LIPOPROTEINS AS MEDIATORS FOR THE EFFECTS OF ALCOHOL-CONSUMPTION AND CIGARETTE-SMOKING ON CARDIOVASCULAR MORTALITY - RESULTS FROM THE LIPID RESEARCH CLINICS FOLLOW-UP-STUDY
LIPOPROTEINS AS MEDIATORS FOR THE EFFECTS OF ALCOHOL-CONSUMPTION AND CIGARETTE-SMOKING ON CARDIOVASCULAR MORTALITY - RESULTS FROM THE LIPID RESEARCH CLINICS FOLLOW-UP-STUDY
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DOI：
10.1093/oxfordjournals.aje.a114702
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发表时间：
1987-10-01
影响因子：
5
通讯作者：
COHN, R
中科院分区：
文献类型：
--
作者：
CRIQUI, MH;COWAN, LD;COHN, R
由于饮酒与高密度脂蛋白（HDL）胆固醇增加和低密度脂蛋白（LDL）胆固醇降低有关，而吸烟与低密度脂蛋白胆固醇和高密度脂蛋白胆固醇有关，因此推测适度饮酒的保护作用和/或吸烟对心血管疾病的有害作用可能在很大程度上由脂蛋白机制介导。作者在1972-1976年对北美10个人群中的7，461名男性和女性进行了一项前瞻性研究，并平均随访了8.5年。适度饮酒对心血管疾病的保护作用较弱，而吸烟与心血管疾病死亡率密切相关。正如预期的那样，LDL胆固醇与心血管疾病死亡率呈正相关，HDL胆固醇与心血管疾病死亡率呈负相关。然而，心血管疾病死亡率的多变量分析交替排除和包括HDL胆固醇和LDL胆固醇作为协变量，表明饮酒对心血管疾病死亡率的影响不依赖于LDL胆固醇途径，仅部分由HDL胆固醇途径介导，而吸烟的影响不依赖于HDL胆固醇和LDL胆固醇途径，提示饮酒和吸烟对心血管疾病的生物学作用机制。
Because alcohol consumption is associated with increased high density lipoprotein (HDL) cholesterol and decreased low density liproptein (LDL) cholesterol, and cigarette smoking is associated with lower HDL cholesterol and higher LDL cholesterol, there has been speculation that the protective effect of moderate alcohol consumption and/or the noxious effect of cigarette smoking for cardiovascular disease might be mediated in large part by a lipoprotein mechanism. The authors examined this question in a prospective study of 7,461 men and women in 10 North American populations initially seen in 1972-1976 and followed for an average of 8.5 years. Moderate alcohol consumption was weakly protective for cardiovascular disease, while cigarette smoking was strongly and significantly associated with cardiovascular disease mortality. As expected, LDL cholesterol was positively related and HDL cholesterol was inversely related to cardiovascular disease mortality. However, multivariable analysis of cardiovascular disease mortality alternately excluding and including HDL cholesterol and LDL cholesterol as covariates indicated that the effect of alcohol consumption on cardiovascular disease mortality was independent of an LDL cholesterol pathway and only partially mediated by an HDL cholesterol pathway, while the effect of cigarette smoking was independent of both the HDL cholesterol and LDL cholesterol pathways, suggesting alternative biologic mechanisms of action for both alcohol consumption and cigarette smoking on cardiovascular disease.