1st Department of Internal Medicine, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Wien Klin Wochenschr. 2017 Nov;129(21-22):793-798. doi: 10.1007/s00508-017-1264-1. Epub 2017 Sep 14.
The blood concentrations of total cholesterol and low-density lipoprotein (LDL) do not predict survival in patients older than 60 years. The atherogenic index of plasma (AIP) is a logarithm of the triacylglycerol to high-density lipoprotein (HDL) ratio and a surrogate for the concentration of small dense LDL. It might be a better reflection of the risk of all-cause death in elderly patients.
We conducted a prospective observational study of patients with arterial hypertension older than 60 years. The concentrations of total cholesterol, LDL, HDL and triacylglycerol were measured at the time of the recruitment and the patients were observed for 10 years. Cox regression analysis was performed to assess the effects of lipoproteins and AIP on survival.
A total of 500 patients were recruited and 473 of them (226 men, 247 women) either died or successfully completed the 10-year follow-up and were included in the analysis. The AIP was positively associated, while HDL concentration was negatively associated with the risk of all-cause death adjusted for age, smoking habits, statin use, history of diabetes mellitus, myocardial infarction, stroke and peripheral artery occlusive disease (PAOD) in elderly women but not in men. The LDL, total cholesterol, triacylglycerol and non-HDL concentrations were not associated with the risk of death in both sexes.
The AIP is positively associated with the risk of all-cause death in elderly women with arterial hypertension independent of age, smoking habits, statin therapy and comorbidities.
总胆固醇和低密度脂蛋白（LDL）的血液浓度不能预测 60 岁以上患者的生存情况。血浆致动脉粥样硬化指数（AIP）是三酰甘油与高密度脂蛋白（HDL）比值的对数，是小而密 LDL 浓度的替代指标。它可能更能反映老年患者全因死亡的风险。
我们对 60 岁以上动脉高血压患者进行了前瞻性观察研究。在招募时测量了总胆固醇、LDL、HDL 和三酰甘油的浓度，并对患者进行了 10 年的观察。进行 Cox 回归分析评估脂蛋白和 AIP 对生存的影响。
共招募了 500 名患者，其中 473 名（226 名男性，247 名女性）要么死亡，要么成功完成了 10 年的随访并纳入分析。AIP 与全因死亡风险呈正相关，而 HDL 浓度与全因死亡风险呈负相关，调整年龄、吸烟习惯、他汀类药物使用、糖尿病史、心肌梗死、卒中和外周动脉闭塞性疾病（PAOD）后，这在老年女性中是如此，但在男性中并非如此。LDL、总胆固醇、三酰甘油和非 HDL 浓度与两性的死亡风险均无关。
AIP 与老年女性动脉高血压患者的全因死亡风险呈正相关，与年龄、吸烟习惯、他汀类药物治疗和合并症无关。
