A cohort study of the effect of cumulative exposure to LDL-C on cardiovascular disease among the uyghur population in southern Xinjiang

CHENG Jing; MA Rulin; HE Jia; RUI Dongsheng; LI Yu; ZHANG Xianghui; JIAN Leyao; LI Jiahang; GUO Shuxia; GUO Heng

doi:10.16462/j.cnki.zhjbkz.2024.07.005

Volume 28 Issue 7

Jul. 2024

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Article Navigation > CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION > 2024 > 28(7): 770-776

CHENG Jing, MA Rulin, HE Jia, RUI Dongsheng, LI Yu, ZHANG Xianghui, JIAN Leyao, LI Jiahang, GUO Shuxia, GUO Heng. A cohort study of the effect of cumulative exposure to LDL-C on cardiovascular disease among the uyghur population in southern Xinjiang[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(7): 770-776. doi: 10.16462/j.cnki.zhjbkz.2024.07.005

Citation:

CHENG Jing, MA Rulin, HE Jia, RUI Dongsheng, LI Yu, ZHANG Xianghui, JIAN Leyao, LI Jiahang, GUO Shuxia, GUO Heng. A cohort study of the effect of cumulative exposure to LDL-C on cardiovascular disease among the uyghur population in southern Xinjiang[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(7): 770-776. doi: 10.16462/j.cnki.zhjbkz.2024.07.005

Citation:

CHENG Jing, MA Rulin, HE Jia, RUI Dongsheng, LI Yu, ZHANG Xianghui, JIAN Leyao, LI Jiahang, GUO Shuxia, GUO Heng. A cohort study of the effect of cumulative exposure to LDL-C on cardiovascular disease among the uyghur population in southern Xinjiang[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(7): 770-776. doi: 10.16462/j.cnki.zhjbkz.2024.07.005

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A cohort study of the effect of cumulative exposure to LDL-C on cardiovascular disease among the uyghur population in southern Xinjiang

doi: 10.16462/j.cnki.zhjbkz.2024.07.005

CHENG Jing^{1, 2},
MA Rulin¹,
HE Jia¹,
RUI Dongsheng¹,
LI Yu¹,
ZHANG Xianghui¹,
JIAN Leyao¹,
LI Jiahang¹,
GUO Shuxia^{1, 2},
GUO Heng^{1, 2
,
,}

1.
Department of Preventive Medicine, Shihezi University School of Medicine, Shihezi 832000, China
2.
Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, Shihezi 832000, China

Funds:

The Science and Technology Project of Xinjiang Production and Construction Corps 2021AB030

Tianshan Young Talent Scientific and Technological Innovation Team: Innovative Team for Research on Prevention and Treatment of High-incidence Disease in Central Asia 2023TSYCTD0020

More Information

Corresponding author: GUO Heng，E-mail: guoheng@shzu.edu.cn
Received Date: 2023-08-16
Rev Recd Date: 2024-04-18

Available Online: 2024-08-19

Publish Date: 2024-07-10

Abstract

Abstract

Objective To explore the effect of cumulative exposure to low-density lipoprotein cholesterol (LDL-C) on cardiovascular disease (CVD) among the Uyghur population in southern Xinjiang. Methods We recruited 2 950 Uyghurs from the 51st Corps of the 3rd division of Xinjiang Production and Construction Corps, who had measured LDL-C at least three times during the 2016-2022 survey period, and two adjacent measurement intervals ≥2 years. Cumulative LDL-C (cumLDL-C) exposure was calculated by the weighted sum of LDL-C measured value for each time interval (value × time). Participants were grouped according to the cumLDL-C tertiles. The Log-rank test was used to compare the differences in the cumulative incidence of CVD among the groups. Cox proportional hazard regression models were used to estimate the effect of cumLDL-C on CVD. Results During the follow-up period, 322(10.92%) CVD events occurred. The cumulative incidence of CVD from the first to third tertile group of cumLDL-C was 7.12%, 11.08%, and 14.55%, respectively ($ \begin{equation}\chi^2\end{equation}$=27.440, P ＜ 0.001). Cox proportional hazards model showed that after adjusting for multiple confounders, the risk of CVD in the third tertile of cumLDL-C compared with the first tertile was 1.51 times higher (HR=1.51, 95% CI: 1.12-2.06). Each standard deviation increase in cumLDL-C was associated with a 14% increased risk of CVD (HR=1.14, 95% CI: 1.01-1.28). Conclusions In the Uyghur population in southern Xinjiang, cumulative exposure to high LDL-C is an independent risk factor for CVD, and maintaining low LDL-C levels for a long period of time can help reduce the risk of CVD in this population.
- Low-density lipoprotein cholesterol,
- Cumulative exposure,
- Cardiovascular disease,
- Cohort study

