Chinese General Practice ›› 2026, Vol. 29 ›› Issue (12): 1579-1587.DOI: 10.12114/j.issn.1007-9572.2024.0308

• Article • Previous Articles     Next Articles

Study on the Differences in Blood Lipid Levels among Different Ethnic Groups in Xinjiang Uyghur Autonomous Region after Treatment with PCSK9 Inhibitors

  

  1. 1. The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China
    2. Xinjiang Medical University, Urumqi 830000, China
    3. State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi 830000, China
  • Received:2024-07-23 Revised:2024-12-02 Published:2026-04-20 Online:2026-03-12
  • Contact: FU Zhenyan

新疆维吾尔自治区不同民族接受PCSK9抑制剂治疗后的血脂水平差异研究

  

  1. 1.830000 新疆维吾尔自治区乌鲁木齐市,新疆医科大学第一附属医院
    2.830000 新疆维吾尔自治区乌鲁木齐市,新疆医科大学
    3.830000 新疆维吾尔自治区乌鲁木齐市,省部共建中亚高发病成因与防治国家重点实验室
  • 通讯作者: 付真彦
  • 作者简介:

    作者贡献:

    刘紫阳、付真彦提出主要研究目标,负责研究的构思与设计;刘紫阳负责研究的实施,撰写论文;金梦龙进行数据的收集与整理,统计学处理,图、表的绘制与展示;刘森、魏梦伟、苏比努尔·居热提进行论文的修订;付真彦负责文章的质量控制与审查,对文章整体负责,监督管理。

  • 基金资助:
    国家重点研发计划(2021YFC2500605); 自治区重点研发计划项目(2022B03022-4); "天山英才"培养计划(2022TSYCLJ0030); 省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(SKL-HIDCA-2023-36)

Abstract:

Background

Cardiovascular disease (CVD) is a leading cause of death worldwide, and hyperlipidemia is a significant risk factor for CVD. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have emerged as an important target for lipid-lowering therapy and CVD prevention.

Objective

To investigate the differences in blood lipid levels among Han, Uyghur, Kazakh, Hui, and Mongolian ethnic groups in Xinjiang after treatment with PCSK9 inhibitors and to explore ethnic variations.

Methods

This retrospective cohort study included 4 167 patients with hyperlipidemia from Han, Uyghur, Kazakh, Hui, and Mongolian ethnic groups who were hospitalized in the Heart Center of the First Affiliated Hospital of Xinjiang Medical University between April 2019 and May 2024 and received evolocumab or alirocumab for lipid-lowering therapy for more than 4 weeks. Baseline data were collected, and multiple linear regression analysis was used to explore the correlation between ethnicity and blood lipids in different categories of hyperlipidemia patients.

Results

A total of 2 634 Han patients (63.2%), 1 027 Uyghur patients (24.6%), 218 Kazakh patients (5.2%), 251 Hui patients (6.0%), and 37 Mongolian patients (1.0%) were included. Statistically significant differences were observed among Han, Uyghur, Kazakh, Hui, and Mongolian patients in terms of gender, body weight, BMI, education level, smoking, alcohol consumption, hypertension, aspartate aminotransferase (AST), total bilirubin, use of statins, ezetimibe, proportion of PCSK9 inhibitor use, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) (P<0.05). Multiple linear regression analysis showed that after treatment with PCSK9 inhibitors, Uyghur patients had 4.713% and 11.173% higher TC and LDL-C levels, respectively, and 6.889% lower HDL-C levels compared to Han patients (P<0.05). Kazakh patients had 5.925%, 5.925%, and 12.720% higher TC, HDL-C, and LDL-C levels, respectively, and 23.792% lower TG levels compared to Han patients (P<0.05). Mongolian patients had 14.025% higher TC levels compared to Han patients (P<0.05). After treatment with evolocumab, Uyghur patients had 5.196% and 11.173% higher TC and LDL-C levels, respectively, and 4.720% lower HDL-C levels compared to Han patients (P<0.05). Kazakh patients had 7.399%, 5.925%, and 17.220% higher TC, HDL-C, and LDL-C levels, respectively, and 25.011% lower TG levels compared to Han patients (P<0.05). Hui patients had 1.599% lower HDL-C levels compared to Han patients (P<0.05), while Mongolian patients had 21.899% and 13.240% higher TC and HDL-C levels, respectively, compared to Han patients (P<0.05). After treatment with alirocumab, Uyghur patients had 10.662% higher LDL-C levels and 12.502% lower HDL-C levels compared to Han patients (P<0.05). Stratified analysis by age and gender showed that male patients treated with PCSK9 inhibitors had 4.472% and 10.917% higher TC and LDL-C levels, respectively, and 6.675% lower HDL-C levels in Uyghur patients compared to Han patients (P<0.05). Kazakh patients had 4.713% higher HDL-C levels and 26.549% lower TG levels compared to Han patients (P<0.05). Hui patients had 4.940% lower HDL-C levels compared to Han patients (P<0.05). Female patients treated with PCSK9 inhibitors had 9.648% higher LDL-C levels and 8.589% lower HDL-C levels in Uyghur patients compared to Han patients (P<0.05). Kazakh patients had 11.173% higher TC levels compared to Han patients (P<0.05). In patients younger than 60 years treated with PCSK9 inhibitors, Uyghur patients had 6.905% and 15.878% higher TC and LDL-C levels, respectively, and 5.811% lower HDL-C levels compared to Han patients (P<0.05). Kazakh patients had 16.145% higher LDL-C levels and 28.879% lower TG levels compared to Han patients (P<0.05). There were no statistically significant differences in TC, TG, HDL-C, and LDL-C levels between Hui and Han patients (P>0.05). Mongolian patients had 17.761% higher TC levels compared to Han patients (P<0.05). In patients 60 years and older treated with PCSK9 inhibitors, Uyghur patients had 8.167% lower HDL-C levels compared to Han patients (P<0.05). Kazakh patients had 6.905% higher HDL-C levels and 17.965% lower TG levels compared to Han patients (P<0.05).

