Association between Lipoprotein(a) Levels and Metabolic Syndrome in a Middle-aged and Elderly Chinese Cohort
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摘要
Objective The association between lipoprotein(a) [Lp(a)] levels and metabolic syndrome(MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between Lp(a) levels and MetS in a middle-aged and elderly Chinese cohort. Methods A cross-sectional study of 10,336 Chinese adults aged 40 years or older was conducted in Jiading District, Shanghai, China. Logistic regression analysis was used to evaluate the association between serum Lp(a) levels and MetS. Results In the overall population, 37.5% of participants had MetS. Compared with individuals in the lowest quartile of serum Lp(a) levels, those in the highest quartile had a lower prevalence of MetS(30.9% vs. 46.9%, P for trend < 0.0001). Multivariate logistic regression analyses showed that compared with participants in the bottom quartile of serum Lp(a) levels, those in the top quartile had decreased odds ratio(OR) for prevalent MetS [multivariate-adjusted OR 0.45(95% confidence interval 0.39-0.51); P < 0.0001]. Additionally, Lp(a) level was conversely associated with the risk of central obesity, high fasting glucose, high triglycerides, and low HDL cholesterol, but not with hypertension. Stratified analyses suggested that increasing levels of Lp(a) was associated with decreased risk of MetS in all the subgroups. Conclusion Serum Lp(a) level was inversely associated with the risk of prevalent MetS in a middle-aged and elderly Chinese cohort.
Objective The association between lipoprotein(a) [Lp(a)] levels and metabolic syndrome(MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between Lp(a) levels and MetS in a middle-aged and elderly Chinese cohort. Methods A cross-sectional study of 10,336 Chinese adults aged 40 years or older was conducted in Jiading District, Shanghai, China. Logistic regression analysis was used to evaluate the association between serum Lp(a) levels and MetS. Results In the overall population, 37.5% of participants had MetS. Compared with individuals in the lowest quartile of serum Lp(a) levels, those in the highest quartile had a lower prevalence of MetS(30.9% vs. 46.9%, P for trend < 0.0001). Multivariate logistic regression analyses showed that compared with participants in the bottom quartile of serum Lp(a) levels, those in the top quartile had decreased odds ratio(OR) for prevalent MetS [multivariate-adjusted OR 0.45(95% confidence interval 0.39-0.51); P < 0.0001]. Additionally, Lp(a) level was conversely associated with the risk of central obesity, high fasting glucose, high triglycerides, and low HDL cholesterol, but not with hypertension. Stratified analyses suggested that increasing levels of Lp(a) was associated with decreased risk of MetS in all the subgroups. Conclusion Serum Lp(a) level was inversely associated with the risk of prevalent MetS in a middle-aged and elderly Chinese cohort.
Objective The association between lipoprotein(a) [Lp(a)] levels and metabolic syndrome(MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between Lp(a) levels and MetS in a middle-aged and elderly Chinese cohort. Methods A cross-sectional study of 10,336 Chinese adults aged 40 years or older was conducted in Jiading District, Shanghai, China. Logistic regression analysis was used to evaluate the association between serum Lp(a) levels and MetS. Results In the overall population, 37.5% of participants had MetS. Compared with individuals in the lowest quartile of serum Lp(a) levels, those in the highest quartile had a lower prevalence of MetS(30.9% vs. 46.9%, P for trend < 0.0001). Multivariate logistic regression analyses showed that compared with participants in the bottom quartile of serum Lp(a) levels, those in the top quartile had decreased odds ratio(OR) for prevalent MetS [multivariate-adjusted OR 0.45(95% confidence interval 0.39-0.51); P < 0.0001]. Additionally, Lp(a) level was conversely associated with the risk of central obesity, high fasting glucose, high triglycerides, and low HDL cholesterol, but not with hypertension. Stratified analyses suggested that increasing levels of Lp(a) was associated with decreased risk of MetS in all the subgroups. Conclusion Serum Lp(a) level was inversely associated with the risk of prevalent MetS in a middle-aged and elderly Chinese cohort.
