Salonen J T, Salonen R, Seppänen K, Rauramaa R, Tuomilehto J
Department of Community Health and General Practice, University of Kuopio, Finland.
Circulation. 1991 Jul;84(1):129-39. doi: 10.1161/01.cir.84.1.129.
We investigated the association of cholesterol concentrations in serum high density lipoprotein (HDL) and its subfractions HDL2 and HDL3 with the risk of acute myocardial infarction in 1,799 randomly selected men 42, 48, 54, or 60 years old.
Baseline examinations in the Kuopio Ischaemic Heart Disease Risk Factor Study were done during 1984-1987. In Cox multivariate survival models adjusted for age and examination year, serum HDL cholesterol of less than 1.09 mmol/l (42 mg/dl) was associated with a 3.3-fold risk of acute myocardial infarction (95% confidence intervals [CI], 1.7-6.4), serum HDL2, cholesterol of less than 0.65 mmol/l (25 mg/dl) was associated with a 4.0-fold risk of acute myocardial infarction (95% CI, 1.9-8.3), and serum HDL3 cholesterol of less than 0.40 mmol/l (15 mg/dl) was associated with a 2.0-fold (95% CI, 1.1-4.0) risk of acute myocardial infarction. Adjustments for obesity, ischemic heart disease, other cardiovascular disease, maximal oxygen uptake, systolic blood pressure, antihypertensive medication, serum low density lipoprotein cholesterol, and triglyceride concentrations reduced the excess risks associated with serum HDL, HDL2, and HDL3 cholesterol in the lowest quartiles by 52%, 48%, and 41%, respectively. Additional adjustments for alcohol consumption, cigarettes smoked daily, smoking years, and leisure time energy expenditure reduced these excess risks associated with low HDL, HDL2, and HDL3 cholesterol levels by another 26%, 24% and 21%, respectively.
Our data confirm that both total HDL and HDL2 levels have inverse associations with the risk of acute myocardial infarction and may thus be protective factors in ischemic heart disease, whereas the role of HDL3 remains equivocal.
我们在1799名年龄分别为42、48、54或60岁的随机选取男性中，研究了血清高密度脂蛋白（HDL）及其亚组分HDL2和HDL3中的胆固醇浓度与急性心肌梗死风险之间的关联。
库奥皮奥缺血性心脏病危险因素研究中的基线检查于1984年至1987年期间进行。在根据年龄和检查年份进行调整的Cox多变量生存模型中，血清HDL胆固醇低于1.09 mmol/l（42 mg/dl）与急性心肌梗死风险增加3.3倍相关（95%置信区间[CI]，1.7 - 6.4），血清HDL2胆固醇低于0.65 mmol/l（25 mg/dl）与急性心肌梗死风险增加4.0倍相关（95% CI，1.9 - 8.3），血清HDL3胆固醇低于0.40 mmol/l（15 mg/dl）与急性心肌梗死风险增加2.0倍（95% CI，1.1 - 4.0）相关。对肥胖、缺血性心脏病、其他心血管疾病、最大摄氧量、收缩压、抗高血压药物、血清低密度脂蛋白胆固醇和甘油三酯浓度进行调整后，最低四分位数中与血清HDL、HDL2和HDL3胆固醇相关的额外风险分别降低了52%、48%和41%。对饮酒量、每日吸烟量、吸烟年限和休闲时间能量消耗进行进一步调整后，与低HDL、HDL2和HDL3胆固醇水平相关的这些额外风险又分别降低了26%、24%和21%。
我们的数据证实，总HDL和HDL2水平均与急性心肌梗死风险呈负相关，因此可能是缺血性心脏病的保护因素，而HDL3的作用仍不明确。
