Lipid levels and the risk of ischemic stroke in women
Lipid levels and the risk of ischemic stroke in women
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DOI：
10.1212/01.wnl.0000254472.41810.0d
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发表时间：
2007-02-20
期刊：
影响因子：
9.9
通讯作者：
Gaziano, J. M.
中科院分区：
文献类型：
--
作者：
Kurth, T.;Everett, B. M.;Gaziano, J. M.
目的：在一个大型的健康女性队列中，评价总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、总胆固醇与HDL-C比值和非HDL-C与缺血性卒中风险之间的关系。研究方法：在27，937名参与妇女健康研究的年龄≥ 45岁的美国妇女中进行的前瞻性队列研究，这些妇女提供了基线血液样本。中风的发生是自我报告的，并通过病历审查得到证实。我们将血脂测量值分为五分位数。我们使用考克斯比例风险模型来评估血脂和缺血性卒中风险之间的关系。结果：在11年的随访中，发生了282例缺血性卒中。在年龄校正模型中，所有血脂水平均与缺血性卒中风险增加密切相关。在调整潜在混杂因素后，这种相关性尤其减弱了HDL-C。对于最高与最低五分位数的比较，（95% CI;平均五分位数值的趋势p）为2.27（1.43，3.60; p（趋势）< 0.001）总胆固醇; 1.74（1.14，2.66; ptrend = 0.003）LDL-C; 0.78（0.52，1.17; p（趋势）= 0.27）HDL-C; 1.65对于总胆固醇与HDL-C的比率为2.45（1.06，2.58; p（趋势）= 0.02）;对于非HDL-C为2.45（1.54，3.91; p（趋势）< 0.001）。结论：在这一大群表面健康的女性中，总胆固醇、低密度脂蛋白胆固醇、总胆固醇与高密度脂蛋白胆固醇的比值和非高密度脂蛋白胆固醇与缺血性卒中风险增加显著相关。
Objective: To evaluate the association between total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol to HDL-C ratio, and non-HDL-C with the risk of ischemic stroke in a large cohort of apparently healthy women. Methods: Prospective cohort study among 27,937 US women aged >= 45 years participating in the Women's Health Study who provided baseline blood samples. Stroke occurrence was self-reported and confirmed by medical record review. We categorized plasma lipid measurements into quintiles. We used Cox proportional hazards models to evaluate the association between lipids and risk of ischemic stroke. Results: During 11 years of follow-up, 282 ischemic strokes occurred. All lipid levels were strongly associated with increased risk of ischemic stroke in age-adjusted models. The association attenuated particularly for HDL-C after adjustment for potential confounders. For the comparison of the highest to the lowest quintile, the multivariable-adjusted hazard ratios (95% CI; p for trend across mean quintile values) of ischemic stroke were 2.27 (1.43, 3.60; p(trend) < 0.001) for total cholesterol; 1.74 (1.14, 2.66; ptrend = 0.003) for LDL-C; 0.78 (0.52, 1.17; p(trend) = 0.27) for HDL-C; 1.65 (1.06, 2.58; p(trend) = 0.02) for the total cholesterol to HDL-C ratio; and 2.45 (1.54, 3.91; p(trend) < 0.001) for non-HDL-C. Conclusions: In this large cohort of apparently healthy women, total cholesterol, low-density lipoprotein cholesterol, the total cholesterol to high-density lipoprotein cholesterol ratio, and non-high-density lipoprotein cholesterol were significantly associated with increased risk of ischemic stroke.