Longo-Mbenza B, Mambune H F A, Kasiam J B, Vita E K, Fuele S M, Nsenga J N, Mabwa L, Nzuzi V
Division of Cardiology, Department of Internal Medicine, University of Kinshasa, DR Congo.
West Afr J Med. 2007 Jul-Sep;26(3):183-90. doi: 10.4314/wajm.v26i3.28306.
There are controversies as to what the traditional risk factors for coronary heart disease should be in sub-Saharan Africa.
To assess the relationship between cholesterol and cardiovascular disease risk factors including Helicobacter pylori infection in black Africans with congestive heart failure.
A cross-sectional and observational study of 48 men and 52 women.
Congestive heart failure was associated with abdomal obesity, hypertension, chronic renal failure, moderate levels of low HDL-C, excessive alcohol intake and hyperuricaemia, but low levels of cholesterol and triglycerides. TC was related by Univariate analysis with red cells, glucose, weight, waist circumference with HDL-C, CRP, fibrinogen and IgG antibodies against H pylori. Multivariate analysis revealed that waist circumference (B=0.688) and HDL-C (B=0.826) were the significant determinants of TC. There was a respective U-shaped relationship between CVD (P>0.05), chronic renal failure (P<0.05) H. pylori-induced chronic gastritis (P<0.05) and the HDL-categories. Ischemic stroke and myocardial infarction were significantly (p<0.05) associated with low HDL-C, respectively. Clinical insulin resistance (P<0.01) was predominantly more commonin the intermediate HDL-C category than in low and high HDL-categories. There was an inverse relation between lower TC: HDL-C ratio, high HDL-C and abdominal obesity/ insulin resistance in men. H. pylori gastritis was positively related to higher TC: HDL-C ratio in both men and women.
Preventive measures, more studies on the interplay between HDL-C level and its function and a specific ethnic dfinition of metabolic syndrome in the African are needed.
关于撒哈拉以南非洲地区冠心病的传统危险因素究竟有哪些，存在争议。
评估胆固醇与包括幽门螺杆菌感染在内的心血管疾病危险因素之间的关系，研究对象为患有充血性心力衰竭的非洲黑人。
对48名男性和52名女性进行横断面观察性研究。
充血性心力衰竭与腹部肥胖、高血压、慢性肾衰竭、低水平高密度脂蛋白胆固醇（HDL-C）、过量饮酒和高尿酸血症相关，但与低水平胆固醇和甘油三酯有关。单因素分析显示，总胆固醇（TC）与红细胞、血糖、体重、腰围、HDL-C、C反应蛋白（CRP）、纤维蛋白原以及抗幽门螺杆菌IgG抗体有关。多因素分析表明，腰围（B = 0.688）和HDL-C（B = 0.826）是TC的重要决定因素。心血管疾病（P>0.05）、慢性肾衰竭（P<0.05）、幽门螺杆菌引起的慢性胃炎（P<0.05）与HDL-C类别之间分别呈U形关系。缺血性中风和心肌梗死分别与低HDL-C显著相关（P<0.05）。临床胰岛素抵抗（P<0.01）在中等HDL-C类别中比在低HDL-C和高HDL-C类别中更为常见。男性中，较低的TC:HDL-C比值、高HDL-C与腹部肥胖/胰岛素抵抗呈负相关。幽门螺杆菌胃炎与男性和女性较高的TC:HDL-C比值呈正相关。
需要采取预防措施，进一步研究HDL-C水平与其功能之间的相互作用，并针对非洲人代谢综合征给出特定的种族定义。
