Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.
Eur J Clin Invest. 2010 Dec;40(12):1081-93. doi: 10.1111/j.1365-2362.2010.02357.x.
Although the total to high-density lipoprotein cholesterol ratio (TC/HDL-C) has been used for decades to identify individuals at risk for coronary heart disease (CHD), apolipoprotein-based (apolipoprotein B/apolipoprotein A-I [apoB/apoA-I]) and nuclear magnetic resonance spectroscopy (NMR)-based lipoprotein concentrations (low-density lipoprotein(NMR) /high-density lipoprotein(NMR) [LDL(NMR) /HDL(NMR)]) may also be useful for CHD risk stratification.
In a case-control study conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study population, 870 individuals who developed CHD during a 6-year follow-up were matched to 1659 controls on the basis of gender, age and enrollment time. LDL(NMR) and HDL(NMR) were measured by proton NMR spectroscopy.
After adjusting for traditional CHD risk factors, men in the top quintile of the various lipoprotein ratios proved to be at increased CHD risk (OR = 2·59 [95% IC, 1·76-3·83] for TC/HDL-C ratio, 2·59 [1·75-3·83] for apoB/apoA-I ratio and 2·78 [1·86-4·17] for LDL(NMR) /HDL(NMR) ratio) compared with men in the bottom quintile. Similar associations were observed in women (OR = 2·86 [1·71-4·80] for TC/HDL-C ratio, 2·94 [1·74-4·97] for apoB/apoA-I ratio and 2·03 [1·21-3·43] for LDL(NMR)/HDL(NMR) ratio). Compared with participants with only one component of the metabolic syndrome, those who had five had an increased TC/HDL-C ratio (73·0% and 80·4% in men and women respectively), apoB/apoA-I ratio (58·0% and 62·9% in men and women respectively) and for LDL(NMR)/HDL(NMR) ratio (52·6% and 54·1% in men and women respectively).
In this European study population, the TC/HDL-C, apoB/apoA-I and LDL(NMR) /HDL(NMR) ratios were similarly associated with components of the metabolic syndrome and CHD risk.
尽管总胆固醇与高密度脂蛋白胆固醇比值（TC/HDL-C）已被用于数十年以识别患冠心病（CHD）的风险个体，但载脂蛋白为基础（载脂蛋白 B/载脂蛋白 A-I [apoB/apoA-I]）和基于核磁共振光谱（NMR）的脂蛋白浓度（低密度脂蛋白（NMR）/高密度脂蛋白（NMR）[LDL（NMR）/HDL（NMR）]）也可能有助于 CHD 风险分层。
在欧洲前瞻性癌症与营养研究（EPIC）-诺福克研究人群中进行的病例对照研究中，在 6 年的随访期间，870 名发生 CHD 的个体按性别、年龄和入组时间与 1659 名对照相匹配。通过质子 NMR 光谱法测量 LDL（NMR）和 HDL（NMR）。
在调整了传统的 CHD 危险因素后，处于各种脂蛋白比值最高五分位数的男性患 CHD 的风险增加（TC/HDL-C 比值的比值比[OR] = 2.59 [95%CI，1.76-3.83]，apoB/apoA-I 比值的比值比[OR] = 2.59 [1.75-3.83]，LDL（NMR）/HDL（NMR）比值的比值比[OR] = 2.78 [1.86-4.17]），与处于最低五分位数的男性相比。在女性中也观察到类似的关联（TC/HDL-C 比值的比值比[OR] = 2.86 [1.71-4.80]，apoB/apoA-I 比值的比值比[OR] = 2.94 [1.74-4.97]，LDL（NMR）/HDL（NMR）比值的比值比[OR] = 2.03 [1.21-3.43]）。与只有代谢综合征一个成分的参与者相比，具有五个成分的参与者 TC/HDL-C 比值（男性分别为 73.0%和 80.4%，女性分别为 73.0%和 80.4%）、apoB/apoA-I 比值（男性分别为 58.0%和 62.9%，女性分别为 58.0%和 62.9%）和 LDL（NMR）/HDL（NMR）比值（男性分别为 52.6%和 54.1%，女性分别为 52.6%和 54.1%）。
在这项欧洲研究人群中，TC/HDL-C、apoB/apoA-I 和 LDL（NMR）/HDL（NMR）比值与代谢综合征的成分和 CHD 风险具有相似的相关性。
