残余胆固醇与更年期妇女颈动脉粥样硬化的相关性研究

Correlation between Residual Cholesterol and Carotid Atherosclerosis in Menopausal Women

背景颈动脉粥样硬化(CAS)作为全身动脉硬粥样化前期表现的重要指标,已有研究证明残余胆固醇(RC)水平升高与CAS的发病机制密切相关,然而,关于RC与更年期妇女CAS发病的相关性研究较少。目的探讨RC与更年期妇女CAS发病的相关性。方法选取2020年1月—2023年10月参加国家脑卒中高危人群筛查项目并完善颈动脉超声检查的定西市安定区凤翔镇的更年期妇女307例作为研究对象。收集人群的一般资料,并利用彩色多普勒超声分析参与者的颈动脉内膜特征。根据颈部超声结果结果将受试者分为CAS组和非CAS组,采用Spearman秩相关分析探究RC与CAS发病的其他危险因素的相关性,采用多因素Logistic回归分析探究RC是否为更年期妇女发生CAS的影响因素。结果CAS组(n=130)更年期妇女年龄、脑卒中和短暂性脑缺血发作(TIA)史比例、空腹血糖(FPG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、RC、脉压水平高于非CAS组(n=177)(P<0.05)。Spearman秩相关分析结果显示,RC与FPG、TC呈正相关(r_(s)=0.113、0.280,P<0.05);与LDL-C呈负相关(r_(s)=-0.112,P<0.05)。多因素Logistic回归分析结果显示,高RC水平(OR=1.539,95%CI=1.185~1.999,P=0.001)、高龄(OR=1.059,95%CI=1.003~1.117,P=0.038)、脑卒中和TIA史(OR=1.910,95%CI=1.047~3.485,P=0.035)是更年期妇女CAS发病的危险因素。根据RC中位数将更年期妇女分为高RC组(RC≥0.70 mmol/L,n=155)、低RC组(RC<0.70 mmol/L,n=152),高RC组更年期妇女患有血脂异常比例、CAS比例、腰围、BMI、TG比低RC组高,HDL-C比低RC组低(P<0.05)。结论高RC水平与更年期妇女发生CAS有关,且RC高水平可能是更年期妇女发生CAS的独立危险因素。

Background Carotid atherosclerosis(CAS)is a significant indicator of early systemic atherosclerosis.Previous studies have demonstrated a close relationship between elevated remnant cholesterol(RC) levels and the pathogenesis of CAS.However,limited information is available regarding the association between RC and the development of CAS in menopausal women.Objective To investigate the correlation between RC and the pathogenesis of CAS in menopausal women.Methods A total of 307 menopausal women from Fengxiang Town,Anding District,Dingxi City were selected as the research subjects.These women had participated in the national high-risk stroke screening project and completed carotid artery ultrasound examination between January 2020 and October 2023.General information on the ordinary people was collected and participants' characteristics of the carotid artery intima were analyzed by means of using color doppler ultrasound.Based on the cervical ultrasound results,the subjects were divided into CAS group and non-CAS group.Spearman rank correlation analysis was used to explore the correlation between RC and other risk factors for CAS.Furthermore,multifactor Logistic regression was employed to analyze and explore the correlation between RC and CAS in menopausal women.Results The findings revealed that participants in the CAS group(n=130) has higher levels than those in the non-CAS group(n=177) in terms of menopausal female age,history of stroke and transient ischemic attack(TIA),fasting plasma glucose(FPG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),RC and pulse pressure(P<0.05).Spearman rank correlation analysis indicated a positive correlation between RC and FPG as well as TC(r_s=0.113,0.280,P<0.05),while a negative correlation was observed with LDL-C(r_(s)=-0.112,P<0.05).Furthermore,multivariate logistic regression analysis identified high RC levels(OR=1.539,95%CI=1.185-1.999,P=0.001),age(OR=1.059,95%CI=1.003-1.117,P=0.038),and history of stroke and TIA(OR=1.910,95%CI=1.047-3.485,P=0.035) as risk factors for the onset of CAS in menopausal women.The menopausal women were further divided into high RC(RC ≥ 0.70 mmol/L,n=155) and low RC(RC<0.70 mmol/L,n=152) groups based on the median RC.The high RC group had a higher proportion of women with dyslipidemia,CAS,waist circumference,BMI,and TG compared to the low RC group(P<0.05).Additionally,the high RC group had lower levels of high density lipoprotein cholesterol(HDL-C)compared to the low RC group(P<0.05).Conclusion High RC levels are associated with CAS in menopausal women and may be an independent risk factor for CAS in menopausal women.