中国非动脉硬化性心血管疾病人群脂蛋白（a）水平分布特征及影响因素

Journal article

Objective
To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.

Methods
This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.

Results
Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M (Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) (OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced (OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity.

Conclusions
Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.

Authors: Ke, Y; Pan, L; Lyu, J; Sun, D; Pei, P

• Alternative title: Distribution and influencing factors of lipoprotein (a) levels in non-arteriosclerotic cardiovascular disease population in China
• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Zhonghua Yixuehui, Chinese Medical Association
• Journal: Zhonghua Liu Xing Bing Xue Za Zhi / Chinese Journal of Epidemiology
• Volume: 45
• Issue: 6
• Pages: 779-786
• Publication date: 2024-06-10
• Acceptance date: 2024-03-29
• DOI: 10.3760/cma.j.cn112338-20240105-00004
• ISSN: 0254-6450
• Pmid: 38889976
• Language: Chinese
• Keywords: lipoprotein (a); non-arteriosclerotic cardiovascular disease population; distribution; influencing factor