SERUM-CHOLESTEROL IN YOUNG MEN AND SUBSEQUENT CARDIOVASCULAR-DISEASE
SERUM-CHOLESTEROL IN YOUNG MEN AND SUBSEQUENT CARDIOVASCULAR-DISEASE
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DOI：
10.1056/nejm199302043280504
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发表时间：
1993-02-04
影响因子：
158.5
通讯作者：
LEVINE, DM
中科院分区：
文献类型：
--
作者：
KLAG, MJ;FORD, DE;LEVINE, DM
背景中年人血清胆固醇水平升高与心血管疾病的风险增加已被明确，但很少有机会检查年轻男性血清胆固醇水平测定与日后临床明显的早发心血管疾病之间的潜在联系。我们对1017名年轻男性（平均年龄22岁）进行了一项前瞻性研究，随访27至42年，以量化与成年早期血清胆固醇水平相关的心血管疾病风险和总死亡率。入组时平均血清胆固醇水平为192 mg/dl（5.0 mmol/L）。在平均30.5年的随访中，有125例心血管疾病事件，其中97例是由于冠心病。基线血清胆固醇水平与冠心病和心血管疾病相关事件的发生率以及总死亡率和心血管疾病导致的死亡率密切相关。无论这些事件发生在50岁之前还是之后，风险都是相似的。在调整了年龄、体重指数（体重（千克）除以身高（米）的平方）、体力活动水平、咖啡摄入量、吸烟状况的变化以及随访期间糖尿病和高血压的发病率，基线时血清胆固醇水平的差异为36 mg/dl（0.9 mmol/L）-研究人群基线胆固醇水平的第25和第75个单位之间的差异-与心血管疾病风险增加有关（相对危险度，1.72; 95%可信区间，1.39 ~ 2.14），冠心病（相对危险度，2.01; 95%可信区间，1.59 ~ 2.53），心血管疾病死亡率（相对危险度，2.02; 95%可信区间，1.23 ~ 3.32）。基线血清胆固醇水平差异为36 mg/dl与50岁之前死亡风险增加显著相关（相对风险，1.64; 95%置信区间，1.03 - 2.61），但与总体死亡风险无关（相对风险，1.21; 95%置信区间，0.93 - 1.58）。结论.这些发现表明，男性成年早期测得的血清胆固醇水平与中年心血管疾病之间存在密切联系。
Background. The increased risk of cardiovascular disease associated with higher serum cholesterol levels in middle-aged persons has been clearly established, but there have been few opportunities to examine a potential link between serum cholesterol levels measured in young men and clinically evident premature cardiovascular disease later in life.Methods. We performed a prospective study of 1017 young men (mean age, 22 years) followed for 27 to 42 years to quantify the risk of cardiovascular disease and total mortality associated with serum cholesterol levels during early adult life. The mean serum cholesterol level at entry was 192 mg per deciliter (5.0 mmol per liter).Results. During a median follow-up of 30.5 years, there were 125 cardiovascular-disease events, 97 of which were due to coronary heart disease. The serum cholesterol level at base line was strongly associated with the incidence of events related to coronary heart disease and cardiovascular disease, as well as to total mortality and mortality due to cardiovascular disease. The risks were similar whether the events occurred before or after the age of 50. In a proportional-hazards analysis adjusted for age, body-mass index (the weight in kilograms divided by the square of the height in meters), the level of physical activity, coffee intake, change in smoking status, and the incidence of diabetes and hypertension during follow-up, a difference in the serum cholesterol level at base line of 36 mg per deciliter (0.9 mmol per liter) - the difference between the 25th and 75th percentiles of cholesterol level in the study population at base line - was associated with an increased risk of cardiovascular disease (relative risk, 1.72; 95 percent confidence interval, 1.39 to 2.14), coronary heart disease (relative risk, 2.01; 95 percent confidence interval, 1.59 to 2.53), and mortality due to cardiovascular disease (relative risk, 2.02; 95 percent confidence interval, 1.23 to 3.32). A difference in the base-line serum cholesterol level of 36 mg per deciliter was significantly associated with an increased risk of death before the age of 50 (relative risk, 1.64; 95 percent confidence interval, 1.03 to 2.61), but not with the overall risk of death (relative risk, 1.21; 95 percent confidence interval, 0.93 to 1.58). Conclusions. These findings indicate a strong association between the serum cholesterol level measured early in adult life in men and cardiovascular disease in midlife.