Association for Cardiac Research, Rome, Italy.
Association for Cardiac Research, Rome, Italy; EA 4650, Signalisation, électrophysiologie et imagerie des lésions d'ischémie reperfusion myocardique, Université de Normandie, Caen, Normandie, France.
Nutr Metab Cardiovasc Dis. 2020 Jul 24;30(8):1337-1346. doi: 10.1016/j.numecd.2020.04.018. Epub 2020 Apr 25.
The association of serum cholesterol levels with the occurrence of coronary heart disease (CHD) mortality during a follow-up of 50 years was rarely investigated previously. Thus, we took advantage of results at hand in 10 pooled cohorts of men aged 40-59 years from the Seven Countries Study (9063 individuals and 2057 CHD fatal events) and we assessed this.
Cox proportional hazards models were run with CHD fatal events (as dependent variable) and cholesterol levels (as independent variables) at years 0, 10, and 25 (in 5 cohorts). Cumulative events during subsequent decades (cumulative approach: CA) and separately in each subsequent decade (partitioned approach: PA) were analyzed. The ecological correlation of average baseline serum cholesterol levels with CHD mortality was very high (R = 0.97). Serum cholesterol and CHD mortality for 50 years were associated at the individual level, and the association estimated by the Cox's coefficients (and related hazards ratios) was initially strong in both CA and PA, but slightly declined during later decades. Hazards ratios (for a difference of 40 mg/dl) ranged from 1.39 to 1.20 for CA and from 1.39 to 0.80 for PA. Coefficients were larger for CA than for PA and the decline was more evident for the latter. Partitioned coefficient became negative and significant in the last decade (from year 40-50). Coefficients derived from cholesterol levels measured at year 10 of follow-up showed similar trends but their magnitude was smaller.
Thus, the relationship of serum cholesterol levels with CHD mortality remained relatively stable during at least 40 years after a single cholesterol measurement at baseline in middle-aged men.
此前很少有研究调查血清胆固醇水平与 50 年随访期间冠心病（CHD）死亡率之间的关系。因此，我们利用来自 7 个国家研究（9063 人，2057 例 CHD 死亡事件）的 10 个合并队列的数据评估了这种关系。
使用 Cox 比例风险模型，以 CHD 死亡事件（作为因变量）和胆固醇水平（作为自变量）为指标，对 0 年、10 年和 25 年（5 个队列）进行了分析。分析了随后几十年的累积事件（累积方法：CA）和在每个随后的十年中分别进行的分析（分区方法：PA）。平均基线血清胆固醇水平与 CHD 死亡率的生态相关性非常高（R = 0.97）。个体水平上血清胆固醇与 CHD 死亡率之间存在关联，Cox 系数（和相关风险比）估计的关联在 CA 和 PA 中最初都很强，但在随后的几十年中略有下降。风险比（差异为 40mg/dl）在 CA 中为 1.39-1.20，在 PA 中为 1.39-0.80。CA 的系数大于 PA，且后者的下降更为明显。分区系数在最后十年（从第 40-50 年）变为负且显著。从随访第 10 年测量的胆固醇水平得出的系数显示出相似的趋势，但幅度较小。
因此，在中年男性基线单次胆固醇测量后至少 40 年内，血清胆固醇水平与 CHD 死亡率之间的关系相对稳定。
