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1、AMeta-AnalysisofLow-DensityLipoproteinCholesterol,Non-High-DensityLipoproteinCholesterol,andApolipoproteinBasMarkersofCardiovascularRiskAllanD.Sniderman,MD;KenWilliams,MSc;JohnH.Contois,PhD;HowardM.Monroe,PhD;MatthewJ.McQueen,MBChB,PhD;JacquelinedeGraaf,MD,P
2、hD;CurtD.Furberg,MD,PhDBackground—WhetherapolipoproteinB(apoB)ornon-high-densitylipoproteincholesterol(HDL-C)addstothepredictivepoweroflow-densitylipoproteincholesterol(LDL-C)forcardiovascularriskremainscontroversial.MethodsandResults—Thismeta-analysisisbase
3、donallthepublishedepidemiologicalstudiesthatcontainedestimatesoftherelativerisksofnon-HDL-CandapoBoffatalornonfatalischemiccardiovascularevents.Twelveindependentreports,including233455subjectsand22950events,wereanalyzed.Allpublishedriskestimateswereconverted
4、tostandardizedrelativeriskratios(RRRs)andanalyzedbyquantitativemeta-analysisusingarandom-effectsmodel.Whetheranalyzedindividuallyorinhead-to-headcomparisons,apoBwasthemostpotentmarkerofcardiovascularrisk(RRR,1.43;95%CI,1.35to1.51),LDL-Cwastheleast(RRR,1.25;9
5、5%CI,1.18to1.33),andnon-HDL-Cwasintermediate(RRR,1.34;95%CI,1.24to1.44).Theoverallcomparisonsofthewithin-studydifferencesshowedthatapoBRRRwas5.7%non-HDL-C(P0.001)and12.0%LDL-C(P0.0001)andthatnon-HDL-CRRRwas5.0%LDL-C(P0.017).OnlyHDL-Caccountedforanysubs
6、tantialportionofthevarianceoftheresultsamongthestudies.Wecalculatedthenumberofclinicaleventspreventedbyahigh-risktreatmentregimenofallthose70thpercentileoftheUSadultpopulationusingeachofthe3markers.Overa10-yearperiod,anon-HDL-Cstrategywouldprevent300000more
7、eventsthananLDL-Cstrategy,whereasanapoBstrategywouldprevent500000moreeventsthananon-HDL-Cstrategy.Conclusions—TheseresultsfurthervalidatethevalueofapoBinclinicalcare.(CircCardiovascQualOutcomes.2011;4:337-345.)Downloadedfromhttp://ahajournals.orgbyonAugust11
8、,2018KeyWords:cholesterolLDLcholesterolHDLapolipoproteinsBcardiovasculardiseasesriskmeta-analysisLow-densitylipoproteincholesterol(LDL-C)isnowsotagesofamore-complexandexpensivetechnologytha
