高尿酸血症与心血管疾病危险因素的相关性分析

目的研究高尿酸血症(HUA)与心血管疾病(CVD)危险因素的相关性。方法选取在本院体检中发现的高尿酸血症患者300例作为观察组,尿酸正常体检者300例作为对照组。比较两组的心血管危险因素水平:体质量指数(BMI)、血压、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),并探究血清尿酸水平与心血管各危险因素间的关系。结果观察组的血压、TC、TG及LDL-C水平均明显高于对照组,而HDL-C低于对照组,差异有统计学意义(P0.05);多元线性回归分析表明,血清尿酸水平与收缩压(SBP)、舒张压(DBP)、TC、TG呈正相关关系,与HDL-C呈负相关关系(P0.05)。结论高尿酸血症与心血管疾病危险因素密切相关,并且会增加心血管疾病病发的风险。     

社区老年人高血压现况调查

目的分析2004~2005年吉林市部分社区60~74岁老年人群高血压患病率及有关特点。方法以4个社区60~74岁1258例心血管病危险因素横断面调查结果为研究样本,对老年人高血压的患病率、高血压的类型、高血压患者合并其他心血管病危险因素等情况进行分析。结果(1)该地区60~74岁人群患病率、治疗率和控制率分别为62.7%、55.8%和20.9%;(2)随着年龄增长,男女两性高血压患病率呈持续上升趋势(P<0.05);与60~65岁组相比70~74岁组男性高血压患病率增加28.7%,女性高血压患病率增加22.4%;(3)老年人单纯收缩期高血压患病率为27.0%,占老年人高血压患者的43.1%;(4)老年人高血压患者合并至少一个其他心血管病危险因素的比例为81%。结论高血压是吉林市部分社区60~74岁老年人群常见的心血管疾病,单纯收缩期高血压是老年高血压的常见类型,老年人高血压患者绝大多数合并有其他心血管病危险因素。     

舟山渔民体脂分布特征与心血管病危险因素的关系

为探讨舟山渔民体脂分布特征与心血管病危险因素的关系,调查了浙江舟山朱家尖自然人群中1000例渔民,年龄为35~59岁。测量其身高、体重、腰围、臀围、心率及收缩压(SBP)、舒张压(DBP);同时测定血清总胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)、甘油三酯(TG)和空腹血糖(FBS)。结果显示:(1)女性的体重指数(BMI)高于男性;而男性的体脂分布(WHR)明显高于女性。(2)无论男女,BMI和WHR与TC、TG、SBP、DBP、FBS呈正相关;与HDL-C呈负相关。(3)调整年龄、BMI后,男性TC、TG、FBS、DBP,女性TG、FBS仍与WHR呈正相关。结果提示:WHR是反映人群心血管病危险因素水平的重要指标,尤其对血脂异常更为重要。WHR和BMI的计算方法简便、无创伤、重复性及可比性较好,是流行病学和人群防治的良好指标。     

西部某大型国企员工高尿酸血症与心血管病危险因素的关联性

目的了解西部某国企员工血尿酸水平及高尿酸血症与心血管病危险因素的关联性。方法采用横断面调查的方法,对西部某国企参加体检的员工进行调查。调查内容包括问卷调查、体格检查以及生化指标测定。结果共调查4 180名员工,高尿酸血症患病率为16.6%。高尿酸血症患者与非高尿酸血症患者的体重指数(BMI)、收缩压、舒张压、总胆固醇、甘油三酯、空腹血糖及男性所占比例、吸烟者所占比例之间的差异存在统计学意义(P0.05)。多元线性回归分析显示,性别、BMI、收缩压、总胆固醇与血尿酸水平存在正相关,年龄与血尿酸水平存在负相关,差异有统计学意义(P0.05)。非条件logistic回归分析显示,年龄、性别、BMI值、血压值、总胆固醇、空腹血糖水平与高尿酸血症密切相关(P0.05),男性、高BMI值、血压值偏高、高胆固醇是高尿酸血症的危险因素;年龄增长、高血糖是高尿酸血症的保护性因素。结论高尿酸血症与心血管病危险因素密切相关。     

降血脂药物的临床选择

高脂血症是冠心病的主要危险因素之一。大量研究证实:血清总胆固醇水平越高,患冠心病的危险性越大:血清低密度脂蛋白(LDL)胆固醇水平与冠心病危险成正比关系;血清高密度脂蛋白(HDL)胆固醇水平与冠心病危险成反比关系。血清甘油三酯(TG)浓度增高与冠心病的看法不一致,未定为冠心病独立的危险因     