引文
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2.Koschinsky ML,Marcovina SM.Structure-function relationships in apolipoprotein(a):insights into lipoprotein(a)assembly and pathogenicity.Curr Opin Lipidol,2004;15,167-74.
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7.Galassi A,Reynolds K,He J.Metabolic syndrome and risk of cardiovascular disease:a meta-analysis.Am J Med,2006;119,812-9.
8.Lu J,Wang L,Li M,et al.Metabolic Syndrome Among Adults in China:The 2010 China Noncommunicable Disease Surveillance.J Clin Endocrinol Metab,2017;102,507-15.
9.Lerman RH,Minich DM,Darland G,et al.Subjects with elevated LDL cholesterol and metabolic syndrome benefit from supplementation with soy protein,phytosterols,hops rho iso-alpha acids,and Acacia nilotica proanthocyanidins.J Clin Lipidol,2010;4,59-68.
10.Bermudez V,Rojas J,Salazar J,et al.Variations of lipoprotein(a)levels in the metabolic syndrome:a report from the Maracaibo City Metabolic Syndrome Prevalence Study.J Diabetes Res,2013;2013,416451.
11.Onat A,Can G,Coban N,et al.Lipoprotein(a)level and MIFgene variant predict incident metabolic syndrome and mortality.J Investig Med,2016;64,392-9.
12.Vonbank A,Saely CH,Rein P,et al.Lipoprotein(a),the Metabolic Syndrome and Vascular Risk in Angiographied Coronary Patients.J Clin Endocrinol Metab,2016;101,3199-203.
13.Gentile M,Iannuzzo G,Mattiello A,et al.Association between Lp(a)and atherosclerosis in menopausal women without metabolic syndrome.Biomark Med,2016;10,397-402.
14.Sung KC,Wild SH,Byrne CD.Lipoprotein(a),metabolic syndrome and coronary calcium score in a large occupational cohort.Nutr Metab Cardiovasc Dis,2013;23,1239-46.
15.Bozbas H,Yildirir A,Pirat B,et al.Increased lipoprotein(a)in metabolic syndrome:is it a contributing factor to premature atherosclerosis?Anadolu Kardiyol Derg,2008;8,111-5.
16.Lu J,Zhang J,Du R,et al.Age at menarche is associated with the prevalence of non-alcoholic fatty liver disease later in life.JDiabetes,2017;9,53-60.
17.Chen Y,Lu J,Huang Y,et al.Association of previous schistosome infection with diabetes and metabolic syndrome:a cross-sectional study in rural China.J Clin Endocrinol Metab,2013;98,E283-7.
18.Goodyear MD,Krleza-Jeric K,Lemmens T.The Declaration of Helsinki.Bmj,2007;335,624-5.
19.Sun J,Zhang Y,Xu B,et al.Autonomic dysfunction assessed by EZSCAN and subclinical atherosclerosis.J Diabetes,2014;6,409-16.
20.Du R,Cheng D,Lin L,et al.Association between serum CA 19-9and metabolic syndrome:A cross-sectional study.J Diabetes,2017;9,1040-7.
21.Lee PH,Macfarlane DJ,Lam TH,et al.Validity of the International Physical Activity Questionnaire Short Form(IPAQ-SF):a systematic review.Int J Behav Nutr Phys Act,2011;8,115.
22.Executive Summary of The Third Report of The National Cholesterol Education Program(NCEP)Expert Panel on Detection,Evaluation,And Treatment of High Blood Cholesterol In Adults(Adult Treatment Panel III).JAMA,2001;285,2486-97.
23.Alberti KG,Zimmet P,Shaw J.The metabolic syndrome--a new worldwide definition.Lancet(London,England),2005;366,1059-62.
24.World Health Organization.Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia.Geneva:World Health Organization,2006.
25.Lu J,Bi Y,Wang T,et al.The relationship between insulin-sensitive obesity and cardiovascular diseases in a Chinese population:results of the REACTION study.Int JCardiol,2014;172,388-94.
26.Vaverkova H,Karasek D,Halenka M,et al.Inverse association of lipoprotein(a)with markers of insulin resistance in dyslipidemic subjects.Physiol Res,2017;66,S113-s20.
