Harari Gil, Green Manfred S, Magid Avi, Zelber-Sagi Shira
School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Am J Cardiol. 2017 Apr 15;119(8):1193-1198. doi: 10.1016/j.amjcard.2017.01.008. Epub 2017 Jan 25.
Non-high-density lipoprotein cholesterol (non-HDL-C) may be equivalent or superior to low-density lipoprotein cholesterol (LDL-C) for prediction of cardiovascular disease (CVD) risk. However, studies comparing the predictive values of LDL-C and non-HDL-C for CVD and total mortality in a long-term follow-up yielded conflicting results. The Cardiovascular Occupational Risk Factor Determination in Israel Study (CORDIS) is a prospective cohort study of a young industrial population of workers with a long-term follow-up. The initial phase of the study was carried out in 1985-1999. Interviews and physical examinations were conducted, and fasting blood samples, including lipid panels, were undertaken. In 2007, after a 22-year follow-up period, the baseline data were merged with data on all-cause and CVD mortality obtained from the Israeli National Death Registry. A total of 4,832 men were included in the analysis with a mean age of 42.1 ± 12.1 years. Univariate analysis indicated a positive association between non-HDL-C and LDL-C levels and an increased risk for both all-cause and CVD mortality. Multiple regression analysis, following adjustment for potential confounders, resulted in attenuation of the association of both lipoproteins with total mortality. The adjusted association between non-HDL-C levels ≥190 mg/dl and CVD mortality remained significant (hazard ratio 1.80, 95% confidence interval 1.10 to 2.96), but the association of LDL-C with CVD mortality was attenuated (hazard ratio 1.53, 95% confidence interval 0.98 to 2.39). In conclusion, non-HDL-C may be a more potent predictor of CVD mortality than LDL-C levels.
非高密度脂蛋白胆固醇(non-HDL-C)在预测心血管疾病(CVD)风险方面可能等同于或优于低密度脂蛋白胆固醇(LDL-C)。然而,在长期随访中比较LDL-C和non-HDL-C对CVD及全因死亡率预测价值的研究结果并不一致。以色列心血管职业风险因素测定研究(CORDIS)是一项对年轻产业工人进行长期随访的前瞻性队列研究。该研究的初始阶段于1985年至1999年进行。进行了访谈和体格检查,并采集了空腹血样,包括血脂指标。2007年,经过22年的随访期后,将基线数据与从以色列国家死亡登记处获得的全因和CVD死亡率数据进行了合并。共有4832名男性纳入分析,平均年龄为42.1±12.1岁。单因素分析表明,non-HDL-C和LDL-C水平与全因和CVD死亡率增加风险呈正相关。在对潜在混杂因素进行调整后的多元回归分析中,两种脂蛋白与总死亡率的关联均减弱。non-HDL-C水平≥190mg/dl与CVD死亡率之间的校正关联仍然显著(风险比1.80,95%置信区间1.10至2.96),但LDL-C与CVD死亡率的关联减弱(风险比1.53,95%置信区间0.98至2.39)。总之,non-HDL-C可能比LDL-C水平更能有效预测CVD死亡率。
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