河北张家口地区体检人群高尿酸血症患病情况及与心血管疾病危险因素相关性研究

目的探讨河北省张家口地区体检人群高尿酸血症患病情况及与心血管疾病危险因素的相关性,为高尿酸血症的预防提供科学依据。方法选取2016年5月至2017年5月在张家口市某医院体检的人群为研究对象,检测其血尿酸、血压、体质指数(BMI)、空腹血糖、甘油三酯和总胆固醇;分别根据男女尿酸水平四分位数分组,统计并比较不同组间上述指标分布差异;根据各指标判定标准分层并比较男女人群高尿酸血症患病率及与各项指标间的关系。采用Spearman秩相关分析尿酸水平与各项指标的相关性,采用logistic回归进行多因素分析。结果本研究人群高尿酸血症的患病率为23.50%(4 060/17 273),男性患病率(31.22%)高于女性(12.04%),差异有统计学意义(P0.01);男女不同尿酸组年龄、BMI、收缩压、舒张压、空腹血糖、甘油三脂、总胆固醇的分布差异均有统计学意义(均P0.01)。男性高尿酸血症患病率随年龄增长而下降(P0.01),女性则升高(P0.01)。随着BMI指数的增加,男女高尿酸血症患病率均升高(均P0.01)。高血压组和高血脂组人群高尿酸血症患病率均高于正常组,差异均有统计学意义(均P0.01)。女性高空腹血糖组高尿酸血症患病率高于空腹血糖正常组(P0.01),而男性高空腹血糖组高尿酸血症患病率则低于空腹血糖正常组(P0.01)。Spearman秩相关分析显示,总人群和女性尿酸水平与BMI、收缩压、舒张压、空腹血糖、甘油三脂和总胆固醇均呈正相关(均P0.01),而男性尿酸水平与空腹血糖呈负相关(r=-0.064,P0.01),与其他指标呈正相关(均P0.01)。多因素logistic回归分析结果显示,超重或肥胖(OR=2.273)、高甘油三脂(OR=2.227)和高胆固醇(OR=1.121)为高尿酸血症的危险因素,而女性(OR=0.398)和高空腹血糖(OR=0.686)则是其保护因素。结论张家口地区体检人群高尿酸血症患病率较高,其与超重或肥胖、高血脂等心血管疾病危险因素互为因果或者有协同效应。     

中国汉族胆固醇调节元件结合蛋白-2基因多态性与高脂血症的关系

目的　了解胆固醇调节元件结合蛋白 2 (SREBP 2 )基因 1784G >C位点多态性在中国汉族人群中的分布情况及其与高脂血症的关系。方法　选取北京市西城区 32 2名高脂血症患者作为病例组 ,同时选择16 4名血脂正常者作为对照组 ,对所有对象均进行血脂谱项目测定及SREBP 2基因 1784G >C位点多态性检测 (PCR RFLP方法 )。结果　高脂血症组和正常对照组 1784位点C等位基因频率分别为 19 6 %和 2 0 1% ,差异无显著性 ,GG、GC和CC三种基因型构成两组间差异亦无显著性 (P >0 0 5 )。各组GG基因型和GC CC基因型间血脂水平差异无显著性 (P >0 0 5 )。按血清TC和TG水平将高脂血症分为高TC血症、高TG血症和混合型高脂血症三个亚组后比较不同基因型血脂水平时发现 ,高TC血症组 1784C等位基因携带者血清TC和LDL C水平明显高于无 1784C等位基因者 ,差异有显著性 (P <0 0 5 )。结论　提示SREBP 2基因 1784G>C位点多态性可能主要影响高胆固醇血症患者血清TC和LDL C水平 ,与血清TG无关 ;C等位基因可能是高胆固醇血症和动脉粥样硬化的危险因素。     

宁波市农村老年人高尿酸血症与血脂异常检出率的关系

目的探讨农村老年人高尿酸血症与血脂异常之间的相关性。方法比较高尿酸患者和尿酸正常组的发病率,分析高尿酸与血脂异常之间的关系。结果农村老年男女尿酸(UA)增高合并甘油三酯(TG)增高患者发生率均明显高于UA正常的发生率(χ2男=17.5,P<0.01;χ2女=32.2,P<0.05)。此外老年女性UA增高合并总胆固醇(TC)增高、低密度脂蛋白胆固醇(LDL-C)增高、高密度脂蛋白胆固醇(HDL-C)增高、混合性血脂增高发生率均明显高于UA正常的发生率。高尿酸危险因素分析示TG是高尿酸的危险因素(OR=2.378)。结论农村老年人高尿酸血症与TG检出率密切相关,TG是高尿酸血症的危险因素,因此在健康体检中推行血尿酸和血脂分析常规筛查,对早期发现早期治疗有相当意义。     

