Frost P H, Davis B R, Burlando A J, Curb J D, Guthrie G P, Isaacsohn J L, Wassertheil-Smoller S, Wilson A C, Stamler J
Cardiovascular Research Institute, University of California, San Francisco 94143-0326, USA.
Circulation. 1996 Nov 15;94(10):2381-8. doi: 10.1161/01.cir.94.10.2381.
The association of serum lipids with coronary heart disease has been studied extensively in middle-aged men and, to a lesser extent, in similar women. Less well defined are lipid variables predictive of CHD in individuals of age > or = 60 years.
The Systolic Hypertension in the Elderly Program recruited 4736 persons (mean age, 72 years; 14% were black; and 43% were men). Mean systolic and diastolic blood pressures were 170 and 77 mm Hg, respectively. Baseline mean total cholesterol was 6.11 mmol/L (236 mg/dL); HDL cholesterol, 1.39 mmol/L (54 mg/dL); and non-HDL cholesterol, 4.72 mmol/L (182 mg/dL). Triglyceride levels were 1.62 mmol/L (144 mg/dL) for fasting participants and 1.78 mmol/L for the total group. LDL cholesterol, estimated in fasting samples with triglycerides of < 4.52 mmol/L, averaged 3.98 mmol/L (154 mg/dL). Mean follow-up was 4.5 years. In multivariate Cox regression analyses, baseline total, non-HDL, and LDL cholesterol levels and the ratios of total, non-HDL, and LDL to HDL cholesterol were significantly related to CHD incidence. HDL cholesterol and triglycerides were not significant in these analyses. In fasting participants with triglyceride levels of < 4.52 mmol/L, a 1.03 mmol/L (40 mg/dL) higher baseline total, non-HDL, or LDL cholesterol was associated with a 30% to 35% higher CHD event rate.
The results of this study support the concept that serum lipids are CHD risk factors in older Americans.
血清脂质与冠心病的关联在中年男性中已得到广泛研究，在类似的女性中研究程度稍低。对于年龄≥60岁个体中预测冠心病的脂质变量，其定义尚不明确。
老年收缩期高血压计划招募了4736人（平均年龄72岁；14%为黑人；43%为男性）。平均收缩压和舒张压分别为170和77 mmHg。基线平均总胆固醇为6.11 mmol/L（236 mg/dL）；高密度脂蛋白胆固醇为1.39 mmol/L（54 mg/dL）；非高密度脂蛋白胆固醇为4.72 mmol/L（182 mg/dL）。空腹参与者的甘油三酯水平为1.62 mmol/L（144 mg/dL），总体人群为1.78 mmol/L。在甘油三酯<4.52 mmol/L的空腹样本中估算的低密度脂蛋白胆固醇平均为3.98 mmol/L（154 mg/dL）。平均随访4.5年。在多变量Cox回归分析中，基线总胆固醇、非高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平以及总胆固醇、非高密度脂蛋白胆固醇和低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值与冠心病发病率显著相关。在这些分析中，高密度脂蛋白胆固醇和甘油三酯不显著。在甘油三酯水平<4.52 mmol/L的空腹参与者中，基线总胆固醇、非高密度脂蛋白胆固醇或低密度脂蛋白胆固醇每升高1.03 mmol/L（40 mg/dL），冠心病事件发生率就会升高30%至35%。
本研究结果支持血清脂质是美国老年人冠心病危险因素这一概念。