27.Rogowski O,Shapira I,Bassat OK,et al.Waist circumference as the predominant contributor to the micro-inflammatory response in the metabolic syndrome:a cross sectional study.JInflamm(Lond),2010;7,35.
28.Wang YI,Schulze J,Raymond N,et al.Endothelial inflammation correlates with subject triglycerides and waist size after a high-fat meal.Am J Physiol Heart Circ Physiol,2011;300,H784-91.
29.Ogbera AO,Azenabor AO.Lipoprotein(a),C-reactive protein and some metabolic cardiovascular risk factors in type 2diabetes.Diabetol metab syndr,2010;2,51.
30.Konerman M,Kulkarni K,Toth PP,et al.Evidence of dependence of lipoprotein(a)on triglyceride and high-density lipoprotein metabolism.J Clin Lipidol,2012;6,27-32.
31.Nordestgaard BG,Chapman MJ,Ray K,et al.Lipoprotein(a)as a cardiovascular risk factor:current status.Eur Heart J,2010;31,2844-53.
32.Kolovou GD,Anagnostopoulou KK,Cokkinos DV.Pathophysiology of dyslipidaemia in the metabolic syndrome.Postgrad Med J,2005;81,358-66.
33.Ginsberg HN,Zhang YL,Hernandez-Ono A.Metabolic syndrome:focus on dyslipidemia.Obesity(Silver Spring),2006;14,41s-9s.
34.Esteve E,Ricart W,Fernández-Real JM.Dyslipidemia and inflammation:an evolutionary conserved mechanism.Clin Nutr,2005;24,16-31.
2.Koschinsky ML,Marcovina SM.Structure-function relationships in apolipoprotein(a):insights into lipoprotein(a)assembly and pathogenicity.Curr Opin Lipidol,2004;15,167-74.
3.Marcovina SM,Koschinsky ML,Albers JJ,et al.Report of the National Heart,Lung,and Blood Institute Workshop on Lipoprotein(a)and Cardiovascular Disease:recent advances and future directions.Clin Chem,2003;49,1785-96.
4.Eckel RH,Cornier MA.Update on the NCEP ATP-III emerging cardiometabolic risk factors.BMC Med,2014;12,115.
5.Tadin-Strapps M,Robinson M,Le Voci L,et al.Development of lipoprotein(a)siRNAs for mechanism of action studies in non-human primate models of atherosclerosis.J Cardiovasc Transl Res,2015;8,44-53.
6.Ariyo AA,Thach C,Tracy R.Lp(a)lipoprotein,vascular disease,and mortality in the elderly.N Engl J Med,2003;349,2108-15.
7.Galassi A,Reynolds K,He J.Metabolic syndrome and risk of cardiovascular disease:a meta-analysis.Am J Med,2006;119,812-9.
8.Lu J,Wang L,Li M,et al.Metabolic Syndrome Among Adults in China:The 2010 China Noncommunicable Disease Surveillance.J Clin Endocrinol Metab,2017;102,507-15.
9.Lerman RH,Minich DM,Darland G,et al.Subjects with elevated LDL cholesterol and metabolic syndrome benefit from supplementation with soy protein,phytosterols,hops rho iso-alpha acids,and Acacia nilotica proanthocyanidins.J Clin Lipidol,2010;4,59-68.
10.Bermudez V,Rojas J,Salazar J,et al.Variations of lipoprotein(a)levels in the metabolic syndrome:a report from the Maracaibo City Metabolic Syndrome Prevalence Study.J Diabetes Res,2013;2013,416451.
11.Onat A,Can G,Coban N,et al.Lipoprotein(a)level and MIFgene variant predict incident metabolic syndrome and mortality.J Investig Med,2016;64,392-9.
12.Vonbank A,Saely CH,Rein P,et al.Lipoprotein(a),the Metabolic Syndrome and Vascular Risk in Angiographied Coronary Patients.J Clin Endocrinol Metab,2016;101,3199-203.
13.Gentile M,Iannuzzo G,Mattiello A,et al.Association between Lp(a)and atherosclerosis in menopausal women without metabolic syndrome.Biomark Med,2016;10,397-402.