北京市50～79岁社区人群血糖水平与颈动脉斑块关系的相关性研究

目的 分析北京市社区人群空腹血糖(FBG)水平与颈动脉斑块患病危险的关系,探讨不同血糖水平合并其他危险因素,与颈动脉斑块患病危险之间的关系.方法 研究人群来自“中国多省市心血管病危险因素前瞻性队列研究(CMCS)”.2007年对北京大学社区随访人群中依然存活的人群进行危险因素复查,对两次调查资料完整,且年龄50～79岁的1046人进行分析.FBG≥7.0 mmol/L或正在服用降糖药物定义为糖尿病.结果 研究人群FBG平均水平为5.89 mmol/L,颈动脉斑块患病率为56.3％.以FBG正常组为参照,仅在单因素和调整年龄时,随着FBG水平的增加,颈动脉斑块的患病危险增加.分性别分析,在调整了其他危险因素后,女性颈动脉斑块患病危险是参照组的2.2倍.将各危险因素异常和正常的两分组与FBG水平的三分组进行组合,男女两性均以各危险因素正常且合并FBG正常组为参照.在调整了其他危险因素后,女性各危险因素异常合并糖尿病组的颈动脉斑块患病危险最高,具有统计学意义,高密度脂蛋白胆周醇降低、低密度脂蛋白胆固醇升高、血压升高、腰围增大合并有糖尿病组的颈动脉斑块患病危险分别是参照组的2.8倍(P=0.014)、2.7倍(P=0.010)、2.4倍(P=0.013)、2.1倍(P=0.031).结论 FBG水平的增加与颈动脉粥样硬化患病危险间的关系在男女两性不一致,糖尿病与颈动脉粥样硬化患病危险间的关系仅存在于女性,FBG水平和其他心血管病危险因素组合后与颈动脉粥样硬化患病危险间存在联合作用.     

浙江省舟山市普陀山中青年僧尼人群心血管疾病危险因素特点

目的了解浙江省舟山市普陀山中青年僧尼人群心血管疾病危险因素流行现状及特点。方法对浙江省舟山市普陀山僧尼人群进行常规体格检查和心血管疾病相关实验室检查,对检查结果进行分析。结果本次实际调查僧尼679人,应答率为84.98%(679/799),排除60岁以上(62名)僧尼以及个别缺失的资料,最终纳入581名中青年僧尼为本研究实际研究对象,男性448名,平均年龄为(37.5±9.5)岁,女性133名,平均年龄为(34.3±9.0)岁。男性血压水平、体质指数(BMI)、血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和空腹血糖水平明显高于女性(P<0.05或<0.01),而高密度脂蛋白胆固醇(HDL-C)水平明显低于女性(P<0.01)。男性高血压、高TC血症、高TG血症、糖尿病、肥胖患病率分别为24.33%、12.28%、25.22%、3.79%、20.09%,女性分别为11.32%、3.76%、9.77%、0.75%、9.77%。随着年龄的升高,高血压、高TC血症、高TG血症、糖尿病(男性)、超重(女性)、肥胖(女性)及超重+肥胖患病率均呈显著增加趋势。不论男性女性人群,低TC发生情况有随年龄增长而降低的趋势。结论普陀山中青年僧尼人群中,主要心血管病危险因素水平男性高于女性,且随年龄增加,危险因素水平呈上升趋势。应对这类人群开展更为有针对性的危险因素干预和管理。     

Borderline fasting hypertriglyceridemia: absence of excess risk of all-cause and cardiovascular disease mortality in healthy men without hypercholesterolemia

