[1]于洋杰 谢坤 高秀芳 施海明 李勇.非高密度脂蛋白胆固醇可以替代低密度脂蛋白胆固醇吗？[J].心血管病学进展,2021,(1):12-16.[doi:10.16806/j.cnki.issn.1004-3934.2021.01.000]
　YU Yangjie,XIE Kun,GAO Xiufang,et al.Can LDL-C be Replaced by non-HDL-C[J].Advances in Cardiovascular Diseases,2021,(1):12-16.[doi:10.16806/j.cnki.issn.1004-3934.2021.01.000]
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非高密度脂蛋白胆固醇可以替代低密度脂蛋白胆固醇吗？()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2021年1期
页码:
12-16
栏目:
综述
出版日期:
2021-01-25

文章信息/Info

Title:
Can LDL-C be Replaced by non-HDL-C
文章编号:
202011077
作者:
于洋杰 谢坤 高秀芳 施海明 李勇
?复旦大学附属华山医院心内科,上海200040)
Author(s):
YU Yangjie;  XIE Kun;  GAO Xiufang;  SHI Haiming;  LI Yong
(Department of CardiologyHuashan Hospital of Fudan University Shanghai 200040China)
关键词:
非高密度脂蛋白胆固醇;  低密度脂蛋白胆固醇;  动脉粥样硬化;  心血管疾病
Keywords:
Non-high-density lipoprotein cholesterol;  Low-density lipoprotein cholesterol;  Atherosclerosis;  Cardiovascular disease
分类号:
R54
DOI:
10.16806/j.cnki.issn.1004-3934.2021.01.000
文献标志码:
A 【DOI】1
摘要:
非高密度脂蛋白胆固醇（non-high-density lipoprotein cholesterol，non-HDL-C）等于总胆固醇减去高密度脂蛋白胆固醇。流行病学研究认为在糖尿病、甘油三酯过高、LDL-C过低的人群中，non-HDL-C比低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）更能反映动脉粥样硬化性心血管疾病（arteriosclerotic cardiovascular disease，ASCVD）发病风险，预测能力更强。对于ASCVD患者，non-HDL-C的目标值已经被写进欧美血脂指南及中国胆固醇教育计划专家建议。但是关于non-HDL-C能否完全替代LDL-C目前尚无定论。本文将简述近年来non-HDL-C相关研究进展，并将non-HDL-C与LDL-C进行比较，从而明确non-HDL-C的临床价值。
Abstract:
Non-HDL-C (non-high-density lipoprotein cholesterol) equals to total cholesterol minus high-density lipoprotein cholesterol. Numerous epidemiological studies have shown that non-HDL-C is a better predictor of the risk of atherosclerotic cardiovascular disease (ASCVD), compared with low-density lipoprotein cholesterol (LDL-C) in patients with diabetes, high TG or low LDL-C. Recently, non-HDL-C has been recognized as a target marker in the treatment of patients with dyslipidemia in European and American guidelines as well as Expert advice on Cholesterol Education Program in China. However, whether LDL-C could be replaced by non-HDL-C remains controversial. In this review, we will summarize the most recent studies of non-HDL-C, and review the clinical value of non-HDL-C.

参考文献/References:

[1] Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association[J]. Circulation,2017, 135(10): e146-e603

[2] Cannon CP, Blazing MA, Giugliano RP, et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes[J]. N Engl J Med ,2015, 372(25): 2387-2397

[3] 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)[J]. JAMA,2001, 285(19): 2486-2497

[4] Chapman MJ, Ginsberg HN, Amarenco P, et al. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management[J]. Eur Heart J,2011, 32(11): 1345-1361

[5] Reiner Z, Catapano AL, De Backer G, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS)[J]. Eur Heart J,2011, 32(14): 1769-1818

[6] Meeusen JW, Donato LJ, Jaffe A S. Should apolipoprotein B replace LDL cholesterol as therapeutic targets are lowered?[J]. Curr Opin Lipidol,2016, 27(4): 359-366

