线性回归,Logistic回归和限制性立方样条回归模型评估sdLDL-C与颈动脉斑块的关系。结果 随着sdLDL-C的增加,颈动脉最大斑块横截面积也逐渐增大;二元Logistic回归分析,sdLDL-C以最低四分位数为参照,最高四分位数经多变量调整后患颈动脉斑块的OR=2.112(95%CI 1.056~4.224)。限制性立方样条回归显示,sdLDL-C与颈动脉斑块呈线性相关(P<0.001)。此外,在正常LDL-C(low-density lipoprotein cholesterol, LDL-C)水平的亚样本人群中(n=987),sdLDL-C与颈动脉斑块相关性仍然显著。结论 在总体检人群中,sdLDL-C水平升高与颈动脉斑块呈正相关,并且在总体检人群中选取LDL-C≤3.10mmol/L的样本为亚临床样本,在亚临床样本中sdLDL-C与颈动脉斑块的关系依旧相关。sdLDL-C作为非传统血脂指标对颈动脉斑块有较好的预测能力。

Objective To explore the small dense low-density lipoprotein cholesterol and its relationship with carotid artery plaque.Methods A total of 1345 patients from 2016 to 2017 were collected and divided into two groups according to the results of carotid artery ultrasound:1089 patients(586 males,503 females)with normal carotid intima-media thickness(CIMT≤1.5mm),and 256 patients with carotid intima-media thickness(CIMT≥1.5mm)plaques(191 males,65 females).Multiple linear regression,logistic regression and restricted cubic spline regression models were used to evaluate the relationship between sdLDL-C and carotid plaque.Results The maximum carotid plaque cross-sectional area increased with the increase of sdLDL-C.With binary logistic regression analysis method,the lowest quartile of sdLDL-C was used as reference,and the multivariate adjusted OR of carotid plaque in the highest quartile was 2.112(95%CI 1.056-4.224).Restricted cubic spline regression showed that sdLDL-C was linearly associated with carotid plaque(P<0.001).In addition,in the normal LDL-C population(n=987),sdLDL-C was significantly correlated with carotid plaques.Conclusion In the general population,the increase of sdLDL-C level is positively correlated with carotid plaque.When samples with LDL-C≤3.10mmol/L in the general population are selected as subclinical samples,the relationship between sdLDL-C and carotid plaque is still correlated in the subclinical samples.sdLDL-C,as a non-traditional lipid index,has a good potential to predict carotid plaque.