The majority of prospective studies have shown no independent effect of triglyceride on the prediction of cardiovascular disease after the effects of cholesterol and other heart disease risk factors have been accounted for statistically. Because the association of borderline elevation of triglyceride levels (250-499 mg/dl) with cardiovascular risk might be obscured by its strong correlation with hypercholesterolemia, we examined the relationship in healthy men without hypercholesterolemia. In a population sample of 1,589 healthy fasting men ages 30-79 without known cardiovascular disease or categorical hypercholesterolemia, the prevalence of borderline hypertriglyceridemia was 4.2%, and was unrelated to age. There was no significant excess of borderline hypertriglyceridemia in men with systolic hypertension, or in men who reported use of antihypertensive drugs, current cigarette smoking, or a family history of heart attack before or after age 50. Only obesity, a personal history of diabetes, and fasting hyperglycemia were significantly more common in men with borderline hypertriglyceridemia. Moreover, hypertriglyceridemia was a relatively weak marker for those with diabetes or obesity, being present in only 9% of the former and 6% of the latter. A 12-year follow-up of these men showed no significant association of hypertriglyceridemia with all-cause or cardiovascular death either by univariate analysis or after adjusting for risk factors. These data support the conclusion that borderline hypertriglyceridemia is a poor marker for cardiovascular risk in healthy older men without hypercholesterolemia.     

11省市代谢综合征患者中心脑血管病发病率队列研究

目的　探讨队列人群代谢综合征与心脑血管病发病率的关系。方法　采用 1 1省市队列人群 (35～ 64岁 )共 2 7739人于 1 992年进行基线危险因素调查的资料 ,计算队列人群代谢综合征患者在观察终点心脑血管病事件的人年标化发病率 ,用Cox回归模型预测危险因素水平与发病率之间的相关性。结果　 (1 ) 1 1省市队列人群代谢综合征患者心脑血管病人年标化发病率明显高于无代谢综合征者 (分别为 652 .3 1 0万和 2 0 6 .7 1 0万 ,二者RR =3 .1 2 ,P <0 .0 0 1 ) ;(2 )有高血压、低高密度脂蛋白和高腰围者心脑血管病人年标化发病率最高 (男性 91 0 .2 1 0万 ,女性 930 .7 1 0万 ) ;(3)男性年龄、吸烟、体重指数、总胆固醇和代谢综合征是心脑血管病发病的最重要的预测因素 ,女性为年龄、体重指数和代谢综合征。结论　 1 1省市队列人群代谢综合征患者心脑血管病人年标化发病率明显高于无代谢综合征者 ,代谢综合征是心脑血管病发病的最重要的预测因素 (尤其脑血管病 ) ,心脑血管病危险因素的一级和二级预防势在必行     

Blood lipid and lipoprotein levels: relationships with educational level and region of residence in the French SU.VI.MAX study

BACKGROUND: Blood lipid profile of French men and women obtained from the general population is not well known. Furthermore, the association between these lipids, as a function of other potential risk factors for cardiovascular disease, and sociodemographic factors such as age, educational level, and region of residence is not well studied in large samples in Europe. METHODS: Data on French healthy volunteers, aged between 40 and 65 years for men (n = 5141) and 35 and 65 years for women (n = 7876) were obtained from the "Supplementation en Vitamines et Mineraux Antioxydants" (SU.VI.MAX) study, a primary prevention trial. Baseline blood samples were collected in 1994-1995 and analyzed for cholesterol, triglyceride, apolipoproteins (apo)-B and -A1. The results were analyzed separately for men and women as a function of age, educational level, and area of residence. RESULTS: Overall, blood lipid levels for men and women did not differ significantly from those reported in other Western industrialized countries. Except for triglyceride in men, all blood lipids were statistically different among ages. In women, cholesterol, apo-A1, and apo-B showed a significant decrease with educational level. Statistical differences were found in both genders between blood lipids and lipoproteins among regions of residence. CONCLUSIONS: Even if differences between region of residence were found in blood lipid levels, this cannot explain the North-East to South gradient in the prevalence of cardiovascular disease in France nor differences between France and other industrialized Western countries.     

Carbohydrate intake is associated with diet quality and risk factors for cardiovascular disease in U.S. adults: NHANES III