Conclusion

After treatment with PCSK9 inhibitors, Uyghur patients had higher TC and LDL-C levels and lower HDL-C levels compared to Han patients. Kazakh patients had higher TC, HDL-C, and LDL-C levels and lower TG levels compared to Han patients. There were no significant differences in TC, TG, HDL-C, and LDL-C levels between Hui and Han patients. Mongolian patients had higher TC levels compared to Han patients.

Key words: Hyperlipidemia, Proprotein convertase subtilisin/kexin type 9 inhibitor, Evolocumab, Alirocumab, Therapeutic effects

摘要:

背景

心血管疾病(CVD)是人类死亡的主要原因,高脂血症是CVD的重要危险因素,前蛋白转化酶枯草溶菌素9(PCSK9)抑制剂已经成为降脂和预防CVD的重要手段。

目的

研究新疆维吾尔自治区汉族、维吾尔族、哈萨克族、回族和蒙古族人群在接受PCSK9抑制剂治疗后血脂水平的差异,探讨民族差异性。

方法

本研究为回顾性队列研究,通过纳入2019年4月—2024年5月在新疆医科大学第一附属医院心脏中心住院并使用依洛尤单抗或者阿利西尤单抗降脂治疗超过4周的汉族、维吾尔族、哈萨克族、回族及蒙古族高脂血症患者4 167例。收集研究对象的基线资料,采用多重线性回归分析探讨不同分类高脂血症患者中民族与血脂的相关性。

结果

共纳入汉族2 634例(63.2%)、维吾尔族1 027例(24.6%)、哈萨克族218例(5.2%)、回族251例(6.0%)、蒙古族37例(1.0%)。汉族、维吾尔族、哈萨克族、回族、蒙古族患者性别、体质量、BMI、受教育程度、吸烟、饮酒、高血压、天冬氨酸氨基转移酶(AST)、总胆红素、他汀类药物、依折麦布、PCSK9抑制剂比例、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)比较,差异有统计学意义(P<0.05)。多重线性回归分析结果显示,接受PCSK9抑制剂治疗后,维吾尔族人群的TC和LDL-C水平较汉族高4.713%和11.173%,维吾尔族人群的HDL-C水平较汉族低6.889%(P<0.05);哈萨克族人群的TC、HDL-C和LDL-C水平较汉族分别高5.925%、5.925%和12.720%,TG水平较汉族低23.792%(P<0.05);蒙古族人群的TC水平较汉族高14.025%(P<0.05)。接受依洛尤单抗治疗后,维吾尔族人群的TC和LDL-C水平较汉族高5.196%和11.173%,HDL-C较汉族低4.720%(P<0.05);哈萨克族人群的TC、HDL-C和LDL-C水平较汉族高7.399%、5.925%和17.220%,TG水平较汉族低25.011%(P<0.05)。回族人群的HDL-C水平较汉族低1.599%(P<0.05);蒙古族人群的TC和HDL-C较汉族高21.899%和13.240%(P<0.05)。接受阿利西尤单抗治疗后,维吾尔族人群的LDL-C水平较汉族高10.662%,HDL-C较汉族低12.502%(P<0.05)。对年龄、性别分层分析结果显示,男性患者接受PCSK9抑制剂治疗后,维吾尔族人群的TC和LDL-C水平较汉族高4.472%和10.917%,HDL-C较汉族低6.675%(P<0.05);哈萨克族人群的HDL-C水平较汉族高4.713%,TG水平较汉族低26.549%(P<0.05);回族人群的HDL-C水平较汉族低4.940%(P<0.05);女性患者接受PCSK9抑制剂治疗后,维吾尔族人群的LDL-C水平较汉族高9.648%,HDL-C较汉族低8.589%(P<0.05);哈萨克族人群的TC水平较汉族高11.173%(P<0.05);<60岁患者接受PCSK9抑制剂治疗后,维吾尔族人群的TC和LDL-C水平较汉族高6.905%和15.878%,HDL-C较汉族低5.811%(P<0.05);哈萨克族人群的LDL-C水平较汉族高16.145%,TG水平较汉族低28.879%(P<0.05);回族和汉族人群的TC、TG、HDL-C和LDL-C水平比较,差异无统计学意义(P>0.05);蒙古族人群的TC水平分别较汉族高17.761%(P<0.05);≥60岁患者接受PCSK9抑制剂治疗后,维吾尔族人群的HDL-C较汉族低8.167%(P<0.05);哈萨克族的HDL-C较汉族高6.905%,TG较汉族低17.965%(P<0.05)。

结论

PCSK9治疗后,维吾尔族人群的TC和LDL-C水平较汉族高,HDL-C水平较汉族低;哈萨克族的TC、HDL-C和LDL-C水平较汉族高,而TG水平较汉族低;回族和汉族的TC、TG、HDL-C和LDL-C水平均无明显差异;蒙古族的TC水平较汉族高。

关键词: 高脂血症, 蛋白转化酶枯草素/酶切蛋白9抑制剂, 依洛尤单抗, 阿利西尤单抗, 治疗效果