The relationship between early-onset coronary artery disease and familial hypercholesterolemia: a cohort study based on the Hakka population in Meizhou, China

早发性冠状动脉疾病与家族性高胆固醇血症的关系:一项基于中国梅州客家人群的队列研究

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Abstract

BACKGROUND: The low diagnosis and treatment rates of familial hypercholesterolemia (FH) have become a global issue. This study aims to explore the correlation between early-onset coronary artery disease (CAD) and FH in the Hakka population in Meizhou, Guangdong. METHODS: Clinical data of Hakka patients with early-onset CAD, admitted to the Meizhou People's Hospital from January 2023 to January 2024 were retrospectively analyzed. The patients were categorized into an FH group and a non-FH group. Biochemical indicators, lipid levels, echocardiographic parameters, clinical phenotypes, and genetic typing of early-onset CAD patients in the Hakka population were analyzed for their correlation with FH. RESULTS: A total of 167 Hakka patients with early-onset CAD were included, among whom 22 patients had FH. The FH group showed lower triglyceride (TG) level [1.785 (1.40, 2.10) vs. 2.090 (1.80, 2.30), P = 0.002] and higher levels of total cholesterol (TC) [6.635 (5.60, 7.10) vs. 4.830 (4.00, 5.40), P<0.001], low-density lipoprotein cholesterol (LDL-C) [4.440 (3.90, 5.20) vs. 2.820 (2.40, 3.30), P<0.001], and apolipoprotein B (Apo B) [1.600 (1.30, 1.80) vs. 0.910 (0.70, 1.10), P<0.001]. FH was correlated with TG, TC, LDL-C and Apo B levels (r1 = -0.235; r2 = 0.441; r3 = 0.483; r4 = 0.538). TG is a risk factor while TC, LDL-C and Apo B are protective factors for FH. CONCLUSION: The incidence of FH is relatively high among early-onset CAD patients in the Hakka population in Meizhou. TG, TC, LDL-C, and Apo B levels are valuable in aiding clinical differential diagnosis of CAD patients with FH.

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