OBJECTIVES: To determine if carbohydrate intake, as a % of energy, was related to diet quality and risk factors for cardiovascular disease (CVD) in adults in a cross-sectional and population-based study in the U.S. METHODS: Data from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) were utilized. The nationally representative sample of the U.S. population (3,754 men, 4,074 women, ages 25 to 64 years) was divided into quintiles of carbohydrate intake (% of energy), which was examined in relation to risk factors for CVD: systolic blood pressure, body mass index (BMI), and concentrations of serum triglyceride, serum total and HDL cholesterol and plasma glucose. RESULTS: When covariates (age, ethnicity, smoking, alcohol intake and total energy intake) were adjusted in multivariate analyses, carbohydrate intakes (% of energy) were inversely associated with BMI and serum total cholesterol concentration in men and BMI in women and positively associated with serum triglyceride concentration in women. When total sugar intake (% of energy) was further controlled as a step to understand the quality of carbohydrate, carbohydrate intakes (% of energy) was a stronger predictor of BMI and plasma glucose in men and BMI in women. A high carbohydrate diet (>57.4% of energy in men and >59.1% of energy in women) was associated with a low serum HDL-cholesterol concentration in men and high serum triglyceride in women. CONCLUSION: Moderately high carbohydrate (50% to 55% of energy) diets were associated with low CVD risks with favorable lipid profiles.     

社区高血压病人体质指数相关因素分析

目的了解社区高血压患者体质指数（BMI）和其他心脑血管疾病的危险因素的分布特点、冠心病发病风险、及它们间的相关情况。方法通过全人群现场调查和血压测量发现疑似病例，2w后对疑似病例复查来确诊高血压患者，对高血压患者进行详细的体检和血液的化验检查。对2015例确诊的社区高血压患者的资料进行统计分析。结果高血压患者中男性、女性的超重或肥胖患病率分别为57．2％、55．4％，远高于一般人群的患病率；BMI与甘油三酯（TG）、总胆固醇（TC）与高密度脂蛋白胆固醇（HDL—C）比值、低密度脂蛋白胆固醇（LDL—C）与高密度脂蛋白胆固醇（HDL-C）比值、TG／HDL—C、血糖的水平呈正相关，与HDL—C水平呈负相关；BMI与未来10a冠心病的预测发病风险呈正相关；超重或肥胖患者中危险因素水平、异常率高于正常体重组。结论高血压患者伴发超重或肥胖时，心脑血管病的发病风险增加，为了预防和控制心脑血管疾病的发生，应及早控制并减轻体重。     

Body fat distribution, serum lipoproteins and blood pressure in middle-aged Finnish men and women

The association of body fat distribution as measured by the ratio of waist to hip girth (WHR) to age, to serum total cholesterol and HDL-cholesterol and to blood pressure was studied in a population-based sample of 2461 men and 2768 women aged 25 to 64 years not treated with cardiovascular drugs. In men, the relationships of age with WHR and age with body mass index (BMI) were similar, an increase levelling at the age of about 50 years. In women, BMI increased linearly, but WHR exponentially with age. In both sexes, age-adjusted WHR and BMI associated positively with non-HDL cholesterol, and with systolic and diastolic blood pressure, and inversely with HDL-cholesterol and the HDL/non-HDL cholesterol ratio. WHR and BMI were independently related to several cardiovascular risk factors. HDL-cholesterol concentration was 19% lower in men, and 17% lower in women who belonged to the upper tertile of both WHR and BMI, than in the subjects in the lower tertiles of WHR and BMI. Age-adjusted WHR and BMI also predicted fasting and 2-hour post-challenge blood glucose values in women aged 45 to 64 years, but not in men. The WHR provides additional information on elevated cardiovascular risk factors in cross-sectional analysis among middle-aged men and women independently of BMI. The measurement of WHR in large-scale risk factor surveys should be recommended, in order to assess the independent contribution of WHR to the risk of cardiovascular disease, and to find out the importance of WHR for the prevention of chronic diseases.     

Coronary heart disease and cardiovascular risk factors among people aged 25–65 years,as seen in Romanian primary healthcare

Background: In Romania data on cardiovascular risk factors are sparse. Objective: To describe the prevalence and distribution of cardiovascular risk factors in a primary care setting in Romania. Methods: In a cross-sectional study, patients aged 25–65 years on the lists of four general practitioners in Iasi (Romania), selected by 1/5 systematic sampling, were invited for a cardiovascular risk evaluation (interview, physical examination, blood tests for cholesterol and glucose). Prevalence rates for coronary heart disease (CHD), diabetes (DM) and other risk factors were estimated, SCORE risk was determined, and treatment targets were evaluated. Results: The response rate was 79% (325 men, 476 women). Prevalence rates were: CHD 7.4%, DM 3.2%, hypercholesterolemia (>190 mg%) 47.2%, hypertension 23.7%, obesity 21.2%, and smoking 33.8%. In women, obesity and lack of physical exercise were more prevalent, whereas in men, higher rates were found for smoking and an unhealthy diet. The proportion of patients considered to be at high risk (CHD, DM or SCORE ≥ 5%) was 39.2%. Female patients failed to meet targets for systolic blood pressure, total cholesterol and glucose, whereas smoking cessation will be the greatest challenge for men. Conclusion: There were relevant gender differences in modifiable cardiovascular risk factors. Many patients failed to meet treatment targets.     

