Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S Second Street, Minneapolis, MN 55454, USA.
Circulation. 2011 Nov 8;124(19):2056-64. doi: 10.1161/CIRCULATIONAHA.111.028373. Epub 2011 Oct 10.
Previous studies have suggested that there is a novel dyslipidemic profile consisting of isolated low high-density lipoprotein cholesterol (HDL-C) level that is associated with increased risk of coronary heart disease, and that this trait may be especially prevalent in Asian populations.
Individual participant data from 220 060 participants (87% Asian) in 37 studies from the Asia-Pacific region were included. Low HDL-C (HDL <1.03 mmol/L in men and <1.30 mmol/L in women) was seen among 33.1% (95% confidence interval [CI], 32.9-33.3) of Asians versus 27.0% (95% CI, 26.5-27.5) of non-Asians (P<0.001). The prevalence of low HDL-C in the absence of other lipid abnormalities (isolated low HDL-C) was higher in Asians compared with non-Asians: 22.4% (95% CI, 22.2-22.5) versus 14.5% (95% CI, 14.1-14.9), respectively (P<0.001). During 6.8 years of follow-up, there were 574 coronary heart disease and 739 stroke events. There was an inverse relationship between low HDL-C with coronary heart disease in all individuals (hazard ratio, 1.57; 95% CI, 1.31-1.87). In Asians, isolated low levels of HDL-C were as strongly associated with coronary heart disease risk as low levels of HDL-C combined with other lipid abnormalities (hazard ratio, 1.67 [95% CI, 1.27-2.19] versus 1.63 [95% CI, 1.24-2.15], respectively). There was no association between low HDL-C and stroke risk in this population (hazard ratio, 0.95 [95% CI, 0.78 to 1.17] with nonisolated low HDL-C and 0.81 [95% CI, 0.67-1.00] with isolated low HDL-C).
Isolated low HDL-C is a novel lipid phenotype that appears to be more prevalent among Asian populations, in whom it is associated with increased coronary risk. Further investigation into this type of dyslipidemia is warranted.
先前的研究表明，有一种新型血脂异常谱，其特征为孤立性低高密度脂蛋白胆固醇（HDL-C）水平升高，与冠心病风险增加相关，而这种特征在亚洲人群中可能更为普遍。
纳入了来自亚太地区 37 项研究的 220060 名参与者（87%为亚洲人）的个体参与者数据。亚洲人群中 33.1%（95%置信区间[CI]，32.9-33.3）存在低 HDL-C（男性<1.03mmol/L，女性<1.30mmol/L），而非亚洲人群中为 27.0%（95%CI，26.5-27.5）（P<0.001）。与非亚洲人相比，亚洲人群中无其他脂质异常（孤立性低 HDL-C）的低 HDL-C 患病率更高：分别为 22.4%（95%CI，22.2-22.5）和 14.5%（95%CI，14.1-14.9）（P<0.001）。随访 6.8 年后，发生了 574 例冠心病和 739 例脑卒中事件。在所有个体中，低 HDL-C 与冠心病呈负相关（危险比，1.57；95%CI，1.31-1.87）。在亚洲人群中，孤立性低水平的 HDL-C 与冠心病风险的相关性与 HDL-C 水平与其他脂质异常相结合（危险比，1.67 [95%CI，1.27-2.19]与 1.63 [95%CI，1.24-2.15]）一样强。在该人群中，低 HDL-C 与脑卒中风险无关联（危险比，0.95 [95%CI，0.78 至 1.17]与非孤立性低 HDL-C 和 0.81 [95%CI，0.67-1.00]与孤立性低 HDL-C）。
孤立性低 HDL-C 是一种新型血脂异常表型，在亚洲人群中似乎更为普遍，与冠心病风险增加相关。需要进一步研究这种类型的血脂异常。