14.Sung KC,Wild SH,Byrne CD.Lipoprotein(a),metabolic syndrome and coronary calcium score in a large occupational cohort.Nutr Metab Cardiovasc Dis,2013;23,1239-46.
15.Bozbas H,Yildirir A,Pirat B,et al.Increased lipoprotein(a)in metabolic syndrome:is it a contributing factor to premature atherosclerosis?Anadolu Kardiyol Derg,2008;8,111-5.
16.Lu J,Zhang J,Du R,et al.Age at menarche is associated with the prevalence of non-alcoholic fatty liver disease later in life.JDiabetes,2017;9,53-60.
17.Chen Y,Lu J,Huang Y,et al.Association of previous schistosome infection with diabetes and metabolic syndrome:a cross-sectional study in rural China.J Clin Endocrinol Metab,2013;98,E283-7.
18.Goodyear MD,Krleza-Jeric K,Lemmens T.The Declaration of Helsinki.Bmj,2007;335,624-5.
19.Sun J,Zhang Y,Xu B,et al.Autonomic dysfunction assessed by EZSCAN and subclinical atherosclerosis.J Diabetes,2014;6,409-16.
20.Du R,Cheng D,Lin L,et al.Association between serum CA 19-9and metabolic syndrome:A cross-sectional study.J Diabetes,2017;9,1040-7.
21.Lee PH,Macfarlane DJ,Lam TH,et al.Validity of the International Physical Activity Questionnaire Short Form(IPAQ-SF):a systematic review.Int J Behav Nutr Phys Act,2011;8,115.
22.Executive Summary of The Third Report of The National Cholesterol Education Program(NCEP)Expert Panel on Detection,Evaluation,And Treatment of High Blood Cholesterol In Adults(Adult Treatment Panel III).JAMA,2001;285,2486-97.
23.Alberti KG,Zimmet P,Shaw J.The metabolic syndrome--a new worldwide definition.Lancet(London,England),2005;366,1059-62.
24.World Health Organization.Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia.Geneva:World Health Organization,2006.
25.Lu J,Bi Y,Wang T,et al.The relationship between insulin-sensitive obesity and cardiovascular diseases in a Chinese population:results of the REACTION study.Int JCardiol,2014;172,388-94.
26.Vaverkova H,Karasek D,Halenka M,et al.Inverse association of lipoprotein(a)with markers of insulin resistance in dyslipidemic subjects.Physiol Res,2017;66,S113-s20.
27.Rogowski O,Shapira I,Bassat OK,et al.Waist circumference as the predominant contributor to the micro-inflammatory response in the metabolic syndrome:a cross sectional study.JInflamm(Lond),2010;7,35.
28.Wang YI,Schulze J,Raymond N,et al.Endothelial inflammation correlates with subject triglycerides and waist size after a high-fat meal.Am J Physiol Heart Circ Physiol,2011;300,H784-91.
29.Ogbera AO,Azenabor AO.Lipoprotein(a),C-reactive protein and some metabolic cardiovascular risk factors in type 2diabetes.Diabetol metab syndr,2010;2,51.
30.Konerman M,Kulkarni K,Toth PP,et al.Evidence of dependence of lipoprotein(a)on triglyceride and high-density lipoprotein metabolism.J Clin Lipidol,2012;6,27-32.
31.Nordestgaard BG,Chapman MJ,Ray K,et al.Lipoprotein(a)as a cardiovascular risk factor:current status.Eur Heart J,2010;31,2844-53.
32.Kolovou GD,Anagnostopoulou KK,Cokkinos DV.Pathophysiology of dyslipidaemia in the metabolic syndrome.Postgrad Med J,2005;81,358-66.
33.Ginsberg HN,Zhang YL,Hernandez-Ono A.Metabolic syndrome:focus on dyslipidemia.Obesity(Silver Spring),2006;14,41s-9s.
34.Esteve E,Ricart W,Fernández-Real JM.Dyslipidemia and inflammation:an evolutionary conserved mechanism.Clin Nutr,2005;24,16-31.