Shikany James M, Bassler John R, Reis Jared P, Schreiner Pamela J, Redden David T, Wilkins John T, Lewis Cora E
Division of General Internal Medicine and Population Science, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
J Lipid Res. 2025 Jan;66(1):100717. doi: 10.1016/j.jlr.2024.100717. Epub 2024 Dec 2.
HDL-C is an established risk marker for coronary heart disease. We investigated sociodemographic, lifestyle, anthropometric/physiologic, and other predictors of HDL-C over 30 years of follow-up in the Coronary Artery Risk Development in Young Adults (CARDIA) study, a multicenter, longitudinal cohort with a baseline exam in 1985-86 and follow-up exams at least every five years through 2016. During exams, participants completed various questionnaires, anthropometric measurements, and blood collection. We performed multiple linear regression of HDL-C at each CARDIA exam in a cross-sectional analysis, and linear mixed-effects regression to assess the longitudinal change of HDL-C across exams, treating time as a linear predictor, separately in women and men. The sample size ranged from 5114 participants at baseline to 3358 at the Year 30 Exam. Just over half of the participants were women and just under half were Black. Several factors were positively associated with HDL-C longitudinally in both women and men: age, self-identified Black race, alcohol intake, physical activity, and energy intake, along with sex-specific associations with current oral contraceptive use, current hormone therapy, and post-menopausal status (women only), and homeostasis model assessment-estimated insulin resistance (HOMA-IR) (men only). Other factors were inversely associated with HDL-C concentration longitudinally in both women and men: cigarette smoking, intakes of carbohydrates and total fat, body mass index, and low-density lipoprotein cholesterol and triglyceride concentrations, along with sex-specific associations with HOMA-IR and parity >0 (women only). We corroborated associations of several factors with HDL-C concentration and provided evidence of associations with several factors not extensively investigated in previous studies.
高密度脂蛋白胆固醇（HDL-C）是冠心病已确定的风险标志物。在“青年成人冠状动脉风险发展研究”（CARDIA研究）中，我们调查了社会人口统计学、生活方式、人体测量学/生理学以及其他在30年随访期间HDL-C的预测因素。该研究是一个多中心纵向队列研究，于1985 - 1986年进行了基线检查，并在2016年之前至少每五年进行一次随访检查。在检查期间，参与者完成了各种问卷调查、人体测量和血液采集。我们在横断面分析中对每次CARDIA检查时的HDL-C进行了多元线性回归，并进行线性混合效应回归以评估HDL-C在各次检查中的纵向变化，将时间视为线性预测变量，分别对女性和男性进行分析。样本量从基线时的5114名参与者到第30年检查时的3358名。略多于一半的参与者为女性，略少于一半为黑人。在女性和男性中，有几个因素与HDL-C纵向呈正相关：年龄、自我认定的黑人种族、酒精摄入量、身体活动和能量摄入，以及与当前口服避孕药使用、当前激素治疗和绝经后状态（仅女性）以及稳态模型评估估计的胰岛素抵抗（HOMA-IR）（仅男性）的性别特异性关联。在女性和男性中，其他因素与HDL-C浓度纵向呈负相关：吸烟、碳水化合物和总脂肪摄入量、体重指数、低密度脂蛋白胆固醇和甘油三酯浓度，以及与HOMA-IR和平产>0（仅女性）的性别特异性关联。我们证实了几个因素与HDL-C浓度的关联，并提供了与先前研究中未广泛研究的几个因素的关联证据。
