Noda Hiroyuki, Iso Hiroyasu, Irie Fujiko, Sairenchi Toshimi, Ohtaka Emiko, Doi Mikio, Izumi Yoko, Ohta Hitoshi
Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Shuita-shi, Osaka 565-0871 Japan.
Circulation. 2009 Apr 28;119(16):2136-45. doi: 10.1161/CIRCULATIONAHA.108.795666. Epub 2009 Apr 13.
Few studies have examined the association between low levels of low-density lipoprotein (LDL) cholesterol and risk of intraparenchymal hemorrhage.
A total of 30 802 men and 60 417 women, 40 to 79 years of age with no history of stroke or coronary heart disease, completed a baseline risk factor survey in 1993 under the auspices of the Ibaraki Prefectural Health Study. Systematic mortality surveillance was performed through 2003, and 264 intraparenchymal hemorrhage deaths were identified. LDL cholesterol levels were calculated with the Friedewald formula. Persons with LDL cholesterol > or =140 mg/dL had half the sex- and age-adjusted risk of death due to intraparenchymal hemorrhage of those with LDL cholesterol <80 mg/dL. After adjustment for cardiovascular risk factors, the multivariable hazard ratio compared with persons with LDL cholesterol <80 mg/dL was 0.65 (95% CI 0.44 to 0.96) for those with LDL cholesterol 80 to 99 mg/dL, 0.48 (0.32 to 0.71) for 100 to 119 mg/dL, 0.50 (0.33 to 0.75) for 120 to 139 mg/dL, and 0.45 (0.30 to 0.69) for >/=140 mg/dL. These inverse associations were not altered substantially after the exclusion of persons with hypertriglyceridemia, after analysis with a Cox proportional hazard model with time-dependent covariates, or in sensitivity analysis for the potential effect of competing risks.
Low LDL cholesterol levels are associated with elevated risk of death due to intraparenchymal hemorrhage.
很少有研究探讨低密度脂蛋白（LDL）胆固醇水平低与脑实质内出血风险之间的关联。
在茨城县健康研究的支持下，共有30802名男性和60417名年龄在40至79岁之间、无中风或冠心病病史的女性在1993年完成了基线风险因素调查。通过2003年进行的系统死亡率监测，确定了264例脑实质内出血死亡病例。LDL胆固醇水平采用Friedewald公式计算。LDL胆固醇≥140mg/dL的人因脑实质内出血导致的性别和年龄调整后死亡风险是LDL胆固醇<80mg/dL者的一半。在调整心血管风险因素后，与LDL胆固醇<80mg/dL的人相比，LDL胆固醇为80至99mg/dL者的多变量风险比为0.65（95%CI 0.44至0.96），100至119mg/dL者为0.48（0.32至0.71），120至139mg/dL者为0.50（0.33至0.75），≥140mg/dL者为0.45（0.30至0.69）。在排除高甘油三酯血症患者后、使用含时间依存协变量的Cox比例风险模型进行分析后，或在对竞争风险的潜在影响进行敏感性分析后，这些反向关联并未有实质性改变。
低LDL胆固醇水平与脑实质内出血导致的死亡风险升高有关。
