de Backer G, de Bacquer D, Kornitzer M
Department of Public Health, University Hospital, Gent, Belgium.
Atherosclerosis. 1998 Apr;137 Suppl:S1-6. doi: 10.1016/s0021-9150(97)00310-9.
Most of the results from epidemiologic studies support the general idea that high density lipoproteins (HDL) cholesterol is inversely related to coronary heart disease (CHD) incidence. Results from the literature and from a large cohort study in Belgium (the BIRNH study) are used to describe the distribution and the major determinants of HDL cholesterol. HDL cholesterol is influenced by a variety of biologic, environmental and behavioral characteristics. Results of a 10-year mortality follow-up of the BIRNH study are presented and compared to those observed in other large cohort studies. The inverse relationship between HDL cholesterol and CHD is confirmed, although the strength of the association varies between studies and is weakened after adjustment for other coronary risk factors. The results from the BIRNH study also suggest that the relation between HDL cholesterol and CVD mortality is curvilinear. At present, only indirect evidence is available to support the idea that raising HDL cholesterol is useful in primary and secondary prevention of CHD.
大多数流行病学研究结果支持这样一个普遍观点，即高密度脂蛋白（HDL）胆固醇与冠心病（CHD）发病率呈负相关。来自文献以及比利时一项大型队列研究（BIRNH研究）的结果被用于描述HDL胆固醇的分布及其主要决定因素。HDL胆固醇受多种生物学、环境和行为特征的影响。本文呈现了BIRNH研究10年死亡率随访的结果，并与其他大型队列研究中观察到的结果进行了比较。HDL胆固醇与CHD之间的负相关关系得到了证实，尽管不同研究中这种关联的强度有所不同，并且在对其他冠心病风险因素进行调整后这种关联会减弱。BIRNH研究的结果还表明，HDL胆固醇与心血管疾病死亡率之间的关系是曲线的。目前，仅有间接证据支持提高HDL胆固醇对冠心病一级和二级预防有用这一观点。
