Haffner S M, Gruber K K, Morales P A, Hazuda H P, Valdez R A, Mitchell B D, Stern M P
Department of Medicine, University of Texas Health Science Center at San Antonio 78284-7873.
Am J Epidemiol. 1992 Nov 1;136(9):1060-8. doi: 10.1093/oxfordjournals.aje.a116571.
There is considerable evidence that lipoprotein(a) (Lp(a)) is a strong independent risk factor for coronary heart disease. Based on their risk factor profile, Mexican Americans have an increased risk of coronary heart disease, yet Mexican Americans have coronary heart disease mortality similar to or lower than that of non-Hispanic whites. The authors therefore attempted to determine whether Mexican Americans had decreased Lp(a) concentrations relative to non-Hispanic whites in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Lp(a) concentrations (mg/dl) were significantly lower in Mexican Americans (n = 316) than in non-Hispanic whites (n = 242) (men: 10.4 vs. 16.3; women: 11.5 vs. 16.4). In addition, the proportion of persons with Lp(a) concentrations of > or = 30 mg/dl (the threshold at which increased risk of coronary heart disease is believed to occur) was significantly higher in non-Hispanic whites than in Mexican Americans (18.6% vs. 7.6%; Mantel-Haenszel odds ratio (adjusted for sex) = 2.79). Age, obesity, body fat distribution, cigarette smoking, alcohol consumption, and glucose and insulin concentrations were not significantly related to Lp(a) levels. Decreased Lp(a) concentrations may account in part for Mexican Americans' relative protection from coronary heart disease mortality.
有大量证据表明，脂蛋白(a) [Lp(a)] 是冠心病的一个强大独立危险因素。基于其危险因素特征，墨西哥裔美国人患冠心病的风险增加，但墨西哥裔美国人的冠心病死亡率与非西班牙裔白人相似或更低。因此，在一项基于人群的糖尿病和心血管疾病研究——圣安东尼奥心脏研究中，作者试图确定墨西哥裔美国人的Lp(a) 浓度相对于非西班牙裔白人是否有所降低。墨西哥裔美国人（n = 316）的Lp(a) 浓度（mg/dl）显著低于非西班牙裔白人（n = 242）（男性：10.4 对 16.3；女性：11.5 对 16.4）。此外，Lp(a) 浓度≥30 mg/dl（被认为冠心病风险增加的阈值）的人群比例在非西班牙裔白人中显著高于墨西哥裔美国人（18.6% 对 7.6%；Mantel-Haenszel 优势比（经性别调整）= 2.79）。年龄、肥胖、体脂分布、吸烟、饮酒以及血糖和胰岛素浓度与Lp(a) 水平无显著相关性。Lp(a)浓度降低可能部分解释了墨西哥裔美国人在冠心病死亡率方面相对受到的保护。
