Association of lipids and lipoprotein level with total mortality and mortality caused by cardiovascular and cancer diseases (Poland and United States collaborative study on cardiovascular epidemiology).
Association of lipids and lipoprotein level with total mortality and mortality caused by cardiovascular and cancer diseases (Poland and United States collaborative study on cardiovascular epidemiology).
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脂质和脂蛋白水平与心血管和癌症疾病引起的总死亡率和死亡率的关联（波兰和美国心血管流行病学合作研究）。
DOI：
10.1016/s0002-9149(99)00374-4
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Kawalec,E
中科院分区：
文献类型：
--
作者：
Rywik,SL;Manolio,TA;Pajak,A;Piotrowski,W;Davis,CE;Broda,GB;Kawalec,E
本研究评估了血清总胆固醇、甘油三酯和高密度脂蛋白（HDL）胆固醇与随后的总死亡率、心血管死亡率和癌症死亡率之间的关系。这些数据来自4,946名美国和5,198名波兰男性和女性，年龄在35至64岁之间，基线死亡率随访超过13年。在所有样本中，总胆固醇与年龄调整后的总死亡率和癌症死亡率呈u形或j形关系，仅在波兰妇女中具有显著性。总死亡率和癌症死亡率的多变量调整相对风险仅在波兰最低胆固醇类别中较高，仅在癌症类别中显著。心血管死亡率与胆固醇呈正相关，但只有在波兰男性和美国女性中，胆固醇水平最高的人群死亡率明显高于胆固醇水平最低的人群。多变量调整后的心血管死亡相对风险在胆固醇水平最高的人群中高于胆固醇水平最低的人群，但这一趋势仅在美国显著。高密度脂蛋白胆固醇与总死亡率（仅在美国男性中显著）和心血管死亡率（仅在美国和波兰男性中显著）呈负相关。高密度脂蛋白胆固醇与癌症死亡率也有类似但不显著的关联。在美国和波兰，总死亡率的多变量调整相对风险与高密度脂蛋白胆固醇呈显著负相关。在所有样本中，高密度脂蛋白胆固醇水平越高，心血管死亡的相对风险就越低。在高密度脂蛋白胆固醇水平最低的美国和波兰，癌症死亡率的相对风险是最高和显著的。甘油三酯升高与总死亡率和心血管死亡率增加有关，但这种趋势仅在美国显著。癌症死亡率与甘油三酯没有显著相关性。目前的研究表明，在地理和文化不同的人群中，血脂与心血管死亡率的关系是相似的。与总死亡率和癌症死亡率的关系因国家、性别和血脂而异。这表明总死亡率和癌症死亡率与脂质或脂蛋白的关系弱于与心血管死亡率的关系。
This study evaluates the relation between total serum cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol, and subsequent total, cardiovascular, and cancer mortality. These data are from 4,946 US and 5,198 Polish men and women aged 35 to 64 years at baseline with mortality follow-up over 13 years. Total cholesterol showed a U-shaped or J-shaped relation to age-adjusted total and cancer mortality across all samples, with significance only in Polish women. The multivariable adjusted relative risk for total and cancer mortality was higher in the lowest cholesterol category only in Poland and significant only for cancer. Cardiovascular mortality was positively related to cholesterol, but only in Polish men and US women was mortality significantly higher in the highest versus the lowest cholesterol category. The multivariable adjusted relative risk of cardiovascular death was greater in the highest versus the lowest cholesterol category, but this trend was significant only in the US. HDL cholesterol was inversely related to total (significant only in US men) and cardiovascular mortality (significant only in US and Polish men). A similar, but not significant, association of HDL cholesterol was found with cancer mortality. The multivariable adjusted relative risk of total mortality was inversely related to HDL cholesterol significant in both the US and Poland. The relative risk of cardiovascular mortality was significantly lower at higher HDL cholesterol levels in all samples. The relative risk of cancer mortality was highest and significant at the lowest HDL cholesterol level in the US and Poland. Elevated triglycerides were associated with increased risk of total and cardiovascular mortality, but this trend was significant only in the US. Cancer mortality was not significantly related to triglycerides. The present study indicates that in geographically and culturally diverse populations, the relation of lipids with cardiovascular mortality is similar. The relation with total and cancer mortality varies by country, gender, and lipids. This suggests that relations of total and cancer mortality with lipids or lipoproteins are weaker than associations with cardiovascular mortality.