A study based on community cohorts provides evidence that genetic predisposition to elevated LDL-C is associated with presence of aortic valve calcium and incidence of aortic stenosis, supporting a causal association between LDL-C and aortic valve disease. The study used a Mendelian randomization study design to evaluate the association of weighted genetic risk scores (GRSs), a measure of the genetic predisposition to elevations in plasma lipids, with aortic valve disease. Total of 6942 participants in 3 community-based cohorts were included with more than a decade of follow up. The prevalence of aortic valve calcium was 32%. Plasma LDL-C, but not HDL-C or TG, was significantly associated with incident aortic stenosis. The LDL-C GRS, but not HDL-C or TG GRS, was significantly associated with presence of aortic valve calcium and with incident aortic stenosis. However, randomized trials with cholesterol-lowering therapies in individuals with established valve disease have failed to demonstrate reduced disease progression. Source: http://jama.jamanetwork.com/article.aspx?articleid=1919440基于社区的组群研究提供的证据表明，升高低密度脂蛋白胆固醇的遗传易感性与主动脉瓣钙化和主动脉瓣狭窄的发病有关，支持低密度脂蛋白胆固醇与主动脉瓣病之间的因果关系。该研究用孟德尔随机试验设计来评价加权的遗传风险评分，一项血脂升高遗传易感性的指标，与主动脉瓣病的关系。共有基于3 个社区组群的6942名参与者，并经十多年随访。主动脉瓣钙化的发生率为32％。血浆低密度脂蛋白胆固醇，而非高密度脂蛋白胆固醇或甘油三酯，与发生主动脉瓣狭窄的发生显著相关。低密度脂蛋白胆固醇遗传风险评分，而非高密度脂蛋白胆固醇或甘油三酯的遗传风险评分，与主动脉瓣钙化和主动脉瓣狭窄的发生显著相关。但是，既有瓣膜病患者的降胆固醇疗法的随机临床试验未能证明减少疾病进展。来源：http://jama.jamanetwork.com/article.aspx?articleid=1919440
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