Serum Low-Density Lipoprotein to High-Density Lipoprotein Ratio as a Predictor of Future Acute Myocardial Infarction Among Men in a 2.7-Year Cohort Study of a Japanese Northern Rural Population
Serum Low-Density Lipoprotein to High-Density Lipoprotein Ratio as a Predictor of Future Acute Myocardial Infarction Among Men in a 2.7-Year Cohort Study of a Japanese Northern Rural Population
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DOI：
10.5551/jat.5215
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发表时间：
2011-01-01
影响因子：
4.4
通讯作者：
Okayama, Akira
中科院分区：
文献类型：
--
作者：
Yokokawa, Hirohide;Yasumura, Seiji;Okayama, Akira
研究并比较日本普通人群中总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、TC/HDL-C和LDL-C/HDL-C比值对未来心血管结局的预测价值。共有24，566名符合条件的参与者，年龄在18岁或以上，无心血管疾病，通过多阶段健康筛查入组，并根据脂蛋白水平或比率分为四分位数组。研究的主要终点是明确的急性心肌梗死（AMI）和缺血性卒中，未纳入原因不明的猝死病例。我们使用考克斯比例风险模型来研究四分位数和AMI或缺血性卒中发病率之间的关系，调整传统的危险因素。结果：平均年龄为63.7岁的男性和60.7岁的女性。平均随访2.7年，共记录40例AMI和182例缺血性卒中。在男性受试者中，LDL-C/HDL-C比值和LDL-C水平的前四分位数以及TC的第三四分位数的AMI风险比（HR）显著较高。LDL-C/HDL-C比值为2.6或更高的男性参与者的HR显著高于其他四分位数。脂蛋白水平或其比例四分位数和缺血性中风之间没有关联被认为是任何性别调整后的危险factors.Conclusions：我们的研究结果表明，LDL-C/HDL-C的比例是一个独立的预测AMI，更好地管理心血管风险的重要性高LDL/HDL C的比例，为预防未来的心血管疾病的人。
To examine and compare the predictive value of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL-C and LDL-C/HDL-C ratios for future cardiovascular outcomes in the general Japanese population.Methods: A total of 24,566 eligible participants aged 18 years or older, without cardiovascular disease, were enrolled through multiphase health screening and divided into quartile groups based on lipoprotein levels or ratios. Primary endpoints of the study were definitive acute myocardial infarction (AMI) and ischemic stroke, and cases of sudden death with unknown causes were not included. We used Cox proportional hazard models to examine the relationships between the quartiles and incidences of AMI or ischemic stroke, adjusting for traditional risk factors.Results: Mean age was 63.7 years for males and 60.7 years for females. Mean follow-up period was 2.7 years, and 40 cases of AMI and 182 cases of ischemic stroke were recorded. The hazard ratio (HR) for AMI was significantly higher in the top quartile of the LDL-C/HDL-C ratio and LDL-C levels, and third quartile of TC among male participants. The HR of male participants with a LDL-C/HDL-C ratio of 2.6 or higher was significantly higher than other quartiles. No association between lipoprotein levels or their ratio quartiles and ischemic stroke was seen for either sex after adjusting for risk factors.Conclusions: Our results indicated that the LDL-C/HDL-C ratio is an independent predictor for AMI, and the importance of better management of cardiovascular risks among people with high LDLC/HDLC ratios for the prevention of future cardiovascular disease.