Lipid alterations and decline in the incidence of coronary heart disease in the Helsinki Heart Study.
Lipid alterations and decline in the incidence of coronary heart disease in the Helsinki Heart Study.
复制标题
赫尔辛基心脏研究中的脂质变化和冠心病发病率下降。
DOI：
10.1001/jama.1988.03410050061031
复制
发表时间：
1988
期刊：
影响因子：
--
通讯作者：
E. Nikkilä
中科院分区：
文献类型：
--
作者：
V. Manninen;M. Elo;M. Frick;K. Haapa;O. Heinonen;P. Heinsalmi;Pekka Helo;J. Huttunen;P. Kaitaniemi;P. Koskinen;H. Mäenpää;M. Mälkönen;M. Mänttäri;S. Norola;A. Pasternack;J. Pikkarainen;M. Romo;T. Sjöblom;E. Nikkilä
在赫尔辛基心脏研究中，一项为期五年的随机双盲试验中，观察到服用吉非罗齐治疗的血脂异常男性的冠心病(CHD)发病率降低了34%。在试验的五年中，与安慰剂相比，吉非罗齐疗法产生的血清总胆固醇水平平均降低了10%，非高密度脂蛋白胆固醇水平平均降低了14%，低密度脂蛋白胆固醇水平平均降低了11%，甘油三酯水平平均降低了35%，高密度脂蛋白胆固醇水平平均提高了11%。虽然所有Fredrickson分型的高密度脂蛋白胆固醇水平变化相似，但对总胆固醇和低密度脂蛋白浓度的影响在IIA型最大，对低密度脂蛋白的影响在IV型最小。CHD发病率的降低在IIB型最大，在IIA型最小。血脂的变化取决于治疗前的血脂水平和服药方案的依从性。应用COX比例风险模型控制冠心病的危险因素，包括年龄、血压、吸烟和饮酒习惯、基线血脂水平、运动和相对体重，在吉非罗齐治疗组中，血清高密度脂蛋白和低密度脂蛋白水平的变化与冠心病发病率的下降具有统计学意义上的相关性。血清甘油三酯水平的大幅下降对冠心病发病率的影响相对较小。因此，这项研究的结果与早期的观察结果一起表明，升高高密度脂蛋白和降低低密度脂蛋白水平在冠心病的一级预防中都是有效的。
In the Helsinki Heart Study, a randomized five-year, double-blind trial, a 34% reduction in the incidence of coronary heart disease (CHD) was observed in dyslipidemic men treated with gemfibrozil. Averaged over the five years of the trial, gemfibrozil therapy produced, compared with placebo, mean decreases of 10% in serum total cholesterol level, 14% in non-high-density lipoprotein (HDL) cholesterol level, 11% in low-density lipoprotein (LDL) cholesterol level, 35% in triglyceride level, and a mean increase of 11% in HDL cholesterol level from baseline levels measured prior to treatment. While changes in HDL cholesterol level were similar in all Fredrickson types, the effect on concentrations of total cholesterol and LDL cholesterol was largest in type IIA and on LDL minimal in type IV. The reduction of CHD incidence over placebo was largest in type IIB and smallest in type IIA. The lipid changes were dependent on lipid levels prior to treatment and on compliance with the medication regimen. When risk factors for CHD, including age, blood pressure, smoking and drinking habits, baseline lipid levels, and exercise and relative weight, were controlled by applying the Cox proportional hazards model, the changes in serum HDL and LDL cholesterol levels were both statistically significantly associated with the decline in CHD incidence within the gemfibrozil-treated group. The large decrease in serum triglyceride levels had relatively small effect on CHD incidence. Thus, the results of this study, together with earlier observations, suggest that both elevating HDL and lowering LDL cholesterol levels are effective in the primary prevention of CHD.
DOI：
10.1001/jama.1987.03400090067035
发表时间：
1987-09
期刊：
JAMA
影响因子：
--
作者：
W. Kannel;P. Wolf;W. Castelli;R. D'Agostino
通讯作者：
W. Kannel;P. Wolf;W. Castelli;R. D'Agostino
DOI：
10.1172/jci111879
发表时间：
1985-05
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
K. Saku;P. Gartside;B. Hynd;M. Kashyap
通讯作者：
K. Saku;P. Gartside;B. Hynd;M. Kashyap
影响因子：
4.8
作者：
KRAUSS, RM
通讯作者：
KRAUSS, RM