Luksiene Dalia, Tamosiunas Abdonas, Baceviciene Migle, Radisauskas Ricardas, Malinauskiene Vilija, Peasey Anne, Bobak Martin
Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Epidemiology and Public Health, University College London, London, United Kingdom.
PLoS One. 2014 Jun 23;9(6):e100158. doi: 10.1371/journal.pone.0100158. eCollection 2014.
The aim of this study was to provide reliable information on dyslipidaemias, to estimate the trend of the prevalence of dyslipidaemias and other selected cardiovascular disease (CVD) risk factors at population level, and to evaluate the risk of all-cause and CVD mortality in relation to presence of mixed dyslipidaemias and other CVD risk factors.
Data from the five surveys (1983-2008) are presented. A random sample of 9,209 subjects aged 45-64 was selected for statistical analysis. During follow-up there were 1653 death cases from any cause, 864 deaths from CVD. Estimates of hazard ratios (HR) and 95% confidence intervals (CI) were based on the multivariate Cox proportional hazards regression for all-cause mortality and CVD mortality.
During 25 year period the prevalence of normal total cholesterol level (<5.2 mmol/L) significantly increased only in women; triglycerides and high density lipoprotein (HDL) cholesterol did not change in men and women. Findings in our longitudinal study showed that in men and women mixed dyslipidaemias (HDL cholesterol <1.03 mmol/L plus triglycerides ≥1.70 mmol/L) significantly increased the risk for all-cause and CVD mortality (respectively in men HR = 1.30; HR = 1.15, in women HR = 1.83; HR = 2.13). These mixed dyslipidaemia combinations combination with the other risk factors such as arterial hypertension, high fasting glucose level increased all-cause and CVD mortality risk in men and women; while, these mixed dyslipidaemias plus smoking increased all-cause and CVD mortality risk only in men compared to never smokers without these dyslipidaemias (respectively HR = 1.89; HR = 1.92); and these dyslipidaemias plus obesity increased all-cause and CVD mortality risk in women (respectively HR = 2.25; HR = 2.39) and CVD mortality risk in men (HR = 1.72), as compared to responders without obesity and these dyslipidaemias.
Mixed dyslipidaemias (reduced HDL cholesterol plus elevated triglycerides) significantly increased the risk for all-cause and CVD mortality in this Lithuanian population aged 45-64 years.
本研究的目的是提供有关血脂异常的可靠信息，估计人群中血脂异常及其他选定心血管疾病（CVD）危险因素的流行趋势，并评估混合性血脂异常及其他CVD危险因素与全因死亡率和CVD死亡率的关系。
呈现了五项调查（1983 - 2008年）的数据。选取了9209名45 - 64岁的受试者作为随机样本进行统计分析。随访期间有1653例全因死亡病例，864例CVD死亡病例。风险比（HR）和95%置信区间（CI）的估计基于多变量Cox比例风险回归分析全因死亡率和CVD死亡率。
在25年期间，正常总胆固醇水平（<5.2 mmol/L）的患病率仅在女性中显著增加；男性和女性的甘油三酯和高密度脂蛋白（HDL）胆固醇水平均未改变。我们纵向研究的结果表明，男性和女性的混合性血脂异常（HDL胆固醇<1.03 mmol/L加甘油三酯≥1.70 mmol/L）显著增加了全因死亡率和CVD死亡率的风险（男性中HR分别为1.30；HR为1.15，女性中HR分别为1.83；HR为2.13）。这些混合性血脂异常组合与动脉高血压、空腹血糖水平高等其他危险因素一起增加了男性和女性的全因死亡率和CVD死亡率风险；然而，与没有这些血脂异常的从不吸烟者相比，这些混合性血脂异常加吸烟仅增加了男性的全因死亡率和CVD死亡率风险（HR分别为1.89；HR为1.92）；与没有肥胖和这些血脂异常的应答者相比，这些血脂异常加肥胖增加了女性的全因死亡率和CVD死亡率风险（HR分别为2.25；HR为2.39）以及男性的CVD死亡率风险（HR为1.72）。
混合性血脂异常（HDL胆固醇降低加甘油三酯升高）显著增加了立陶宛45 - 64岁人群的全因死亡率和CVD死亡率风险。
