Assmann G, Cullen P, Schulte H
Institut für Arterioskleroseforschung, University of Münster, Germany.
Eur Heart J. 1998 Feb;19 Suppl A:A2-11.
The Münster Heart Study (PROCAM) was initiated in 1979 in order to examine cardiovascular risk factors, cardiovascular events including myocardial infarction and stroke, and mortality in people at work. Examination at entry comprised a standardized case history, measurement of blood pressure and anthropometric data, a resting electrocardiogram, and measurement of more than 20 laboratory parameters in a fasting blood sample. The prevalence data in this report are based upon a single examination of 17,437 men aged 40.4 +/- 11.3 years (mean +/- SD) and 8065 women aged 35.7 +/- 12.1 years, which took place between 1979 and 1991. Severe hypercholesterolaemia (> 300 mg.dl-1) was seen in 5% of men and 8% of women aged 45 to 64 years. In men, the prevalence of hypertriglyceridaemia (> 200 mg.dl-1) rose from 5% at age 20 to 20% at age 45 and remained constant thereafter; in women the prevalence of hypertriglyceridaemia increased linearly from 2% at age 20 to 7% at age 60. The LDL/HDL ratio was higher in men than in women at all age groups; in the age group 45 to 64 years, LDL/HDL ratios > 5 were approximately twice as common in men. Lipoprotein(a) levels were distributed in a highly skewed fashion. In men, a slight rise in the geometric mean lipoprotein(a) concentration occurred with age, whereas in women a dramatic increase was seen after age 40. Using multivariate analysis by the multiple logistic function method, total cholesterol, HDL cholesterol, LDL cholesterol and log-transformed triglycerides showed a significant (P < 0.001) age-adjusted correlation with the presence of major coronary events. A risk algorithm has been developed for men aged 40 to 65 years which takes into account the independent risk factors of HDL cholesterol, LDL cholesterol, triglycerides, fibrinogen, age, systolic blood pressure, cigarette smoking, presence of diabetes mellitus and family history of myocardial infarction and angina pectoris. This algorithm can be used in clinical practice to calculate the 8-year risk of an individual suffering a myocardial infarction.
明斯特心脏研究（PROCAM）始于1979年，旨在研究工作人群中的心血管危险因素、包括心肌梗死和中风在内的心血管事件以及死亡率。入组时的检查包括标准化病史、血压测量和人体测量数据、静息心电图以及空腹血样中20多项实验室指标的测量。本报告中的患病率数据基于1979年至1991年间对17437名年龄在40.4±11.3岁（均值±标准差）的男性和8065名年龄在35.7±12.1岁的女性进行的单次检查。在45至64岁的男性中，5%患有严重高胆固醇血症（>300mg.dl-1），女性中这一比例为8%。男性中，高甘油三酯血症（>200mg.dl-1）的患病率从20岁时的5%上升至45岁时的20%，此后保持稳定；女性中，高甘油三酯血症的患病率从20岁时的2%线性增加至60岁时的7%。在所有年龄组中，男性的低密度脂蛋白/高密度脂蛋白比值均高于女性；在45至64岁年龄组中，男性中低密度脂蛋白/高密度脂蛋白比值>5的情况约为女性的两倍。脂蛋白（a）水平呈高度偏态分布。男性中，脂蛋白（a）几何平均浓度随年龄略有上升，而女性在40岁后则显著增加。使用多元逻辑函数法进行多变量分析，总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和经对数转换的甘油三酯与主要冠状动脉事件的发生存在显著（P<0.001）的年龄校正相关性。已为40至65岁的男性开发了一种风险算法，该算法考虑了高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、纤维蛋白原、年龄、收缩压、吸烟、糖尿病的存在以及心肌梗死和心绞痛家族史等独立危险因素。该算法可用于临床实践，以计算个体发生心肌梗死的8年风险。