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References(24)

References

[1]	Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study[J]. J Am Coll Cardiol, 2020, 76(25): 2982-3021. DOI: 10.1016/j.jacc.2020.11.010.
[2]	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2022概要[J]. 中国循环杂志, 2023, 38(6): 583-612. DOI: 10.3969/j.issn.1000-3614.2023.06.001. The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases in China 2022: an updated summary[J]. Chin Circul J, 2023, 38(6): 583-612. DOI: 10.3969/j.issn.1000-3614.2023.06.001.
[3]	Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the american college of cardiology/american heart association task force on clinical practice guidelines[J]. Circulation, 2019, 139(25). DOI: 10.1161/CIR.0000000000000625.
[4]	张梦妮, 李茂婷, 职心乐, 等. 1990-2019年中国动脉粥样硬化心血管病疾病负担变化及其危险因素分析[J]. 中华流行病学杂志, 2021, 42(10): 1797-1803. DOI: 10.3760/cma.j.cn112338-20201208-01390. Zhang MN, Li MT, Zhi XL, et al. Trends of a burden on atherosclerotic cardiovascular disease and its related risk factors in China, 1990 to 2019[J]. Chin J Epidemiol, 2021, 42(10): 1797-1803. DOI: 10.3760/cma.j.cn112338-20201208-01390.
[5]	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. DOI: 10.1016/S0140-6736(10)61350-5.
[6]	Domanski MJ, Tian X, Wu CO, et al. Time course of LDL cholesterol exposure and cardiovascular disease event risk[J]. J Am Coll Cardiol, 2020, 76(13): 1507-1516. DOI: 10.1016/j.jacc.2020.07.059.
[7]	Duncan MS, Vasan RS, Xanthakis V. Trajectories of blood lipid concentrations over the adult life course and risk of cardiovascular disease and all-cause mortality: observations from the framingham study over 35 years[J]. J Am Heart Assoc, 2019, 8(11). DOI: 10.1161/JAHA.118.011433.
[8]	Ference BA, Graham I, Tokgozoglu L, et al. Impact of lipids on cardiovascular health: JACC health promotion series[J]. J Am Coll Cardiol, 2018, 72(10): 1141-1156. DOI: 10.1016/j.jacc.2018.06.046.
[9]	Ference BA, Majeed F, Penumetcha R, et al. Effect of naturally random allocation to lower low-density lipoprotein cholesterol on the risk of coronary heart disease mediated by polymorphisms in NPC1L1, HMGCR, or both[J]. J Am Coll Cardiol, 2015, 65(15): 1552-1561. DOI: 10.1016/j.jacc.2015.02.020.
[10]	Centers For Disease Control And Prevention CDC. Cigarette smoking among adults--United States, 1992, and changes in the definition of current cigarette smoking[J]. MMWR Morb Mortal Wkly Rep, 1994, 43(19): 342-346.
[11]	Sun K, Ren M, Liu D, et al. Alcohol consumption and risk of metabolic syndrome: a meta-analysis of prospective studies[J]. Clin Nutr, 2014, 33(4): 596-602. DOI: 10.1016/j.clnu.2013.10.003.
[12]	来雪峰. 血尿酸和胆红素及其变化与心血管疾病发生风险的前瞻性队列研究[D]. 武汉: 华中科技大学, 2021. Lai XF. Associations of serum uric acid, bilirubin and their change with risk of incident cardiovascular disease in a prospective cohort study[D]. Wuhan: Huazhong University of Science and Technology, 2021.
[13]	诸骏仁, 高润霖, 赵水平, 等. 中国成人血脂异常防治指南(2016年修订版)[J]. 中国循环杂志, 2016, 31(10): 937-953. DOI: 10.3969/j.issn.1000-3614.2016.10.001. Zhu JR, Gao RL, Zhao SP, et al. Chinese guidelines for prevention and control of dyslipidemia in adults (2016 Revision)[J]. Chin Circul J, 2016, 31(10): 937-953. DOI: 10.3969/j.issn.1000-3614.2016.10.001.
