Cardiovascular Therapeutic Lead Diabetes & Cardiovascular Medical Operations, Sanofi KK, Tokyo, Japan.
Division of Cardiology, University of Texas Health Science Center at Houston, Houston, TX, United States.
Am J Med Sci. 2021 Nov;362(5):435-441. doi: 10.1016/j.amjms.2021.04.013. Epub 2021 May 4.
This study aimed to assess sex and racial differences related to high-density lipoprotein cholesterol (HDL-C) levels in those presenting with acute coronary syndromes (ACS).
Records from patients with ACS presenting to the Emergency Department of University of Florida Hospital Jacksonville from 2009 to 2012, were reviewed. Detailed medical history was obtained. HDL-C levels were measured within 72 h of presentation. Pearson chi-square and Wilcoxon rank sum tests were used to compare groups in univariate analysis. Analysis of variance was performed to determine independent predictors of higher HDL-C levels using variable selection.
Of 2400 patients screened, 614 (382 men and 232 women) met inclusion criteria. Hypertension, chronic kidney disease or prior CAD history was similar between sexes and races. Women were more likely to be older (62.4 vs 58.4 years), diabetic (56.5 vs 36.5%) and have higher body mass index (31.2 vs 30.1 kg/m2). Blacks were more likely to be diabetic (50.3 vs 41.3%). After adjusting for all clinical markers, women and blacks along with absence of CAD or diabetes, were significantly associated with higher HDL-C levels.
High HDL-C levels (> 40 mg/dL), considered cardio-protective, were seen in women and blacks with ACS more often than in men and whites. Significant differences in HDL-C levels between sexes were seen in whites but not in blacks. Relevance and quality of HDL-C levels in racial groups need further study as this may have important implications in the interpretation of current guidelines.
本研究旨在评估在急性冠脉综合征（ACS）患者中与高密度脂蛋白胆固醇（HDL-C）水平相关的性别和种族差异。
回顾了 2009 年至 2012 年期间在佛罗里达大学杰克逊维尔医院急诊科就诊的 ACS 患者的病历。获取了详细的病史。在就诊后 72 小时内测量了 HDL-C 水平。使用 Pearson 卡方检验和 Wilcoxon 秩和检验进行单因素分析比较组间差异。使用变量选择进行方差分析，以确定更高 HDL-C 水平的独立预测因素。
在筛选的 2400 名患者中，614 名（382 名男性和 232 名女性）符合纳入标准。性别和种族之间高血压、慢性肾脏病或既往 CAD 病史相似。女性更可能年龄较大（62.4 岁 vs 58.4 岁）、患有糖尿病（56.5% vs 36.5%）和体重指数更高（31.2 公斤/平方米 vs 30.1 公斤/平方米）。黑人更可能患有糖尿病（50.3% vs 41.3%）。调整所有临床标志物后，女性和黑人以及无 CAD 或糖尿病与更高的 HDL-C 水平显著相关。
在 ACS 患者中，较高的 HDL-C 水平（>40mg/dL）被认为具有心脏保护作用，女性和黑人比男性和白人更常见。在白人中观察到性别之间 HDL-C 水平的显著差异，但在黑人中没有观察到。需要进一步研究种族群体中 HDL-C 水平的相关性和质量，因为这可能对当前指南的解释具有重要意义。
