Ettinger W H, Verdery R B, Wahl P W, Fried L P
Department of Internal Medicine, Bowman Gray School of Medicine, Wake Forest University.
J Gerontol. 1994 May;49(3):M116-22. doi: 10.1093/geronj/49.3.m116.
High density lipoprotein (HDL) may be an important risk factor for cardiovascular disease in older people. HDL is heterogeneous with several subfractions. This article describes the distribution and correlates of HDL2 cholesterol (C) and HDL3-C in older people.
HDL subfraction cholesterols were measured in 1,127 females and 825 males > or = 65 years old who participated in the Cardiovascular Health Study. Distributions of HDL subfraction cholesterols and bivariate and multivariate relationships were determined in cross-sectional analyses.
Mean (+/- SD) concentrations of HDL subfractions were: HDL3-C (M .98 +/- .25, F 1.2 +/- .29 mmol/l), HDL2-C (M .09 +/- .08, F .13 +/- .09 mmol/l). HDL2-C, but not HDL3-C, was slightly higher with age. Using multivariate analysis, both HDL2-C and HDL3-C (in females) were inversely correlated with triglyceride, body weight, and fasting insulin; HDL3-C was inversely correlated with central fat distribution in women. Both HDL2-C and HDL3-C were lower in participants with prevalent cardiovascular disease. However, only HDL3-C was significantly inversely related to carotid stenosis, as measured by ultrasound.
The slight increase in HDL-C with age appears to be due to an increase in the HDL2-C subfraction. HDL-C subfractions are independently related to triglyceride levels, body weight, and insulin concentrations in older people, all potentially modifiable risk factors. Both HDL2-C and HDL3-C are lower in older people with prevalent cardiovascular disease, although only HDL3-C was correlated with carotid atherosclerosis. These findings are consistent with the hypothesis that HDL subfractions are important risk factors for atherosclerotic cardiovascular disease in the elderly.
高密度脂蛋白（HDL）可能是老年人心血管疾病的一个重要危险因素。HDL具有异质性，包含多个亚组分。本文描述了老年人中HDL2胆固醇（C）和HDL3-C的分布及其相关因素。
对参加心血管健康研究的1127名65岁及以上女性和825名65岁及以上男性测量HDL亚组分胆固醇。在横断面分析中确定HDL亚组分胆固醇的分布以及双变量和多变量关系。
HDL亚组分的平均（±标准差）浓度为：HDL3-C（男性0.98±0.25，女性1.2±0.29 mmol/L），HDL2-C（男性0.09±0.08，女性0.13±0.09 mmol/L）。HDL2-C随年龄略有升高，而HDL3-C无此现象。采用多变量分析，HDL2-C和HDL3-C（女性）均与甘油三酯、体重和空腹胰岛素呈负相关；HDL3-C与女性中心性脂肪分布呈负相关。患有心血管疾病的参与者中HDL2-C和HDL3-C均较低。然而，通过超声测量，仅HDL3-C与颈动脉狭窄显著负相关。
HDL-C随年龄的轻微升高似乎是由于HDL2-C亚组分增加所致。HDL-C亚组分在老年人中与甘油三酯水平、体重和胰岛素浓度独立相关，这些均为潜在的可改变危险因素。患有心血管疾病的老年人中HDL2-C和HDL3-C均较低，尽管只有HDL3-C与颈动脉粥样硬化相关。这些发现与HDL亚组分是老年人动脉粥样硬化性心血管疾病重要危险因素的假设一致。