[7] Boren J, Williams KJ. The central role of arterial retention of cholesterol-rich apolipoprotein-B-containing lipoproteins in the pathogenesis of atherosclerosis:a triumph of simplicity[J]. Curr Opin Lipidol,2016, 27(5): 473-483

[8] Contois JH, Mcconnell JP, Sethi AA, et al. Apolipoprotein B and Cardiovascular Disease Risk: Position Statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices[J]. Clinical Chemistry,2009, 55(3): 407-419

[9] Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association[J]. Circulation,2011, 123(20): 2292-2333

[10] Tsimikas S. A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies[J]. J Am Coll Cardiol,2017, 69(6): 692-711

[11] Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk[J]. European Heart Journal,2020, 41(1): 111-188

[12] Nordestgaard BG, Langsted A, Mora S, et al. Fasting Is Not Routinely Required for Determination of a Lipid Profile: Clinical and Laboratory Implications Including Flagging at Desirable Concentration Cutpoints-A Joint Consensus Statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine[J]. Clin Chem,2016, 62(7): 930-946

[13] Langlois MR, Descamps OS, van der Laarse A, et al. Clinical impact of direct HDLc and LDLc method bias in hypertriglyceridemia. A simulation study of the EAS-EFLM Collaborative Project Group[J]. Atherosclerosis,2014, 233(1): 83-90

[14] Sun CJ, Mccudden C, Brisson D, et al. Calculated Non-HDL Cholesterol Includes Cholesterol in Larger Triglyceride-Rich Lipoproteins in Hypertriglyceridemia[J]. Journal of the Endocrine Society,2020, 4(1)

[15] Hubacek JA, Stanek V, Gebauerova M, et al. Traditional risk factors of acute coronary syndrome in four different male populations - total cholesterol value does not seem to be relevant risk factor[J]. Physiol Res,2017, 66(Suppl 1): S121-S128

[16] Kwon D, Yi J, Ohrr H, et al. Total cholesterol and mortality from ischemic heart disease and overall cardiovascular disease in Korean adults[J]. Medicine,2019, 98(36): e17013

[17] Zhong G, Huang S, Peng Y, et al. HDL-C is associated with mortality from all causes, cardiovascular disease and cancer in a J-shaped dose-response fashion: a pooled analysis of 37 prospective cohort studies[J]. European Journal of Preventive Cardiology,2020: 948843437

[18] Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease[J]. N Engl J Med,2017, 376(18): 1713-1722

[19] Schwartz GG, Steg PG, Szarek M, et al. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome[J]. N Engl J Med,2018, 379(22): 2097-2107

[20] Brunner FJ, Waldeyer C, Ojeda F, et al. Application of non-HDL cholesterol for population-based cardiovascular risk stratification: results from the Multinational Cardiovascular Risk Consortium[J]. Lancet,2019, 394(10215): 2173-2183

[21] Liu J, Sempos C, Donahue RP, et al. Joint distribution of non-HDL and LDL cholesterol and coronary heart disease risk prediction among individuals with and without diabetes[J]. Diabetes Care,2005, 28(8): 1916-1921

[22] Arsenault BJ, Rana JS, Stroes ES, et al. Beyond low-density lipoprotein cholesterol: respective contributions of non-high-density lipoprotein cholesterol levels, triglycerides, and the total cholesterol/high-density lipoprotein cholesterol ratio to coronary heart disease risk in apparently healthy men and women[J]. J Am Coll Cardiol,2009, 55(1): 35-41

[23] Kastelein JJ, van der Steeg WA, Holme I, et al. Lipids, apolipoproteins, and their ratios in relation to cardiovascular events with statin treatment[J]. Circulation,2008, 117(23): 3002-3009

[24] Liu J, Sempos CT, Donahue RP, et al. Non-high-density lipoprotein and very-low-density lipoprotein cholesterol and their risk predictive values in coronary heart disease[J]. Am J Cardiol,2006, 98(10): 1363-1368

[25] Mora S, Buring JE, Ridker PM. Discordance of Low-Density Lipoprotein (LDL) Cholesterol With Alternative LDL-Related Measures and Future Coronary Events[J]. Circulation,2014, 129(5): 553-561

