Konnov M V, Dobordginidze L M, Deev A D, Gratsiansky N A
Research Institute for Physicochemical Medicine, Moscow, Russia.
Kardiologiia. 2016 Mar;56(3):12-18. doi: 10.18565/cardio.2016.3.12-18.
to elucidate own and parental predictors of low levels of high density lipoprotein cholesterol (HDL-C) in blood of children of persons with early coronary heart disease (ECHD) (onset less or equal 55 years, men, or less or equal 60 years, women).
We examined 305 families: probands with ECAD (n=289, 69.2% men), their spouses (n=213, 17.8% men) and native children of probands (n=399, 56.1% men) aged 5-38 years. Low level of HDL-C in children aged 5-17 years we defined as less or equal 25 percentile (the Lipid Research Clinics, 1981), in children aged 18-38 years - <1.03 (men) and <1.29 (women) mmol/l. Predictors of low HDL-C were selected by logistical regression with adjustment for sex and age.
Low HDL-C was revealed in 48/152 (31.6%) children aged 5-17 years. Its independent predictors were own higher triglycerides (TG) and low HDL-C of spouse. Odds ratio (OR) of top (>0.94 mmol/l) vs two bottom ( less or equal 0.94 mmol/l) tertiles of TG 2.68 (95% confidence interval [CI] 1.03-6.94; =0.043); low HDL-C of spouse 2.33 (95% CI 1.03-5.26; =0.041). Low HDL-C was revealed in 91/247 (36.8%) offsprings aged 18-38 years. Its independent predictors were higher waist circumferences (WC, OR top [>85 cm] vs bottom [ less or equal 73 cm] tertile 5.43, 95% CI 2.39-12.3; =0.000) and TG (OR 1.45, 95% CI 1.01-2.09; =0.047) of these children, atherogenic dyslipidemia of proband (OR 2.44, 95% CI 1.34-4.44; =0.0036); metabolic syndrome (OR 4.14, 95% CI 1.96-8.75; =0.0002) and lower heart rate (OR top [>72 bpm] vs two bottom [ less or equal 72 bpm] tertiles 0.41, 95% CI 0.17-0.97; =0.043) of consort-parent.
In this group of different age children with parental ECHD independent predictors of low HDL-C were mostly own (TG) and parental metabolic factors.
阐明早发性冠心病(ECHD,男性发病年龄小于或等于55岁,女性发病年龄小于或等于60岁)患者子女血液中高密度脂蛋白胆固醇(HDL-C)水平较低的自身及父母相关预测因素。
我们研究了305个家庭:患有早发性冠心病的先证者(n = 289,男性占69.2%)、他们的配偶(n = 213,男性占17.8%)以及先证者5 - 38岁的亲生子女(n = 399,男性占56.1%)。我们将5 - 17岁儿童HDL-C水平较低定义为低于或等于第25百分位数(脂质研究诊所,1981年标准),18 - 38岁儿童HDL-C水平较低定义为男性<1.03 mmol/l,女性<1.29 mmol/l。通过逻辑回归并对性别和年龄进行校正来选择HDL-C水平较低的预测因素。
在152名5 - 17岁儿童中,有48名(31.6%)HDL-C水平较低。其独立预测因素为自身较高的甘油三酯(TG)水平以及配偶的HDL-C水平较低。TG水平处于最高三分位数(>0.94 mmol/l)与最低两个三分位数(≤0.94 mmol/l)相比的优势比(OR)为2.68(95%置信区间[CI] 1.03 - 6.94;P = 0.043);配偶HDL-C水平较低的OR为2.33(95% CI 1.03 - 5.26;P = 0.041)。在247名18 - 38岁的后代中,有91名(36.8%)HDL-C水平较低。其独立预测因素为这些儿童自身较高的腰围(WC,最高三分位数[>85 cm]与最低三分位数[≤73 cm]相比的OR为5.43,95% CI 2.39 - 12.3;P = 0.000)和TG水平(OR 1.45,95% CI 1.01 - 2.09;P = 0.047)、先证者的致动脉粥样硬化血脂异常(OR 2.44,95% CI 1.34 - 4.44;P =
0.0036)、配偶 - 父母的代谢综合征(OR 4.14,95% CI 1.96 - 8.75;P = 0.0002)以及较低的心率(最高三分位数[>72次/分钟]与最低两个三分位数[≤72次/分钟]相比的OR为0.41,95% CI 0.17 - 0.97;P = 0.043)。
在这组有父母患早发性冠心病的不同年龄段儿童中,HDL-C水平较低的独立预测因素大多为自身(TG)及父母的代谢因素。