Daimon Makoto, Oizumi Toshihide, Kameda Wataru, Matsui Jun, Murakami Hiroshi, Ueno Yoshiyuki, Kubota Isao, Yamashita Hidetoshi, Kayama Takamasa, Kato Takeo
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine.
J Atheroscler Thromb. 2015;22(10):1030-9. doi: 10.5551/jat.29181. Epub 2015 May 27.
To evaluate the effects of treatment for hyperlipidemia on total mortality, we examined the association with adjustments for multiple factors, including those related to general health, such as blood hemoglobin and serum levels of albumin, adiponectin, brain natriuretic peptide, and lipids, using a prospective cohort study of a general Japanese population.
The population-based, longitudinal Takahata study enrolled 3,291 Japanese individuals (1515 male, 1776 female; age: 62.5 ± 10.3 years) between 2004 and 2006. The incidence and causes of death were annually monitored until January 10, 2012 (median follow-up period: 2,655 days).
During the follow-up period, there were 169 deaths. The Cox proportional hazard regression model analysis used to adjust for factors related to general health condition, cardiovascular disease risks, and serum lipid levels showed a significant association between treatment for hyperlipidemia and decreased total mortality compared with no treatment for hyperlipidemia [hazard ratio (HR): 0.24; 95% confidence interval (CI): 0.08-0.69) and subjects without hyperlipidemia (HR: 0.34;95%CI: 0.12-0.96). The Cox proportional hazard regression model analysis with adjustments for factors related to general health conditions showed a significantly lower total mortality in subjects without hyperlipidemia than that in subjects with untreated hyperlipidemia (HR: 0.70; 95%CI: 0.50-0.99).
Not only antihyperlipidemic drugs used but also selection bias and non-evaluated factors, such as socio-economic status, educational level, health literacy, and daily nutrition, affected the results. Subjects taking treatment for hyperlipidemia were found to have reduced total mortality, which was independent of serum lipid levels.
为评估高脂血症治疗对总死亡率的影响，我们采用一项针对日本普通人群的前瞻性队列研究，研究了在对包括与一般健康相关因素（如血红蛋白、白蛋白、脂联素、脑钠肽和血脂的血清水平）进行多因素校正后的相关性。
基于人群的纵向高幡研究在2004年至2006年间纳入了3291名日本人（男性1515名，女性1776名；年龄：62.5±10.3岁）。对死亡发生率和原因进行年度监测，直至2012年1月10日（中位随访期：2655天）。
在随访期间，共有169人死亡。用于校正与一般健康状况、心血管疾病风险和血脂水平相关因素的Cox比例风险回归模型分析显示，与未接受高脂血症治疗相比，高脂血症治疗与总死亡率降低之间存在显著相关性[风险比（HR）：0.24；95%置信区间（CI）：0.08 - 0.69]，与无高脂血症的受试者相比（HR：0.34；95%CI：0.12 - 0.96）。对与一般健康状况相关因素进行校正的Cox比例风险回归模型分析显示，无高脂血症的受试者的总死亡率显著低于未治疗的高脂血症受试者（HR：0.70；95%CI：0.50 - 0.99）。
不仅所使用的抗高脂血症药物，而且选择偏倚和未评估的因素（如社会经济地位、教育水平、健康素养和日常营养）都影响了结果。接受高脂血症治疗的受试者的总死亡率降低，这与血脂水平无关。
