日本男性和女性的空腹及非空腹甘油三酯水平与缺血性心血管疾病风险：社区循环风险研究（CIRCS）

Fasting and non-fasting triglycerides and risk of ischemic cardiovascular disease in Japanese men and women: the Circulatory Risk in Communities Study (CIRCS).

作者信息

Iso Hiroyasu, Imano Hironori, Yamagishi Kazumasa, Ohira Tetsuya, Cui Renzhe, Noda Hiroyuki, Sato Shinichi, Kiyama Masahiko, Okada Takeo, Hitsumoto Shinichi, Tanigawa Takeshi, Kitamura Akihiko

机构信息

Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.

Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan; Osaka Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamichi, Higashinari-ku, Osaka, 537-0025, Japan.

出版信息

Atherosclerosis. 2014 Nov;237(1):361-8. doi: 10.1016/j.atherosclerosis.2014.08.028. Epub 2014 Sep 6.

DOI:10.1016/j.atherosclerosis.2014.08.028

PMID:25443874

Abstract

BACKGROUND

Non-fasting triglycerides were reported to have a greater impact on risk of ischemic cardiovascular events than fasting triglycerides. However, evidence from Asia, where the prevalence of dyslipidemia is generally lower, has been limited.

METHODS

We used 1975-1986 baseline surveys to investigate cohort data of 10,659 (4264 men and 6395 women) residents aged 40-69 years, initially free from ischemic heart disease and stroke, in four Japanese communities. Serum triglyceride concentrations at baseline were obtained for 2424 fasting (≥8 h after meal) and 8235 non-fasting (<8 h after meal) participants.

RESULTS

During the 22-year follow-up, 284 (165 men and 119 women) developed ischemic heart disease and 666 (349 men and 317 women) ischemic stroke. After adjustment for age, sex and known cardiovascular risk factors, multivariable hazard ratios (95%CI) of ischemic cardiovascular disease (ischemic heart disease and ischemic stroke) for the highest versus lowest quartiles of triglycerides were 1.71 (1.14-2.59), P for trend = 0.013, for fasting participants and 1.60 (1.25-2.05), P for trend <0.001, for non-fasting participants. The positive associations did not differ between fasting and non-fasting men, while they were strong for non-fasting women. They were stronger for ischemic heart disease than for ischemic stroke. After further adjustment for HDL-cholesterol, these associations were slightly attenuated, but remained statistically significant.

CONCLUSION

Non-fasting as well as fasting triglycerides are predictive of risk of ischemic cardiovascular disease for Japanese men, as are non-fasting triglycerides for women.

摘要

背景

据报道，非空腹甘油三酯对缺血性心血管事件风险的影响大于空腹甘油三酯。然而，在血脂异常患病率普遍较低的亚洲，相关证据有限。

方法

我们利用1975 - 1986年的基线调查，对日本四个社区中10659名（4264名男性和6395名女性）年龄在40 - 69岁、最初无缺血性心脏病和中风的居民进行队列数据研究。对2424名空腹（餐后≥8小时）和8235名非空腹（餐后<8小时）参与者测定了基线时的血清甘油三酯浓度。

结果

在22年的随访期间，284人（165名男性和119名女性）发生了缺血性心脏病，666人（349名男性和317名女性）发生了缺血性中风。在调整年龄、性别和已知心血管危险因素后，甘油三酯最高四分位数与最低四分位数相比，空腹参与者发生缺血性心血管疾病（缺血性心脏病和缺血性中风）的多变量风险比（95%CI）为1.71（1.14 - 2.59），趋势P值 = 0.013；非空腹参与者为1.60（1.25 - 2.05），趋势P值<0.001。空腹和非空腹男性之间的正相关无差异，而非空腹女性的相关性较强。缺血性心脏病的相关性比缺血性中风更强。在进一步调整高密度脂蛋白胆固醇后，这些相关性略有减弱，但仍具有统计学意义。