Ren Jie, Zhao Dong, Liu Jing, Wang Wei, Wang Miao, Sun Jia-Yi, Liu Jun, Li Yan, Qi Yue, Qin Lan-ping, Wu Zhao-su
Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Oct;38(10):934-8.
To evaluate the relationship between serum non-HDL-C and incidence of various cardiovascular disease (CVD) in Chinese population aged 35-64 years.
This prospective study was performed from 1992 to 2004 in 11 provinces of China and the association between baseline non-HDL-C level with the risk of various CVD events was analyzed in 29 937 subjects aged 35-64 years using Cox multivariate proportional hazards regression. CVD events in this study including acute coronary events (ACE), ischemic stroke, hemorrhagic stroke and ischemic cardiovascular disease (ICVD).
(1) Adjusted for age, gender, smoking status, diabetes, body mass index and blood pressure, the relative risk of ACE, ischemic stroke and ICVD in groups of non-HDL-C 3.37 - 4.13 mmol/L (130 - 159 mg/dl), 4.14 - 4.91 mmol/L (160 - 189 mg/dl) and ≥ 4.92 mmol/L (190 mg/dl) was 1.24 (0.91 - 1.70), 1.78 (1.25 - 2.53), 2.23 (1.48 - 3.35); 1.34 (1.07 - 1.68), 1.38 (1.04 - 1.83), 1.38 (0.97 - 1.94) and 1.37 (1.12 - 1.63), 1.52 (1.22 - 1.90), 1.70 (1.30 - 2.22), respectively. The risk of hemorrhagic stroke was declined obviously in group > 4.92 mmol/L (190 mg/dl). (2) The correlation between VLDL-C and ACE was the strongest in four CVD events when VLDL-C and LDL-C were joint analyzed, ICVD events ranked the second. The risk for ischemic stroke also borderline increased with increasing VLDL-C and LDL-C (P > 0.05).
Increased non-HDL-C is associated with increased risk of suffering ACE, ischemic stroke and ICVD and VLDL-C plays a critical role in the development of ICVD events, especially ACS, in middle aged Chinese population.
评估中国35 - 64岁人群血清非高密度脂蛋白胆固醇（non-HDL-C）与各类心血管疾病（CVD）发病率之间的关系。
这项前瞻性研究于1992年至2004年在中国11个省份开展，使用Cox多变量比例风险回归分析了29937名35 - 64岁受试者基线non-HDL-C水平与各类CVD事件风险之间的关联。本研究中的CVD事件包括急性冠脉事件（ACE）、缺血性卒中、出血性卒中和缺血性心血管疾病（ICVD）。
（1）在调整年龄、性别、吸烟状况、糖尿病、体重指数和血压后，non-HDL-C水平在3.37 - 4.13 mmol/L（130 - 159 mg/dl）、4.14 - 4.91 mmol/L（160 - 189 mg/dl）和≥4.92 mmol/L（190 mg/dl）组中，ACE、缺血性卒中和ICVD的相对风险分别为1.24（0.91 - 1.70）、1.78（1.25 - 2.53）、2.23（1.48 - 3.35）；1.34（1.07 - 1.68）、1.38（1.04 - 1.83）、1.38（0.97 - 1.94）和1.37（1.12 - 1.63）、1.52（1.22 - 1.90）、1.70（1.30 - 2.22）。出血性卒中风险在>4.92 mmol/L（190 mg/dl）组中明显下降。（2）当联合分析极低密度脂蛋白胆固醇（VLDL-C）和低密度脂蛋白胆固醇（LDL-C）时，在四类CVD事件中，VLDL-C与ACE的相关性最强，ICVD事件次之。随着VLDL-C和LDL-C升高，缺血性卒中风险也呈临界性增加（P>0.05）。
non-HDL-C升高与ACE、缺血性卒中和ICVD风险增加相关，且VLDL-C在中年中国人群ICVD事件尤其是急性冠脉综合征（ACS）的发生发展中起关键作用。
