Relation of serum total cholesterol and other factors to risk of cerebral infarction in Japanese men with hypercholesterolemia.
Relation of serum total cholesterol and other factors to risk of cerebral infarction in Japanese men with hypercholesterolemia.
复制标题
日本高胆固醇血症男性血清总胆固醇等因素与脑梗死风险的关系。
作者：
Mikio Iwashita;Y. Matsushita;J. Sasaki;K. Arakawa;S. Kono
背景
除了高血压（HT）外，脑梗死的危险因素尚未得到很好的阐明，很少有研究探讨老年人的危险因素。
方法和结果
在4，349名参加九州脂质干预研究的45-74岁血清总胆固醇（TC）浓度≥ 220 mg/dl的日本男性中检查了脑梗死的临床和行为危险因素。在5年的随访期内，共有81名男性发生了明确的脑梗死。采用考克斯比例风险模型，以基线和随访期间的血清TC、血清高密度脂蛋白胆固醇（HDL-C）、HT、糖尿病（DM）等因素为协变量。随访期间的血清总胆固醇（而非基线水平）与脑梗死呈正相关，老年人（≥ 65岁）的相关性强于中年人（<65岁）。当不考虑随访TC时，他汀类药物的使用与脑梗死风险的中度降低有关，但在调整随访TC后，这种降低几乎无效。低浓度的血清HDL-C、糖尿病、高血压和心绞痛均与风险增加相关。没有观察到体重指数、吸烟或饮酒的明显关联。
结论
降低胆固醇对预防中度高胆固醇血症男性的脑梗死很重要。低浓度HDL-C、DM和HT是脑梗死的独立预测因子。
BACKGROUND
Risk factors for cerebral infarction have not been well clarified, except for hypertension (HT), and few studies have examined the risk factors in the elderly.
METHODS AND RESULTS
Clinical and behavioral risk factors for cerebral infarction were examined in 4,349 Japanese men aged 45-74 years with a serum total cholesterol (TC) concentration of 220 mg/dl or greater who participated in the Kyushu Lipid Intervention Study. A total of 81 men developed definite cerebral infarction in a 5-year follow-up period. The Cox proportional hazards model was used with serum TC at baseline and during the follow-up, serum high-density lipoprotein-cholesterol (HDL-C), HT, diabetes mellitus (DM), and other factors as covariates. Serum TC during the follow-up, not at baseline, was positively associated with cerebral infarction, showing a stronger association in the elderly (>or=65 years old) than in the middle-aged (<65 years old). Statin use was related to a moderate decrease in the risk of cerebral infarction when follow-up TC was not considered, but the decrease was almost nullified after adjustment for follow-up TC. A low concentration of serum HDL-C, diabetes mellitus, hypertension, and angina pectoris were each related to an increased risk. No clear association was observed for body mass index, smoking or alcohol use.
CONCLUSIONS
Lowering cholesterol is important in the prevention of cerebral infarction in men with moderate hypercholesterolemia. A low concentration of HDL-C, DM, and HT are independent predictors of cerebral infarction.
影响因子：
8.3
作者：
Leppälä, JM;Virtamo, J;Heinonen, OP
通讯作者：
Heinonen, OP