Zhang X, Patel A, Horibe H, Wu Z, Barzi F, Rodgers A, MacMahon S, Woodward M
Int J Epidemiol. 2003 Aug;32(4):563-72. doi: 10.1093/ije/dyg106.
Cholesterol levels in many Asian countries are rising. Predictions of the likely effects of this on the incidence of cardiovascular diseases have mostly relied on data from Western populations. Whether the associations between total cholesterol and cardiovascular diseases are similar in Asia is not established.
The Asia Pacific Cohort Studies Collaboration (APCSC) is an individual-participant data meta-analysis of prospective studies from the Asia-Pacific region. Cox models were applied to the combined data from 29 cohorts to estimate the region-, sex-, and age-specific hazard ratios of major cardiovascular diseases by the fifths of total cholesterol.
At baseline, the age/sex-adjusted mean value of total cholesterol was higher in Australia and New Zealand (ANZ) (5.52 +/- 1.05 mmol/l) than in Asia (4.87 +/- 1.05 mmol/l). During 2 million person-years of follow-up among 352 033 individuals, 4841 cardiovascular deaths were recorded. The association of total cholesterol with coronary heart disease and stroke was similar in Asian and ANZ cohorts. Overall, each 1-mmol/l higher level of total cholesterol was associated with 35% (95% CI: 26-44%) increased risk of coronary death, 25% (95% CI: 13-40%) increased risk of fatal or non-fatal ischaemic stroke, and 20% (95% CI: 8-30%) decreased risk of fatal haemorrhagic stroke.
In both Asian and non-Asian populations in the Asia-Pacific region, total cholesterol is similarly strongly associated with the risk of CHD and ischaemic, but not haemorrhagic, stroke. Rising population-wide levels of cholesterol would be expected to contribute to a substantial increase in the overall burden of cardiovascular diseases in this region.
许多亚洲国家的胆固醇水平正在上升。关于这对心血管疾病发病率可能产生的影响的预测大多依赖于西方人群的数据。亚洲地区总胆固醇与心血管疾病之间的关联是否相似尚未明确。
亚太队列研究协作组（APCSC）是一项对亚太地区前瞻性研究的个体参与者数据进行的荟萃分析。将Cox模型应用于29个队列的合并数据，以按总胆固醇五分位数估计主要心血管疾病在地区、性别和年龄方面的特定风险比。
在基线时，澳大利亚和新西兰（ANZ）的年龄/性别调整后总胆固醇平均值（5.52±1.05 mmol/L）高于亚洲（4.87±1.05 mmol/L）。在352033名个体的200万人年随访期间，记录了4841例心血管死亡病例。亚洲和ANZ队列中总胆固醇与冠心病和中风的关联相似。总体而言，总胆固醇每升高1 mmol/L，冠心病死亡风险增加35%（95%CI：26 - 44%），致命或非致命缺血性中风风险增加25%（95%CI：13 - 40%），致命性出血性中风风险降低20%（95%CI：8 - 30%）。
在亚太地区的亚洲和非亚洲人群中，总胆固醇与冠心病和缺血性中风（而非出血性中风）风险的关联同样强烈。预计该地区人群胆固醇水平的上升将导致心血管疾病总体负担大幅增加。