Non-obese (body mass index < 25 kg/m2) Asian Indians with normal waist circumference have high cardiovascular risk

OBJECTIVE: Although the prevalence of obesity is not high in Asian Indians, increased prevalence rates of metabolic perturbations and cardiovascular risk factors have been reported. In this study, we evaluated body mass index (BMI), anthropometric measurements, and body fat profiles of obese and non-obese subjects and correlated those values with cardiovascular risk factors. METHODS: This cross-sectional study involved 639 subjects (170 men and 469 women) from low socioeconomic stratum residing in urban slums of New Delhi. Non-obese subjects were categorized into quartiles of percentage of body fat (%BF) and waist circumference (WC). Using logistic regression analysis, the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of cardiovascular risk factors (diabetes mellitus [DM], hypertension, hypercholesterolemia, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, and high levels of low-density lipoprotein cholesterol) were computed with first quartile in the non-obese group as the reference category for the following five categories: %BF and WC quartiles in the non-obese group and obese group (BMI > or = 25 kg/m(2)). RESULTS: In the non-obese group, approximately 66% of men and 88% of women had at least one risk factor. In non-obese women, significantly high ORs and 95% CIs were found for hypertension (3.2, 1.4-7.2), DM (2.8, 1.2-6.3), and hypertriglyceridemia (3.9, 1.9-8.3) in the upper quartiles of %BF, and significantly high OR (95% CIs) was observed for hypertriglyceridemia (3.9, 1.4-10.8) in non-obese men. Among non-obese men, significantly high OR (95% CIs) was found for hypertriglyceridemia (3.2, 1.0-10.3); among non-obese women, significantly high ORs (95% CIs) were observed for hypertension (2.5, 1.1-5.8) and hypertriglyceridemia (2.5, 1.2-5.2) in the normal range of WC (70-80 cm). CONCLUSION: The study showed that Asian Indians have excess cardiovascular risk at BMI and WC values considered "normal." These data suggested that definitions of "normal" ranges of BMI and WC need to be revised for Asian Indians.     

绝经、性激素与血脂关系的研究

本文报告对598名40～54岁更年期妇女的血脂情况进行了调查,发现同年龄绝经者的血脂高于未绝经者,且高脂血症患病率在同年龄组随绝经前→绝经→绝经后逐渐增高。进一步分析表明,绝经对甘油三酯有独立影响,总胆固醇升高与雌二醇下降及雌二醇/孕酮比例失调有关,高密度脂蛋白胆固醇升高可能与睾酮升高有关,而甘油三酯与更年期妇女性激素变化无明显关联。本研究还发现,肥胖综合指数对更年期妇女总胆固醇及高密度脂蛋白胆固醇的影响较体重指数敏感。     

Informativeness of indices of blood pressure, obesity and serum lipids in relation to ischaemic heart disease mortality: the HUNT-II study

The informativeness of blood pressure, obesity and serum lipids associated with cardiovascular events may depend on how the indices are expressed, and mid blood pressure, waist-to-hip ratio adjusted for body-mass index (BMI) and the ratio of total to HDL cholesterol may be more informative than other expressions. Our aim was to study the informativeness of indices of blood pressure, obesity and serum lipids associated with ischaemic heart disease mortality in a large, homogeneous population. Blood pressure, weight, height, waist and hip circumference, total and HDL cholesterol, and triglycerides were measured at baseline (1995-1997) in 28,158 men and 32,573 women. Information on deaths from ischaemic heart disease (IHD) was obtained from the Causes of Death Registry in Norway from baseline until the end of 2007. Informativeness was analysed using the difference in twice the log-likelihood of a Cox model with and without each index. During 11 years of follow-up, 597 men and 418 women had died from IHD. Systolic blood pressure in men and pulse pressure in women were the most informative predictors of blood pressure, and waist-to-hip ratio adjusted for BMI was the most informative expression of obesity in both men and women. Among serum lipids, the most informative predictor was the ratio of total cholesterol to HDL cholesterol. Using more informative expressions of conventional risk factors for ischemic heart disease may improve both the validity and precision of estimates of risk, and may be useful both clinically and for preventive purposes.