Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan.
J Am Heart Assoc. 2012 Oct;1(5):e001974. doi: 10.1161/JAHA.112.001974. Epub 2012 Oct 25.
The relation between serum total cholesterol (TC) and cardiovascular disease in women and in the elderly is unclear, especially in Asian populations.
We examined this relation in the largest-scale pooled analysis of the Japanese population, the Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) study. A total of 65 594 participants who were 40 to 89 years of age and did not have a past history of cardiovascular disease were examined. Cox proportional-hazards models were used to estimate hazard ratios for death from total stroke, cerebral infarction, intracranial cerebral hemorrhage, or coronary heart disease. The mean follow-up period was 10.1 years, with the number of deaths from total stroke, cerebral infarction, cerebral hemorrhage, and coronary heart disease being 875, 457, 212, and 374, respectively. The participants were divided into 2 age groups: middle-aged (40 to 69 years; mean age 55 years) and elderly (70 to 89 years; mean age 75 years). In men, the multivariate-adjusted hazard ratios for coronary heart disease in the highest TC category (≥6.21 mmol/L) compared with the lowest category (<4.14 mmol/L) were 2.52 (95% confidence interval: 1.15-5.07) in middle-aged participants and 2.77 (1.09-7.03) in elderly participants. In women, the hazard ratios of the highest TC category (≥6.72 mmol/L) compared with the lowest category (<4.66 mmol/L) were 3.20 (1.44-7.09) in middle-aged participants and 1.02 (0.42-2.49) in elderly participants. TC levels were not associated with cerebral infarction in any age or sex group and were associated negatively with total stroke and cerebral hemorrhage.
High serum TC levels are associated with coronary heart disease in middle-aged Japanese men and women, but evidence in elderly Japanese individuals is still limited.
血清总胆固醇（TC）与女性和老年人心血管疾病的关系尚不清楚，特别是在亚洲人群中。
我们在日本最大规模的观察性队列人群心血管预防研究（EPOCH-JAPAN 研究）中对这种关系进行了研究。共纳入 65594 名年龄在 40 至 89 岁且无心血管疾病既往史的参与者。采用 Cox 比例风险模型估计全因卒中、脑梗死、颅内出血或冠心病死亡的风险比。平均随访时间为 10.1 年，全因卒中、脑梗死、脑出血和冠心病死亡人数分别为 875、457、212 和 374。参与者被分为 2 个年龄组：中年（40 至 69 岁；平均年龄 55 岁）和老年（70 至 89 岁；平均年龄 75 岁）。在男性中，最高 TC 类别（≥6.21mmol/L）与最低类别（<4.14mmol/L）相比，冠心病的多变量调整风险比在中年参与者中为 2.52（95%置信区间：1.15-5.07），在老年参与者中为 2.77（1.09-7.03）。在女性中，最高 TC 类别（≥6.72mmol/L）与最低类别（<4.66mmol/L）相比，冠心病的风险比在中年参与者中为 3.20（1.44-7.09），在老年参与者中为 1.02（0.42-2.49）。TC 水平与任何年龄或性别组的脑梗死均无相关性，与全因卒中及脑出血呈负相关。
高血清 TC 水平与日本中年男女的冠心病相关，但日本老年人群的证据仍然有限。