[14]	宋永健, 杜鑫, 郑梦伊, 等. 低密度脂蛋白胆固醇累积暴露对新发急性心肌梗死影响的前瞻性队列研究[J]. 中国循环杂志, 2020, 35(3): 246-253. DOI: 10.3969/j.issn.1000-3614.2020.03.004. Song YJ, Du X, Zheng MY, et al. A prospective cohort study of the effect of cumulative exposure to low density lipoprotein cholesterol on new-onset acute myocardial infarction[J]. Chin Circul J, 2020, 35(3): 246-253. DOI: 10.3969/j.issn.1000-3614.2020.03.004.
[15]	Zhang Y, Pletcher MJ, Vittinghoff E, et al. Association between cumulative low-density lipoprotein cholesterol exposure during young adulthood and middle age and risk of cardiovascular events[J]. JAMA Cardiol, 2021, 6(12): 1406. DOI: 10.1001/jamacardio.2021.3508.
[16]	Mo J, Chen Z, Xu J, et al. The impact of the cumulative burden of LDL-C and hs-CRP on cardiovascular risk: a prospective, population-based study[J]. Aging (Albany NY), 2020, 12(12): 11990-12001. DOI: 10.18632/aging.103365.
[17]	Goldstein JL, Brown MS. A century of cholesterol and coronaries: from plaques to genes to statins[J]. Cell, 2015, 161(1): 161-172. DOI: 10.1016/j.cell.2015.01.036.
[18]	Ference BA, Ginsberg HN, Graham I, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. a consensus statement from the european atherosclerosis society consensus panel[J]. Eur Heart J, 2017, 38(32): 2459-2472. DOI: 10.1093/eurheartj/ehx144.
[19]	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2020概要[J]. 中国循环杂志, 2021, 36(6): 521-545. DOI: 10.3969/j.issn.1000-3614.2021.06.001. The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases in China 2020: an updated summary[J]. Chin Circul J, 2021, 36(6): 521-545. DOI: 10.3969/j.issn.1000-3614.2021.06.001.
[20]	曾雨虹, 刘静, 刘军, 等. 超高危ASCVD患者的界定标准对住院ACS患者降脂治疗需求的影响[J]. 中华心血管病杂志, 2020, 48(12): 1039-1046. DOI: 10.3760/cma.j.cn112148-20200710-00549. Zeng YH, Liu J, Liu J, et al. The expanding needs on lipid-lowering treatment in patients with acute coronary syndrome by applying newly issued definition of extreme high-risk by Chinese society of cardiology[J]. Chin J Cardiol, 2020, 48(12): 1039-1046. DOI: 10.3760/cma.j.cn112148-20200710-00549.
[21]	Vallejo-Vaz AJ, Robertson M, Catapano AL, et al. Low-density lipoprotein cholesterol lowering for the primary prevention of cardiovascular disease among men with primary elevations of low-density lipoprotein cholesterol levels of 190 mg/dL or above: analyses from the WOSCOPS (West of Scotland Coronary Prevention Study) 5-year randomized trial and 20-year observational follow-up[J]. Circulation, 2017, 136(20): 1878-1891. DOI: 10.1161/CIRCULATIONAHA.117.027966.
[22]	Sever PS, Chang CL, Gupta AK, et al. The anglo-scandinavian cardiac outcomes trial: 11-year mortality follow-up of the lipid-lowering arm in the U. K[J]. Eur Heart J, 2011, 32(20): 2525-2532. DOI: 10.1093/eurheartj/ehr333.
[23]	LIPID Study Group Long-term Intervention With Pravastatin In Ischaemic Disease. Long-term effectiveness and safety of pravastatin in 9014 patients with coronary heart disease and average cholesterol concentrations: the LIPID trial follow-up[J]. Lancet, 2002, 359(9315): 1379-1387. DOI: 10.1016/S0140-6736(02)08351-4.
[24]	王宇翔, 马儒林, 郭恒, 等. 新疆农村地区维吾尔族人群心血管疾病患病率及其影响因素[J]. 中华疾病控制杂志, 2023, 27(4): 385-391. DOI: 10.16462/j.cnki.zhjbkz.2023.04.003. Wang YX, Ma RL, Guo H, et al. Prevalence of cardiovascular disease and its influencing factors among the Uygur population in rural areas of Xinjiang[J]. Chin J Dis Control Prev, 2023, 27(4): 385-391. DOI: 10.16462/j.cnki.zhjbkz.2023.04.003.