Pennington Biomedical Research Center, Baton Rouge, LA, USA.
Eur J Prev Cardiol. 2013 Feb;20(1):89-97. doi: 10.1177/1741826711428242. Epub 2011 Oct 24.
To evaluate the single and joint associations of serum high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol with coronary heart disease (CHD) risk.
Study cohorts included 21,375 Finnish participants who were 25-74 years of age and free of CHD and stroke at baseline.
During a median follow-up period of 10.8 years, 437 participants developed CHD. The sex- and multivariable-adjusted hazard ratios (HRs) of CHD at different levels of HDL cholesterol [<40 (reference), 40-49, 50-59, 60-69, and ≥ 70 mg/dL] were 1.00, 1.00, 0.74, 0.58, and 0.69 (p (trend) = 0.006), respectively. The sex- and multivariable-adjusted HRs of CHD at different levels of LDL cholesterol [<100 (reference), 100-129, 130-159, and ≥ 160 mg/dL] were 1.00, 1.25, 1.92, and 2.65 (p (trend) < 0.001), respectively. In joint analyses, a decreased trend in the incidence rate of CHD with an increasing HDL cholesterol level was consistent in people with any level of LDL cholesterol. Likewise, an increasing trend in incidence of CHD with an increase in the LDL cholesterol level was consistent in subjects with any level of HDL cholesterol.
These results suggest an inverse association between HDL cholesterol and CHD risk and a direct association between LDL cholesterol and CHD risk, independent of other risk factors. The protective effect of HDL cholesterol on CHD risk is observed at all levels of LDL cholesterol.
评估血清高密度脂蛋白（HDL）和低密度脂蛋白（LDL）胆固醇与冠心病（CHD）风险的单一和联合关联。
研究队列包括 21375 名芬兰参与者，他们在基线时年龄在 25-74 岁之间，且无 CHD 和中风病史。
在中位随访 10.8 年期间，有 437 名参与者发生 CHD。不同 HDL 胆固醇水平 [<40（参考值）、40-49、50-59、60-69 和 ≥ 70mg/dL] 的 CHD 发生的校正后性别和多变量危险比（HR）分别为 1.00、1.00、0.74、0.58 和 0.69（p（趋势）=0.006）。不同 LDL 胆固醇水平 [<100（参考值）、100-129、130-159 和 ≥ 160mg/dL] 的 CHD 发生的校正后性别和多变量 HR 分别为 1.00、1.25、1.92 和 2.65（p（趋势）<0.001）。在联合分析中，无论 LDL 胆固醇水平如何，随着 HDL 胆固醇水平升高，CHD 发生率呈下降趋势。同样，随着 LDL 胆固醇水平的升高，CHD 发生率呈上升趋势，无论 HDL 胆固醇水平如何。
这些结果表明，HDL 胆固醇与 CHD 风险呈负相关，LDL 胆固醇与 CHD 风险呈正相关，与其他危险因素无关。在所有 LDL 胆固醇水平下，HDL 胆固醇对 CHD 风险都具有保护作用。
