Palo Alto Medical Foundation Research Institute, Palo Alto, CA (A.T.H.F., B.Z., P.O.J., K.M.J.A., L.P.P.) and Kaiser Permanente Center for Health Research Northwest, Portland, OR (S.P.F.).
Circulation. 2014 Feb 4;129(5):570-9. doi: 10.1161/CIRCULATIONAHA.113.005757. Epub 2013 Nov 5.
No studies have comprehensively examined the prevalence of dyslipidemia, a major risk factor for cardiovascular disease, among diverse racial/ethnic minority groups. The primary aim of this study was to identify racial/ethnic differences in dyslipidemia among minorities including Asian Americans (Asian Indian, Chinese, Filipino, Japanese, Korean, or Vietnamese), Mexican Americans, and blacks compared with non-Hispanic whites.
Using a 3-year cross section (2008-2011), we identified 169 430 active primary care patients (35 years or older) from an outpatient healthcare organization in northern California. Age-standardized prevalence rates were calculated for 3 dyslipidemia subtypes: high triglycerides (fasting laboratory value ≥150 mg/dL), low levels of high-density lipoprotein cholesterol (fasting laboratory value <40 mg/dL [men] and <50 mg/dL [women]), and high levels of low-density lipoprotein cholesterol (fasting laboratory value ≥130 mg/dL or taking low-density lipoprotein-lowering agents). Odds ratios were calculated by multivariable logistic regression, with adjustment for patient characteristics (age, measured body mass index, smoking). Compared with non-Hispanic whites, every minority subgroup had an increased prevalence of high triglycerides except blacks. Most minority groups had an increased prevalence of low high-density lipoprotein cholesterol, except for Japanese and blacks. The prevalence of high low-density lipoprotein cholesterol was increased among Asian Indians, Filipinos, Japanese, and Vietnamese compared with non-Hispanic whites.
Minority groups, except for blacks, were more likely to have high triglyceride/low high-density lipoprotein cholesterol dyslipidemia. Further research is needed to determine how racial/ethnic differences in dyslipidemia affect racial/ethnic differences in cardiovascular disease rates.
目前尚无研究全面评估心血管疾病主要危险因素——血脂异常在不同种族/少数民族群体中的流行情况。本研究的主要目的是确定少数族裔(包括亚裔美国人[印度裔、华裔、菲律宾裔、日裔、韩裔或越裔]、墨西哥裔和非裔)与非西班牙裔白人间血脂异常的种族/民族差异。
本研究使用了 3 年的横断面数据(2008-2011 年),对加利福尼亚州北部一家门诊医疗保健机构的 169430 名 35 岁及以上的活跃初级保健患者进行了识别。计算了 3 种血脂异常亚型的年龄标准化患病率:高甘油三酯血症(空腹实验室值≥150mg/dL)、高密度脂蛋白胆固醇水平低(空腹实验室值<40mg/dL[男性]和<50mg/dL[女性])和低密度脂蛋白胆固醇水平高(空腹实验室值≥130mg/dL 或服用降低低密度脂蛋白的药物)。通过多变量逻辑回归计算比值比,并对患者特征(年龄、测量体重指数、吸烟)进行调整。与非西班牙裔白人相比,除黑人外,每个少数民族群体的高甘油三酯血症患病率均有所增加。除了日裔和非裔外,大多数少数民族群体的低高密度脂蛋白胆固醇血症患病率都有所增加。与非西班牙裔白人相比,印度裔、菲律宾裔、日裔和越裔的低密脂蛋白胆固醇血症患病率较高。
除了黑人之外,少数族裔更有可能患有高甘油三酯/低高密度脂蛋白胆固醇血症。需要进一步研究种族/民族差异在血脂异常方面的差异如何影响心血管疾病的种族/民族差异。