Frontini Maria G, Srinivasan Sathanur R, Xu Ji-Hua, Tang Rong, Bond M Gene, Berenson Gerald
Tulane Center for Cardiovascular Health, Department of Epidemiology, Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
Am J Cardiol. 2007 Jul 1;100(1):64-8. doi: 10.1016/j.amjcard.2007.01.071. Epub 2007 May 11.
Direct comparative data on the utility of non-high-density lipoprotein (HDL) cholesterol versus low-density lipoprotein cholesterol, HDL cholesterol, triglycerides, apolipoprotein (apo) B, apo A-I, ratio to total cholesterol to HDL cholesterol, and ratio of apo B to apo A-I in detecting increased carotid intima-media thickness (IMT), a validated measurement of subclinical atherosclerosis, in asymptomatic younger adults are scant. This aspect was examined in 1,203 black and white subjects (71% white, 43% men) 24 to 43 years of age. In multivariate logistic regression analysis of each lipoprotein measurement (top quartile vs lower 3 quartiles specific for age, race, and gender) for detecting increased carotid IMT (top decile vs lower 9 deciles specific for age, race, and gender), only non-HDL cholesterol, total cholesterol/HDL cholesterol, and apo B emerged as significant correlates with respective odds ratios of 1.75 (95% confidence interval [CI] 1.10 to 2.78), 2.02 (95% CI 1.27 to 3.19), and 2.13 (95% CI 1.38 3.29), after adjusting for body mass index, systolic blood pressure, and other lipoprotein measurements. Regarding discriminating values of different lipoprotein measurements in detecting increased carotid IMT, area (c-value) under the receiver operating characteristic curve analysis for each lipoprotein measurement adjusted for age, race, gender, body mass index, and systolic blood pressure indicated that the c-value for non-HDL cholesterol (0.73) was similar to those for low-density lipoprotein cholesterol (0.76), total cholesterol/HDL cholesterol (0.72), apo B/apo A-I (0.71), and HDL cholesterol (0.70), but significantly (p <0.001) higher than that for apo A-I (0.69), triglycerides (0.64), and apo B (0.64). In conclusion, non-HDL cholesterol is as good as or better than other widely recommended lipoprotein measurements in the identification of subclinical atherosclerosis in young adults.
关于非高密度脂蛋白（HDL）胆固醇与低密度脂蛋白胆固醇、HDL胆固醇、甘油三酯、载脂蛋白（apo）B、apo A-I、总胆固醇与HDL胆固醇的比值以及apo B与apo A-I的比值在检测无症状年轻成年人颈动脉内膜中层厚度（IMT）增加方面的效用的直接对比数据很少，而颈动脉IMT增加是亚临床动脉粥样硬化的一项有效测量指标。在1203名年龄在24至43岁的黑人和白人受试者（71%为白人，43%为男性）中对这一方面进行了研究。在对每种脂蛋白测量值（年龄、种族和性别特异性的最高四分位数与较低的三个四分位数）进行多因素逻辑回归分析以检测颈动脉IMT增加（年龄、种族和性别特异性的最高十分位数与较低的九个十分位数）时，在调整了体重指数、收缩压和其他脂蛋白测量值后，只有非HDL胆固醇、总胆固醇/HDL胆固醇和apo B显示为显著相关，各自的优势比分别为1.75（95%置信区间[CI]1.10至2.78）、2.02（95%CI 1.27至3.19）和2.13（95%CI 1.38至3.29）。关于不同脂蛋白测量值在检测颈动脉IMT增加方面的判别值，在对年龄、种族、性别、体重指数和收缩压进行调整后，每种脂蛋白测量值的受试者工作特征曲线分析下的面积（c值）表明，非HDL胆固醇的c值（0.73）与低密度脂蛋白胆固醇（0.76）、总胆固醇/HDL胆固醇（0.72）、apo B/apo A-I（0.71）和HDL胆固醇（0.70）的c值相似，但显著高于apo A-I（0.69）、甘油三酯（0.64）和apo B（0.64）的c值（p<0.001）。总之，在识别年轻成年人的亚临床动脉粥样硬化方面，非HDL胆固醇与其他广泛推荐的脂蛋白测量值一样好或更好。
