Higgins M, Keller J B
National Heart, Lung, and Blood Institute, Bethesda, MD 20892.
Ann Epidemiol. 1992 Jan-Mar;2(1-2):69-76. doi: 10.1016/1047-2797(92)90039-s.
Relationships between serum cholesterol and coronary heart disease (CHD) were investigated in Tecumseh men and women who were 45 to 92 years old and initially free of CHD. Recruitment continued through three cycles of examinations over a period of 10 years, beginning in 1959. Follow-up for mortality ended in 1986 to 1987. Age-adjusted relative risks for CHD death for cholesterol levels of 5.2 to 6.2 mmol/L and greater than 6.2 mmol/L, compared with levels less than 5.2 mmol/L for men aged 45 to 64 years, were 1.2 and 1.7; for older men they were 1.0 and 1.8. Comparable relative risks for CHD death by cholesterol level were .7 and 1.4 for 45- to 64-year-old women and .8 and .7 for older women. Coefficients for cholesterol were significant for fatal CHD in men under and those 65 years and older when age, systolic blood pressure, body mass index, cigarette smoking status, and glucose intolerance were controlled in proportional hazards models. Cholesterol was a significant predictor of fatal CHD plus nonfatal myocardial infarction in middle-aged, but not elderly women. Relative risks for total mortality were lowest for middle-aged men and women with cholesterol levels of 5.2 to 6.2 mmol/L and the difference was significant in men.
对年龄在45至92岁且最初无冠心病的蒂卡姆西镇男性和女性，研究了血清胆固醇与冠心病（CHD）之间的关系。从1959年开始，在10年期间通过三个周期的检查持续招募研究对象。对死亡率的随访于1986年至1987年结束。45至64岁男性中，胆固醇水平为5.2至6.2 mmol/L以及高于6.2 mmol/L者，与低于5.2 mmol/L者相比，经年龄调整后的冠心病死亡相对风险分别为1.2和1.7；年龄较大的男性相对风险分别为1.0和1.8。45至64岁女性中，按胆固醇水平划分的冠心病死亡可比相对风险分别为0.7和1.4，年龄较大的女性分别为0.8和0.7。在比例风险模型中，当控制年龄、收缩压、体重指数、吸烟状况和葡萄糖耐量时，胆固醇系数对65岁及以下和65岁以上男性的致命性冠心病具有显著意义。胆固醇是中年女性而非老年女性致命性冠心病加非致命性心肌梗死的显著预测因素。胆固醇水平为5.2至6.2 mmol/L的中年男性和女性总死亡率相对风险最低，且男性中的差异具有显著性。