[26] Wongcharoen W, Sutthiwutthichai S, Gunaparn S, et al. Is non-HDL-cholesterol a better predictor of long-term outcome in patients after acute myocardial infarction compared to LDL-cholesterol? : a retrospective study[J]. BMC Cardiovascular Disorders,2017, 17(1)

[27] Dali-Sahi M, Kachekouche Y, Dennouni-Medjati N, et al. Non-HDL cholesterol predictive factor of type 2 diabetes in the city of Tlemcen[J]. Diabetes & Metabolic Syndrome: Clinical Research & Reviews,2019, 13(1): 518-521

[28] Kumpatla S, Soni A, Narasingan SN, et al. Presence of elevated non-HDL among patients with T2DM with CV events despite of optimal LDL-C–A report from South India[J]. Indian Heart Journal,2016, 68(3): 378-379

[29] Modi KD, Chandwani R, Ahmed I, et al. Discordance between lipid markers used for predicting cardiovascular risk in patients with type 2 diabetes[J]. Diabetes & Metabolic Syndrome: Clinical Research & Reviews,2016, 10(1): S99-S102

[30] Zeng RX, Li XL, Zhang MZ, et al. Non-HDL cholesterol is a better target for predicting periprocedural myocardial injury following percutaneous coronary intervention in type 2 diabetes[J]. Atherosclerosis,2014, 237(2): 536-543

[31] Liu H, Deng X, Peng Y, et al. Meta-analysis of serum non-high-density lipoprotein cholesterol and risk of coronary heart disease in the general population[J]. Clinica Chimica Acta,2017, 471: 23-28

[32] Cao Y, Yan L, Guo N, et al. Non-high-density lipoprotein cholesterol and risk of cardiovascular disease in the general population and patients with type 2 diabetes: A systematic review and meta-analysis[J]. Diabetes Research and Clinical Practice,2019, 147: 1-8

[33] Kouvari M, Panagiotakos DB, Chrysohoou C, et al. Sex-Related Differences of the Effect of Lipoproteins and Apolipoproteins on 10-Year Cardiovascular Disease Risk; Insights from the ATTICA Study (2002–2012)[J]. Molecules,2020, 25(7): 1506

[34] Saito I, Yamagishi K, Kokubo Y, et al. Non-High-Density Lipoprotein Cholesterol and Risk of Stroke Subtypes and Coronary Heart Disease: The Japan Public Health Center-Based Prospective (JPHC) Study[J]. J Atheroscler Thromb,2020, 27(4): 363-374

[35] Shapiro MD, Minnier J, Tavori H, et al. Relationship Between Low‐Density Lipoprotein Cholesterol and Lipoprotein(a) Lowering in Response to PCSK9 Inhibition With Evolocumab[J]. Journal of the American Heart Association,2019, 8(4)

[36] Bowman L, Hopewell JC, Chen F, et al. Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease[J]. N Engl J Med,2017, 377(13): 1217-1227

[37] Baigent C, Blackwell L, Emberson J, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials[J]. Lancet,2010, 376(9753): 1670-1681

[38] Di Angelantonio E, Gao P, Pennells L, et al. Lipid-related markers and cardiovascular disease prediction[J]. JAMA,2012,307(23): 2499-2506

[39] Silverman MG, Ference BA, Im K, et al. Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis[J]. JAMA,2016, 316(12): 1289-1297

[40] Bhatt DL, Steg PG, Miller M, et al. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia[J]. New England Journal of Medicine,2019, 380(1): 11-22

[41] Jacobson TA, Ito MK, Maki KC, et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1 - executive summary[J]. J Clin Lipidol,2014, 8(5): 473-488

[42] Catapano AL, Graham I, De Backer G, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias[J]. Eur Heart J,2016, 37(39): 2999-3058

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备注/Memo

备注/Memo:
收稿日期：2020-07-01

通信作者：施海明，E-mail：Shihm@medmail.com.cn

更新日期/Last Update: 2021-03-18