Hargreaves A D, Logan R L, Thomson M, Elton R A, Oliver M F, Riemersma R A
Department of Cardiology, University of Edinburgh.
BMJ. 1991 Sep 21;303(6804):678-81. doi: 10.1136/bmj.303.6804.678.
To investigate long term changes in total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol concentrations and in measures of other risk factors for coronary heart disease and to assess their importance for the development of coronary heart disease in Scottish men.
Longitudinal study entailing follow up in 1988-9 of men investigated during a study in 1976.
Edinburgh, Scotland.
107 men from Edinburgh who had taken part in a comparative study of risk factors for heart disease with Swedish men in 1976 when aged 40.
The men were invited to attend a follow up clinic in 1988-9 for measurement of cholesterol concentrations and other risk factor measurements. Eighty three attended and 24 refused to or could not attend.
Changes in total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol concentrations, body weight, weight to height index, prevalence of smoking, and alcohol intake; number of coronary artery disease events.
Mean serum total cholesterol concentration increased over the 12 years mainly due to an increase in the low density lipoprotein cholesterol fraction (from 3.53 (SD 0.09) to 4.56 (0.11) mmol/l) despite a reduction in high density lipoprotein cholesterol concentration. Body weight and weight to height index increased. Fewer men smoked more than 15 cigarettes/day in 1988-9 than in 1976. Blood pressure remained stable and fasting triglyceride concentrations did not change. The frequency of corneal arcus doubled. Alcohol consumption decreased significantly. Eleven men developed clinical coronary heart disease. High low density lipoprotein and low high density lipoprotein cholesterol concentrations in 1976, but not total cholesterol concentration, significantly predicted coronary heart disease (p = 0.05). Almost all of the men who developed coronary heart disease were smokers (91% v 53%, p less than 0.05).
Over 12 years the lipid profile deteriorated significantly in this healthy cohort of young men. Smoking, a low high density lipoprotein concentration and a raised low density lipoprotein concentration were all associated with coronary heart disease in middle aged Scottish men, whereas there was no association for total cholesterol concentration. The findings have implications for screening programmes.
研究总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇浓度的长期变化，以及冠心病其他危险因素的指标变化，并评估这些因素对苏格兰男性冠心病发病的重要性。
纵向研究，对1976年一项研究中调查过的男性在1988 - 1989年进行随访。
苏格兰爱丁堡。
1976年40岁时参加与瑞典男性进行的心脏病危险因素比较研究的107名来自爱丁堡的男性。
邀请这些男性在1988 - 1989年参加随访门诊，测量胆固醇浓度及其他危险因素指标。83人参加，24人拒绝或未能参加。
总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇浓度变化、体重、体重身高指数、吸烟率和酒精摄入量；冠心病事件数量。
在12年期间，平均血清总胆固醇浓度升高，主要是由于低密度脂蛋白胆固醇部分增加（从3.53（标准差0.09）升至4.56（0.11）mmol/L），尽管高密度脂蛋白胆固醇浓度有所降低。体重和体重身高指数增加。1988 - 1989年每天吸烟超过15支的男性比1976年减少。血压保持稳定，空腹甘油三酯浓度未变。角膜弓出现频率翻倍。酒精摄入量显著下降。11名男性患临床冠心病。1976年低密度脂蛋白胆固醇水平高和高密度脂蛋白胆固醇水平低，而非总胆固醇浓度，显著预测冠心病（p = ０.05）。几乎所有患冠心病的男性都是吸烟者（91%对53%，p＜0.05）。
在这一健康的年轻男性队列中，12年间血脂状况显著恶化。吸烟、高密度脂蛋白浓度低和低密度脂蛋白浓度升高均与中年苏格兰男性冠心病有关，而总胆固醇浓度与之无关。这些发现对筛查项目具有启示意义。
