Apolipoprotein A-1 predicts coronary heart disease only at low concentrations of high-density lipoprotein cholesterol: an epidemiological study of Japanese-Americans.
Apolipoprotein A-1 predicts coronary heart disease only at low concentrations of high-density lipoprotein cholesterol: an epidemiological study of Japanese-Americans.
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载脂蛋白 A-1 仅在低浓度高密度脂蛋白胆固醇时预测冠心病：一项针对日裔美国人的流行病学研究。
DOI：
10.1007/s005990070032
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Marcovina,SM
中科院分区：
文献类型：
--
作者：
Sharp,DS;Burchfiel,CM;Rodriguez,BL;Sharrett,AR;Sorlie,PD;Marcovina,SM
载脂蛋白A-1和高密度脂蛋白胆固醇的传统流行病学和临床研究表明，当联合检查时，高密度脂蛋白是冠心病的更好预测因子。该策略未考虑已知的脂质代谢关系。考虑到载脂蛋白A-1是高密度脂蛋白颗粒的组成部分的统计方法更合适。在檀香山心脏计划队列的1，177名基线（1980-1982年）无疾病的日裔美国男性中，182例新发冠心病病例在12年的随访期内发生。在消除与高密度脂蛋白-胆固醇的线性关系后，推导出载脂蛋白A-1浓度的相对测量值。基于“低”和“高”相对载脂蛋白A-1浓度以及高密度脂蛋白-胆固醇分布≤40和>40 mg/dl的联合条件，创建了4个分组。在高/≤40、低/≤40、高/>40和低/>40的相对联合分组中，12年冠心病发病率分别为28.6、18.2、8.3至11.7例/1,000人-年。统计学交互作用检验具有显著性（P=0.028）。其他分析显示，甘油三酯>190 mg/dl的男性更容易患冠心病。相对载脂蛋白A-1水平、高密度脂蛋白胆固醇和甘油三酯与冠心病发病之间的关系与临床、实验室和转基因动物研究中观察到的模式一致，这些模式更能阐明疾病的病因机制。这项流行病学研究表明，类似的机制可能在人群水平上起作用，并可能导致冠心病的公共卫生负担。
Conventional epidemiological and clinical studies of apolipoprotein A-1 and high-density lipoprotein-cholesterol have demonstrated, when examined jointly, that high-density lipoprotein is a better predictor of coronary heart disease. This strategy does not take into account known lipid metabolic relationships. A statistical approach that takes into account apoliprotein A-1 being a constituent of the high-density lipoprotein particle is more appropriate. Among 1,177 Japanese-American men of the Honolulu Heart Program cohort free of disease at baseline (1980–1982), 182 new coronary heart disease cases developed over a 12-year follow-up period. After removing the linear relationship with high-density lipoprotein-cholesterol, a relative measure of apoliprotein A-1 concentration was derived. Based on joint conditions of ‘low’ and ‘high’ relative apoliprotein A-1 concentration and ≤40 and >40 mg/dl for the high-density lipoprotein-cholesterol distribution, four groupings were created. Among relative joint groupings of high/≤40, low/≤40, high/>40, and low/>40, respectively, the 12-year coronary heart disease incidence varied from 28.6, 18.2, 8.3, to 11.7 cases per 1,000 person-years. A test of statistical interaction was significant (P=0.028). Additional analyses revealed coronary heart disease cases were more likely among men with triglycerides >190 mg/dl. Observed patterns of relationships among relative apoliprotein A-1 level, high-density lipoprotein cholesterol, and triglycerides with incident coronary heart disease are consistent with patterns noted in clinical, laboratory, and transgenic animal research more capable of elucidating mechanisms of disease causation. This epidemiological study suggests similar mechanisms may be operating at a population level, and may contribute to the public health burden of coronary heart disease.