男性 PACC 项目参与者亚临床动脉粥样硬化、非高密度脂蛋白胆固醇、运动和饮食之间的关系。

The relationship between subclinical atherosclerosis, non-high-density lipoprotein cholesterol, exercise, and diet among male participants of the PACC Project.

机构信息

Medstar Health Research Institute, Washington Hospital Center and Georgetown University, Washington, DC, USA.

出版信息

J Clin Lipidol. 2012 Mar-Apr;6(2):174-9. doi: 10.1016/j.jacl.2011.11.005. Epub 2011 Dec 3.

DOI:10.1016/j.jacl.2011.11.005

PMID:22385551

Abstract

BACKGROUND

Non-high-density lipoprotein (HDL) cholesterol is recommended as a secondary lipid goal treated initially with lifestyle modification. However, the relationship between non-HDL and subclinical atherosclerosis is unknown. We examined the independent relationships between coronary artery calcium (CAC), lipids including non-HDL, exercise, and diet among healthy male participants of the Prospective Army Coronary Calcium (PACC) Project.

METHODS

Male participants from the PACC Project (n = 1637, mean age 42.8 years; no history of coronary heart disease) were studied. We used validated surveys to measure dietary quality and habitual physical exercise. Fasting lipid concentrations and other cardiovascular risk variables were measured. Subclinical atherosclerosis was detected with the use of electron beam computed tomography for CAC. Factors independently associated with the presence of any detectable CAC (CAC score > 0), including standard CV risk variables, non-HDL, exercise, and diet, were evaluated with the use of logistic regression.

RESULTS

The mean Framingham risk score was 4.6 ± 2.6%; CAC was present in 22.4%. Fasting lipid concentrations showed mean LDL-C 128 ± 32 mg/dL, HDL-C 50 ± 13 mg/dL, TG-C 130 ± 86 mg/dL, and non-HDL-C 154 ± 37 mg/dL. Men with CAC had significantly greater levels of LDL-C (135 vs 127 mg/dL), TG (148 vs 124 mg/dL), and non-HDL-C (164 vs 151 mg/dL) and less habitual physical activity (P = 0.006). There were nonsignificant trends between prevalent CAC, greater amounts of dietary fat intake, and lower HDL-C. In successive multivariable logistic regression models for the dependent variable CAC, only non-HDL-C (odds ratio [OR] 1.012 per mg/dL; 95% CI 1.002-1.023; P = .019) and age (OR 1.119 per year; 95% CI 1.063-1.178; P < .001) were independently associated with the presence of CAC, and exercise (OR 0.808; 95% CI 0.703-0.928; P = 0.003) was associated with the absence of CAC.

CONCLUSIONS

Non-HDL-C and exercise are independently predictive of the presence of subclinical CAC among healthy lower-risk middle-aged men.

摘要

背景

非高密度脂蛋白（HDL）胆固醇被推荐为初始通过生活方式改变来治疗的次要脂质目标。然而，非 HDL 与亚临床动脉粥样硬化之间的关系尚不清楚。我们研究了健康男性参与者前瞻性陆军冠状动脉钙（PACC）项目中冠状动脉钙（CAC）、包括非 HDL 在内的血脂、运动和饮食之间的独立关系。

方法

对 PACC 项目的男性参与者（n=1637，平均年龄 42.8 岁；无冠心病史）进行了研究。我们使用经过验证的调查来衡量饮食质量和习惯性体力活动。测量空腹血脂浓度和其他心血管风险变量。使用电子束计算机断层扫描检测亚临床动脉粥样硬化，以检测 CAC。使用逻辑回归评估与任何可检测 CAC（CAC 评分>0）存在相关的因素，包括标准 CV 风险变量、非 HDL、运动和饮食。

结果

Framingham 风险评分的平均值为 4.6±2.6%；CAC 阳性率为 22.4%。空腹血脂浓度显示 LDL-C 为 128±32mg/dL、HDL-C 为 50±13mg/dL、TG-C 为 130±86mg/dL、非 HDL-C 为 154±37mg/dL。有 CAC 的男性 LDL-C（135 比 127mg/dL）、TG（148 比 124mg/dL）和非 HDL-C（164 比 151mg/dL）水平显著更高，习惯性体力活动水平显著更低（P=0.006）。在 CAC 的患病率、饮食中脂肪摄入量的增加和 HDL-C 水平的降低之间存在不显著的趋势。在因变量 CAC 的连续多变量逻辑回归模型中，只有非 HDL-C（每毫克/dL 增加 1.012；95%CI 为 1.002-1.023；P=0.019）和年龄（每年增加 1.119；95%CI 为 1.063-1.178；P<0.001）与 CAC 的存在独立相关，而运动（OR 0.808；95%CI 0.703-0.928；P=0.003）与 CAC 的不存在独立相关。