CAJ | 학술논문

目的探讨血脂参数在ABO血型与冠心病发生相关性中的作用.方法连续收集武汉市第五医院及北京阜外心血管病医院2013年5月至2014年6月入院的疑诊冠心病并进行选择性冠状动脉造影检查的898例患者,按冠状动脉造影结果分为冠心病组(450例)和非冠心病组(对照组,448例),按血型分为O型组(292例)和非O型组(606例),A型组(259例)和非A型组(639例),分析ABO血型、血脂和冠心病的相互关系.结果 A型组冠心病的检出率明显高于非A型组[57.1％ (148/259)比47.3％ (302/639),P＜0.01];A型组总胆固醇(TC)水平[(4.43±1.12) mmol/L比(4.18±1.09) mmol/L]和低密度脂蛋白胆固醇(LDL-C)水平[(2.79 ±0.99) mmo/L比(2.59±1.01) mmol/L]明显高于非A型组(P＜0.01);冠心病组TC[(4.36±1.05) mmol/L比(4.131.16) mmol/L]、LDL-C[(2.61 ±0.87) mmol/L比(2.47±0.94) mmol/L]、高密度脂蛋白胆固醇(HDL-C)[(1.06±0.28) mmol/L比(1.15±0.34)mmol/L]和ApoA Ⅰ水平[(1.38±0.29) mmol/L比(1.45 ±0.33) mmol/L]与非冠心病组比较,差异均有统计学意义(P＜0.01).多因素logistic回归分析显示,校正年龄、性别、糖尿病、高血压、吸烟等传统危险因素后,A血型(OR=1.88,95％ CI1.280 ～2.774,P＜0.01)和TC(OR=1.03,95％CI 1.018 ～1.033,P＜0.01)是冠心病的独立危险因素.采用中介变量分析模型显示,A血型和冠心病的关系中10.5％由TC介导(P=0.037).结论血脂参数TC在ABO血型与冠心病发生的相关性中发挥中介介导作用.
목적 탐토혈지삼수재ABO혈형여관심병발생상관성중적작용.방법 련속수집무한시제오의원급북경부외심혈관병의원2013년5월지2014년6월입원적의진관심병병진행선택성관상동맥조영검사적898례환자,안관상동맥조영결과분위관심병조(450례)화비관심병조(대조조,448례),안혈형분위O형조(292례)화비O형조(606례),A형조(259례)화비A형조(639례),분석ABO혈형、혈지화관심병적상호관계.결과 A형조관심병적검출솔명현고우비A형조[57.1％ (148/259)비47.3％ (302/639),P＜0.01];A형조총담고순(TC)수평[(4.43±1.12) mmol/L비(4.18±1.09) mmol/L]화저밀도지단백담고순(LDL-C)수평[(2.79 ±0.99) mmo/L비(2.59±1.01) mmol/L]명현고우비A형조(P＜0.01);관심병조TC[(4.36±1.05) mmol/L비(4.131.16) mmol/L]、LDL-C[(2.61 ±0.87) mmol/L비(2.47±0.94) mmol/L]、고밀도지단백담고순(HDL-C)[(1.06±0.28) mmol/L비(1.15±0.34)mmol/L]화ApoA Ⅰ수평[(1.38±0.29) mmol/L비(1.45 ±0.33) mmol/L]여비관심병조비교,차이균유통계학의의(P＜0.01).다인소logistic회귀분석현시,교정년령、성별、당뇨병、고혈압、흡연등전통위험인소후,A혈형(OR=1.88,95％ CI1.280 ～2.774,P＜0.01)화TC(OR=1.03,95％CI 1.018 ～1.033,P＜0.01)시관심병적독립위험인소.채용중개변량분석모형현시,A혈형화관심병적관계중10.5％유TC개도(P=0.037).결론 혈지삼수TC재ABO혈형여관심병발생적상관성중발휘중개개도작용.
Objective To find a potential link among ABO blood group,lipid profiles and coronary artery disease (CAD) and to estimate the effect size of connection using mediation analysis model.Methods A total of 898 consecutive patients undergoing coronary angiography were enrolled,and divided into CAD group and non-CAD group according to angiographic findings.According to ABO blood group,patients were divided into O blood group and non-O blood group,as well as A blood group and non-A blood group.Baseline characteristics among various groups were compared and the association of ABO blood group,CAD and lipid profile was explored.Results Subjects of blood type A had higher concentration of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) compared with that of non-A type (TC:(4.43 ± 1.12) mmol/L vs.(4.18 ± 1.09) mmol/L,LDL-C:(2.79 ±0.99) mmo/L vs.(2.59-± 1.01) mmol/L,all P ＜ 0.01).TC and LDL-C were significantly higher while high density lipoprotein cholesterol (HDL-C) and ApoA Ⅰ levels were significantly lower in CAD group than in non-CAD group (TC:(4.36 ± 1.05) mmol/L vs.(4.13 ± 1.16)mmol/L,LDL-C:(2.61 ±0.87) mmol/L vs.(2.47 ±0.94) mmol/L;ApoA Ⅰ:(1.38 ± 0.29) mmol/L vs.(1.45 ± 0.33) mmol/L;all P ＜ 0.01).After adjustment for traditional cardiovascular risk factors,blood group A and TC remained significantly associated with the risk of CAD (OR =1.88,95％ CI 1.280-2.774,P ＜0.01;OR =1.03,95％ CI 1.018-1.033,P ＜0.01,respectively).Specially,mediation analysis indicated that 10.5％ of the effect of A blood group on CAD was mediated by TC levels (P ＜0.01).Conclusion Our data indicate that there is an association between ABO blood group,TC levels and risk of CAD.Around 10.5％ of the effect of A blood group on CAD is mediated by TC levels.