| 摘要: | 前言：本研究旨在探討小而緻密低密度脂蛋白膽固醇 （Small dense LDL,sdLDL） 在台灣作為新的心血管風險指標的潛力。本研究以某間大學醫院進行過sdLDL與低密度脂蛋白（low-density lipoprotein, LDL）檢測的病人為對象，探討 sdLDL與LDL高低分布與基本特質相關性，及在sdLDL與LDL高的門診病患中，採用不同的用藥策略後，病患sdLDL與LDL數值降幅之比較。
方法：本研究追蹤某醫學大學附設醫院2018-2021年之四年資料，共有5,066位納入追蹤，以sdLDL與LDL高低進行分組，共分成4個族群。再以4個族群裡，各族群其他項目，如三酸甘油酯（Triglycerides, TG）、高密度脂蛋白膽固醇（High-density lipoprotein, HDL）等數值等之表現做觀察，了解LDL與sdLDL的數值異常比例及其他健檢項目表現差異。另外以Statin等藥物使用後，治療的成效做觀察，以降低sdLDL比例來比較用藥的藥品與濃度造成的治療效果差異。
結果：本研究結果顯示，sdLDL在正常人中的異常比例不容忽視。結果顯示在LDL正常人中有17.99%的受測者具有sdLDL-C異常，異常sdLDL-C受測者具有更高的心血管風險而且不自知。另外降血脂用藥方面則是觀察到高劑量降血脂藥物史他汀（Statin）與PCSK9i抑制劑對於sdLDL的降幅表現良好。
結論：sdLDL-C 在台灣作為心血管硬化風險指標是具有潛力的，進一步研究 sdLDL-C 的潛力和作用是有必要的。
ABSTRACT
Introduction:
This study aims to explore the potential of small, dense low-density lipoprotein cholesterol (sdLDL-C) as a novel cardiovascular risk indicator in Taiwan. We conducted this study using patients who underwent sdLDL and LDL testing at a university hospital, investigating the relationship between sdLDL and LDL levels and their basic characteristics. Additionally, we compared the reduction in sdLDL and LDL values in outpatient patients with high sdLDL and LDL levels after employing different medication strategies.
Methods:
This study tracked four years of data from a medical university hospital in Taiwan, spanning from 2018 to 2021, with a total of 5,066 participants included in the study. Participants were categorized into four groups based on their sdLDL and LDL levels. Within each group, we observed the performance of other parameters (such as TG, HDL, etc.) to understand the prevalence of abnormal sdLDL and differences in the performance of other health check parameters. Furthermore, we assessed the effectiveness of treatments with drugs like Statins, aiming to compare the therapeutic effects of different medications and concentrations on reducing sdLDL levels.
Results:
The results of this study demonstrate that the prevalence of abnormal sdLDL levels among individuals with normal LDL levels cannot be overlooked. Specifically, 17.99% of the tested individuals with normal LDL levels were found to have abnormal sdLDL-C levels. Those with abnormal sdLDL-C levels had a higher cardiovascular risk profile, often remaining unaware of their condition. Moreover, in terms of lipid-lowering medications, high-dose Statins and PCSK9 inhibitors (PCSK9i) exhibited favorable effects in reducing sdLDL levels.
Conclusion:
The use of sdLDL-C as a cardiovascular atherosclerosis risk indicator in Taiwan shows promise, underscoring the necessity for further research on the potential and role of sdLDL-C. |
