Primary Low Level of High-Density Lipoprotein Cholesterol and Risks of Coronary Heart Disease, Cardiovascular Disease, and Death: Results From the Multi-Ethnic Study of Atherosclerosis
Primary Low Level of High-Density Lipoprotein Cholesterol and Risks of Coronary Heart Disease, Cardiovascular Disease, and Death: Results From the Multi-Ethnic Study of Atherosclerosis
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DOI：
10.1093/aje/kwv305
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发表时间：
2016-05-15
影响因子：
5
通讯作者：
Blaha, Michael J.
中科院分区：
文献类型：
--
作者：
Ahmed, Haitham M.;Miller, Michael;Blaha, Michael J.
先前观察低水平高密度脂蛋白(高密度脂蛋白)胆固醇与心血管疾病(CVD)之间关系的研究通常是在有代谢或其他脂质异常的人中进行的。在这项研究中，我们在多种族动脉粥样硬化研究(MESA)中，对调整混杂因素后的冠心病(CHD)、心血管疾病(CVD)和全因死亡之间的关系进行了调查。没有临床心血管疾病的参与者从2000年到2002年从6个美国研究中心招募，并进行了中位数10.2年的跟踪调查。我们将“低密度脂蛋白胆固醇”定义为高密度脂蛋白胆固醇水平40 mg/dL(男性)或50 mg/dL(女性)，甘油三酯水平100 mg/dL，低密度脂蛋白胆固醇水平100 mg/dL(n=158)。我们将“最佳”血脂水平定义为高密度脂蛋白胆固醇(HDLc)，男性为40 mg/dL，女性为50 mg/dL，甘油三酯和低密度脂蛋白胆固醇为100 mg/dL(n=780)。对于高密度脂蛋白胆固醇水平较低的参与者，调整后的总冠心病、心血管疾病和死亡的风险比分别为2.25(95%可信区间：1.20，4.21；P=0.011)、1.93(95%可信区间：1.11，3.34；P=0.020)和1.11(95%可信区间：0.67，1.84；P=0.69)。具有低高密度脂蛋白胆固醇的参与者比具有最佳血脂特征的参与者有更高的冠心病和心血管疾病风险，但在中位数10.2年的随访中，存活率没有差异。
Prior studies observing associations between low levels of high-density lipoprotein (HDL) cholesterol and cardiovascular disease (CVD) have often been conducted among persons with metabolic or other lipid abnormalities. In this study, we investigated the association between primary low HDL cholesterol and coronary heart disease (CHD), CVD, and all-cause death after adjustment for confounders in the Multi-Ethnic Study of Atherosclerosis (MESA). Participants who were free of clinical CVD were recruited from 6 US research centers from 2000 to 2002 and followed for a median duration of 10.2 years. We defined "primary low HDL cholesterol" as HDL cholesterol level < 40 mg/dL (men) or < 50 mg/dL (women), triglyceride level < 100 mg/dL, and low-density lipoprotein cholesterol level < 100 mg/dL (n = 158). We defined an "optimal" lipid profile as HDL cholesterol a parts per thousand yen40 mg/dL (men) or a parts per thousand yen50 mg/dL (women) and triglycerides and low-density lipoprotein cholesterol < 100 mg/dL (n = 780). For participants with primary low HDL cholesterol versus those with an optimal lipid profile, adjusted hazard ratios for total CHD, CVD, and death were 2.25 (95% confidence interval (CI): 1.20, 4.21; P = 0.011), 1.93 (95% CI: 1.11, 3.34; P = 0.020), and 1.11 (95% CI: 0.67, 1.84; P = 0.69), respectively. Participants with primary low HDL cholesterol had higher risks of CHD and CVD than participants with optimal lipid profiles but no difference in survival after a median 10.2 years of follow-up.