中国医学科学院北京协和医学院Xi Li团队近期取得重要工作进展，他们在一项全国性调查研究中提出，人群中残粒脂蛋白胆固醇与心血管和癌症死亡率具有相关性。相关研究成果2023年12月19日在线发表于《科学通报》杂志上。

据介绍，富含甘油三酯的脂蛋白，也称为残粒脂蛋白胆固醇，对健康的意义越来越得到认可。然而，以前没有足够的证据表明它们与普通人群的特定原因死亡率有关。

为了探索这些关联及其亚组间的异质性，从2014年11月到2022年12月，研究人员进行了一项前瞻性队列研究，包括3403414名来自ChinaHEART（一项正在进行的中国政府资助的公共卫生项目）的社区参与者。该研究评估了全因死亡率、心血管疾病（CVD）死亡率（分别包括缺血性心脏病（IHD）、缺血性脑卒中（IS）和出血性脑卒中（HS）的死亡率）和癌症死亡率（分别包括肺癌、胃癌和肝癌）的风险。在4年的随访中，23646人死于心血管疾病（包括8807人死于IHD，3067人死于IS，5190人死于HS），20318人死于癌症（包括6208人死于肺癌，3013人死于肝癌，2174人死于胃癌）。

与残余胆固醇<17.9 mg/dL的个体相比，残余胆固醇≥27.7 mg/dL个体的多变量调整后死亡率危险比（HR）全因死亡率为1.03（1.00–1.05），CVD为1.17（1.12–1.21）（IHD死亡率为1.19（1.12-1.27），IS死亡率为1.22（1.09–1.36）），全癌死亡率为0.90（0.87–0.94）（其中肺癌为0.94（0.87-1.02），肝癌为0.59（0.53–0.66），胃癌为0.73（0.64–0.83））。

总之，这一研究揭示了残粒脂蛋白胆固醇水平升高与心血管疾病死亡率升高，以及某些类型癌症死亡率降低之间的相关性。

附：英文原文

Title: Associations of remnant cholesterol with cardiovascular and cancer mortality in a nationwide cohort

Author: anonymous

Issue&Volume: 2023/12/19

Abstract: The health significance of triglyceride-rich lipoproteins, also known as remnant cholesterol, has been increasingly recognized. However, evidence of their associations with cause-specific mortality in the general population was previously insufficient. To explore these associations and their heterogeneities across subgroups, a prospective cohort study was conducted including 3,403,414 community-based participants from ChinaHEART, an ongoing government-funded public health program throughout China, from November 2014 through December 2022. The study assessed mortality risk of all-cause mortality, cardiovascular disease (CVD) mortality (including mortality from ischemic heart diseases (IHD), ischemic stroke (IS), and hemorrhagic stroke (HS), separately), and cancer mortality (including lung cancer, stomach cancer, and liver cancer, separately). During the 4-year follow-up, 23,646 individuals died from CVD (including 8807 from IHD, 3067 from IS, and 5190 from HS), and 20,318 from cancer (including 6208 from lung cancer, 3013 from liver cancer, and 2174 from stomach cancer). Compared with individuals with remnant cholesterol <17.9 mg/dL, multivariable-adjusted mortality hazard ratios (HRs) for individuals with remnant cholesterol ≥27.7 mg/dL were 1.03 (1.00–1.05) for all-cause mortality, 1.17 (1.12–1.21) for CVD (1.19 (1.12–1.27) for IHD mortality, and 1.22 (1.09–1.36) for IS mortality), and 0.90 (0.87–0.94) for all-cancer mortality (0.94 (0.87–1.02) for lung cancer, 0.59 (0.53–0.66) for liver cancer, and 0.73 (0.64–0.83) for stomach cancer). In summary, this study revealed a correlation between increased remnant cholesterol levels and an elevated risk of cardiovascular disease mortality, as well as a reduced risk of mortality for certain types of cancer.

DOI: 10.1016/j.scib.2023.12.035

Source: https://www.sciencedirect.com/science/article/abs/pii/S2095927323009064