Established and emerging coronary risk factors in patients with heterozygous familial hypercholesterolaemia
Established and emerging coronary risk factors in patients with heterozygous familial hypercholesterolaemia
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DOI：
10.1136/hrt.2003.022764
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发表时间：
2004-12-01
期刊：
影响因子：
5.7
通讯作者：
Humphries, SE
中科院分区：
文献类型：
--
作者：
Neil, HAW;Seagroatt, V;Humphries, SE
目的：评估与杂合子家族性高胆固醇血症患者冠心病（CAD）易感性个体间差异相关的临床和生化因素。设计：对英国6家血脂诊所招募的410名患者进行横断面研究。211名男性中有104名记录了CAD，199名女性中有55名记录了CAD，平均发病年龄分别为43.1岁和46.5岁。CAD在男性中明显更常见（49% vs28%，p < 0.001），吸烟患者比从不吸烟的患者更常见（51% vs28%，p < 0.001）。校正年龄、性别和当前吸烟状况后，冠心病患者与非冠心病患者在脂蛋白（a）、同型半胱氨酸、纤维蛋白原、纤溶酶原激活物抑制剂-1、白色血细胞计数、体重指数、葡萄糖、甘油三酯或总胆固醇方面无显著差异。然而，高密度脂蛋白（HDL）胆固醇浓度显着低于那些与CAD（6%，95%置信区间（CI）1%至11%，p = 0.03），女性的差异大于男性（12%对2%，p = 0.041）。这些结果表明，在接受治疗的家族性高胆固醇血症的成人中，新出现的冠状动脉危险因素似乎与CAD无关，但与吸烟的密切联系表明，应在儿童早期发现患者，并劝阻他们不要开始吸烟。
Objectives: To assess the clinical and biochemical factors associated with inter-individual variation in susceptibility to coronary artery disease (CAD) in treated heterozygous familial hypercholesterolaemia.Design: A cross sectional study was conducted of 410 patients recruited from six lipid clinics in the UK.Results: CAD was documented in 104 of the 211 men and in 55 of the 199 women with mean ages of onset of 43.1 and 46.5 years, respectively. CAD was significantly more common in men (49% v 28%, p < 0.001) and in patients who had smoked cigarettes versus patients who had never smoked (51% v 28%, p < 0.001). After adjusting for age, sex, and current smoking status, there were no significant differences between patients with or without CAD in lipoprotein(a), homocysteine, fibrinogen, plasminogen activator inhibitor-1, white blood cell count, body mass index, glucose, triglyceride or total cholesterol. However, high density lipoprotein (HDL) cholesterol concentrations were significantly lower in those with CAD (6%, 95% confidence interval (CI) 1% to 11%, p = 0.03) and this difference was greater in women than men (12% v 2%, p = 0.041).Conclusions: These results indicate that emerging coronary risk factors appear not to be associated with CAD in adults with treated familial hypercholesterolaemia, but the strong association with smoking suggests that patients should be identified early in childhood and discouraged from ever starting to smoke.