Department of Neurology, Columbia University, New York, NY, USA.
Am Heart J. 2011 May;161(5):886-92. doi: 10.1016/j.ahj.2011.01.018.
The aim of this study was to explore race-ethnic differences in the association between plasma lipid components and risk of incident myocardial infarction (MI).
DESIGN/METHODS: As part of the Northern Manhattan Study, 2,738 community residents without cardiovascular disease were prospectively evaluated. Baseline fasting blood samples were collected, and lipid panel components were analyzed as continuous and categorical variables. Cox proportional hazards models were used to calculate HRs and 95% CIs for incident MI after adjusting for demographic and cardiovascular risk factors.
The mean age was 68.8 ± 10.4 years; 36.7% were men. Of the participants, 19.9% were non-Hispanic white; 24.9%, non-Hispanic black; and 52.8%, Hispanic (>80% from the Caribbean). Hispanics had lower mean high-density lipoprotein cholesterol (HDL-C) and higher triglycerides (TG)/HDL-C. During a mean 8.9 years of follow-up, there were 163 incident MIs. In the whole cohort, all lipid profile components were associated with risk of MI in the expected directions. However, HDL-C (adjusted HR per 10 mg/dL increase 0.93, 95% CI 0.76-1.12) and TG/HDL-C >2 (adjusted HR 0.89, 95% CI 0.51-1.55) were not predictive of MI among Hispanics but were predictive among non-Hispanic blacks and whites. Triglycerides/HDL-C per unit increase was associated with an 8% higher risk of MI among Hispanics (adjusted HR 1.08, 95% CI 1.04-1.12).
In Hispanics, low HDL-C and TG/HDL-C >2 were not associated with MI risk. Our data suggest that a different TG/HDL ratio cutoff may be needed among Hispanics to predict MI risk.
本研究旨在探讨血浆脂质成分与心肌梗死（MI）发病风险之间的关联在不同种族-民族群体中的差异。
作为北方曼哈顿研究的一部分，前瞻性评估了 2738 名无心血管疾病的社区居民。采集基线空腹血样，分析血脂谱成分的连续和分类变量。使用 Cox 比例风险模型，在校正人口统计学和心血管危险因素后，计算 MI 发病的 HRs 和 95%CI。
参与者的平均年龄为 68.8 ± 10.4 岁，其中 36.7%为男性。参与者中，19.9%为非西班牙裔白人，24.9%为非西班牙裔黑人，52.8%为西班牙裔（加勒比地区裔占 80%以上）。西班牙裔人群的平均高密度脂蛋白胆固醇（HDL-C）水平较低，甘油三酯（TG）/HDL-C 水平较高。在平均 8.9 年的随访期间，发生了 163 例 MI。在整个队列中，所有血脂谱成分均按预期方向与 MI 风险相关。然而，HDL-C（每增加 10mg/dL 的调整 HR 为 0.93，95%CI 为 0.76-1.12）和 TG/HDL-C >2（调整 HR 为 0.89，95%CI 为 0.51-1.55）与西班牙裔人群的 MI 无相关性，但与非西班牙裔黑人和白人相关。TG/HDL-C 每单位增加与西班牙裔人群 MI 风险增加 8%相关（调整 HR 为 1.08，95%CI 为 1.04-1.12）。
在西班牙裔人群中，低 HDL-C 和 TG/HDL-C >2 与 MI 风险无关。我们的数据表明，预测 MI 风险时，西班牙裔人群可能需要不同的 TG/HDL 比值截断值。
