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Circulation:降血脂和心血管事件风险的相关性

2019-10-23 QQY MedSci原创

在研究降低甘油三酯的随机试验中,心血管事件并不是一直随之减少。研究人员对三种降脂疗法进行系统回顾和试验级的荟萃回归分析,这三种降脂疗法降低甘油三酯的作用比降低密度胆固醇(LDL-C)的更大:贝特类、烟酸类和ω-3脂肪酸。主要的评估指标是与脂质参数绝对降低相关的大血管事件风险比(RR)。本研究纳入了24个非他汀类药物治疗试验的197 270位受试者(25 218例大血管事件)和25个他汀类药物治疗试

在研究降低甘油三酯的随机试验中,心血管事件并不是一直随之减少。

研究人员对三种降脂疗法进行系统回顾和试验级的荟萃回归分析,这三种降脂疗法降低甘油三酯的作用比降低密度胆固醇(LDL-C)的更大:贝特类、烟酸类和ω-3脂肪酸。主要的评估指标是与脂质参数绝对降低相关的大血管事件风险比(RR)。

本研究纳入了24个非他汀类药物治疗试验的197 270位受试者(25 218例大血管事件)和25个他汀类药物治疗试验的177 088位受试者(20 962例大血管事件),共374?358位受试者,46 180例大血管事件。首先是非高密度脂蛋白胆固醇,它是极低密度脂蛋白和低密度脂蛋白的替代物,非高密度脂蛋白每降低1-mmol/L的RR为0.79(95% CI 0.76-0.82;P<0.0001;0.78每40mg/dL)。在包含LDL-C和甘油三酯的多变量meta回归模型中,

LDL-C和甘油三酯每降低1-mmol/L的RR分别是0.80和0.84(0.79每40mg/dL和0.92每40mg/dL)。剔除一个显著离群和强影响的试验(REDUCE-IT)后,

LDL-C和甘油三酯每降低1-mmol/L的RR分别变成0.79和0.91(0.78每40mg/dL和0.96每40mg/dL)。至于ω-3脂肪酸的剂量,二十碳五烯酸 1g/d,可降低7%的大血管事件的相对风险(RR 0.93),但二十二碳六烯酸的剂量与大血管事件的相对风险降低无显著相关性。

在随机对照试验中,甘油三酯降低与大血管事件风险降低相关,即使经LDL-C降低校正后,虽然效果较LDL-C的弱一些。此外,ω-3脂肪酸,特别是大剂量的二十碳五烯酸,不仅仅可降低血脂,还可降低大血管事件风险。

原始出处:

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1992998, encodeId=4dfc19929981a, content=<a href='/topic/show?id=29c598209ca' target=_blank style='color:#2F92EE;'>#降血脂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98209, encryptionId=29c598209ca, topicName=降血脂)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIW7uIr5ebYvJohUq0dkkVV05uF9jPpeyCrlcx904mUdMI9UKqpO3bt4GkgYBNdv485qT2NsVE27w/132, createdBy=023c2500122, createdName=ms8543593053280928, createdTime=Wed Jul 01 02:38:00 CST 2020, time=2020-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643656, encodeId=a7a616436561a, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Wed Sep 16 03:38:00 CST 2020, time=2020-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837741, encodeId=9e1b183e741e8, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Sun Mar 08 13:38:00 CST 2020, time=2020-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287684, encodeId=7dfd128e684ea, content=<a href='/topic/show?id=3c3d51e4459' target=_blank style='color:#2F92EE;'>#心血管事件风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51744, encryptionId=3c3d51e4459, topicName=心血管事件风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Fri Oct 25 13:38:00 CST 2019, time=2019-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374410, encodeId=925a3e441088, content=写的真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/10/21/e031c1d6c6115cbe1737b2149e602c1d.jpg, createdBy=3c105212218, createdName=147612bem32暂无昵称, createdTime=Fri Oct 25 11:51:39 CST 2019, time=2019-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374314, encodeId=95e33e4314d8, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Oct 24 00:20:27 CST 2019, time=2019-10-24, status=1, ipAttribution=)]
    2019-10-25 147612bem32暂无昵称

    写的真好

    0

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    2019-10-24 飛歌

    学习了很有用不错

    0

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