Keys A, Karvonen M J, Punsar S, Menotti A, Fidanza F, Farchi G
Int J Epidemiol. 1984 Dec;13(4):428-35. doi: 10.1093/ije/13.4.428.
Examinations of 'healthy' men in Helsinki and in rural west and east Finland in 1956 included estimation of total cholesterol and that in the HDL and beta fractions separated by electrophoresis. Vital status to the end of 1980 has been ascertained for all but eight of the 526 men aged 35-61 and for all but two of 261 men aged 30-34 at entry. Among the men aged 35-61, in 24 years 155 died, 63 from coronary heart disease; among the men aged 30-34, 36 died, 16 from coronary heart disease. All causes and coronary death rates were highest in east Finland where HDL cholesterol was also highest. Coronary death rates were not related to HDL cholesterol in east or west Finland but 16 men dead from coronary heart disease in Helsinki tended to have low HDL values. Consideration of five other entry characteristics did not change the picture with regard to HDL-mortality relationships. Solution of the multiple logistic equation using all those variables found the probability of 24-year coronary death was not significantly related to HDL but was significantly related, positively, to the non-HDL cholesterol concentration. HDL and total cholesterol mean values for men of the same age in the same area of Finland, with lipoprotein separation by the new recommended methods, agree closely with the means recorded in 1956. These 24-year findings are not necessarily in conflict with reports in the literature on an inverse relationship between coronary heart disease incidence and HDL cholesterol based on much shorter periods of follow-up and few data on mortality.
1956年在赫尔辛基以及芬兰西部和东部农村地区对“健康”男性进行的检查包括对总胆固醇以及通过电泳分离的高密度脂蛋白（HDL）和β组分中的胆固醇进行评估。对于526名年龄在35至61岁的男性中除8人之外的所有人，以及261名年龄在30至34岁的男性中除2人之外的所有人，已确定其截至1980年底的生命状况。在年龄为35至61岁的男性中，24年间有155人死亡，其中63人死于冠心病；在年龄为30至34岁的男性中，有36人死亡，其中16人死于冠心病。所有原因导致的死亡率和冠心病死亡率在芬兰东部最高，而该地区的高密度脂蛋白胆固醇水平也最高。在芬兰东部或西部，冠心病死亡率与高密度脂蛋白胆固醇无关，但在赫尔辛基，16名死于冠心病的男性往往具有较低的高密度脂蛋白值。考虑其他五个初始特征并未改变高密度脂蛋白与死亡率关系的情况。使用所有这些变量求解多元逻辑方程发现，24年冠心病死亡的概率与高密度脂蛋白无显著相关性，但与非高密度脂蛋白胆固醇浓度呈显著正相关。采用新推荐方法进行脂蛋白分离后，芬兰同一地区相同年龄男性的高密度脂蛋白和总胆固醇平均值与1956年记录的平均值非常接近。这些24年的研究结果不一定与文献中基于更短随访期和很少死亡率数据的关于冠心病发病率与高密度脂蛋白胆固醇之间负相关的报道相冲突。
