High density lipoprotein cholesterol and longevity.

In the Twin Cities Prospective Study, executive men aged 45 to 55 and "healthy" at the entry examinations in 1948 were re-examined yearly to 1975. Follow-up through 1983 lost only one man. High density lipoprotein cholesterol (HDL) in the serum was measured in 1955 with a method checked with recent standard methods. Among 217 men, 130 were dead by 1983, 56 from coronary heart disease (CHD) and 27 from neoplasms. Survivors did not differ in mean HDL from the men who died but they had higher values than the men dead from CHD. Men dead from neoplasms had significantly higher HDL than men dead from CHD. Men dying early did not differ in HDL from those dying later but they had higher blood pressures. HDL was unrelated to age at death from all causes but was related to age at death from CHD. HDL was not related to age, total cholesterol, smoking, or respiratory function but was negatively correlated with measures of body fatness. Multiple regression and multiple logistic analyses showed no difference in HDL between survivors and men dead from all causes, but men dead from CHD tended to have lower HDL. The data indicate that longevity is not related to HDL in middle age.     

Cradle-to-grave atherosclerosis: high density lipoprotein cholesterol.

This presentation reviews environmental and genetic factors that relate to high density lipoprotein cholesterol, the most potent independent lipoprotein risk factor for coronary heart disease. Although at least three decades of work have focused upon the primary atherogenic lipoprotein, low density lipoprotein cholesterol (C-LDL), which has a strong positive association with coronary heart disease (CHD), it has only been in the past decade that detailed epidemiologic and biochemical studies have revealed that high density lipoprotein cholesterol (C-HDL) is the most potent lipoprotein cholesterol related to coronary heart disease; this relationship is, however, inverse.     

High density lipoprotein cholesterol increases with living altitude

BACKGROUND: The relationship between high density lipoprotein cholesterol (HDL) serum level and the altitude at which people live is controversial. METHODS: A cross-sectional study was carried out in the adult population (30-64 years) of the Island of El Hierro (Canary Islands, Spain). In all, 594 individuals representative of the El Hierro population for gender, age, district and the altitude at which they lived were included. The factors measured included HDL, living altitude, body mass index (BMI), smoking habits, alcohol consumption, diabetes, menopause in women, and physical activity and dietary habits. RESULTS: The HDL showed a correlation with living altitude (r = 0.14, P < 0.01) and with BMI (r = -0.19, P < 0.01). Smokers had lower HDL levels than ex-smokers and non-smokers (P < 0.05). Men who were moderate drinkers had higher HDL levels than heavy or mild drinkers and non-drinkers (P < 0.01). Physical activity was only related to HDL in men with levels >1.52 mmol/l, who walked on the average more than the rest (P < 0.05). Variables not showing the expected relationship with HDL were diabetes and the menopause in women (probably due to a low statistical power of their subsamples). Regression analysis, with HDL as dependent variable showed that the association between HDL and altitude persists when taking altitude as a categorical or a continuous variable. CONCLUSIONS: High density lipoprotein cholesterol levels are linearly and significantly increased when living at a higher altitude. This fact should be taken into account when comparing cardiovascular risk in populations living at different altitudes.     

Association of serum low density lipoprotein cholesterol, smoking and hypertension with different manifestations of atherosclerosis

We investigated the association of elevated serum low density lipoprotein (LDL) cholesterol levels, smoking and hypertension with different manifestations of carotid atherosclerosis in a population-based sample of 720 Eastern Finnish men aged 42, 48, 54 or 60 years, examined in the Kuopio Ischaemic Heart Disease Risk Factor Study. Carotid atherosclerosis was assessed with high-resolution B-mode ultrasonography. Men who had neither a history nor symptoms of cardiovascular disease with serum LDL cholesterol concentration in the highest tertile (4.17 mM or more) had 3.40-fold (95% confidence interval (CI) 1.98-5.84) age-, smoking- and hypertension-adjusted probability of intimal-medial thickening as compared to men in the lowest serum LDL cholesterol tertile. The odds ratio for carotid plaque versus intimal-medial thickening was only 1.03 (95% CI 0.47-2.28). The respective odds ratios for smoking (28 pack-years or more) were 1.62 (95% CI 0.79-3.32) and 3.02 (95% CI 1.41-6.47) and those for hypertension were 1.10 (95% CI 0.70-1.73) and 0.99 (95% CI 0.53-1.84). Our findings suggest that elevated serum LDL cholesterol concentration associates with an increased risk of common carotid arterial wall thickening, whereas smoking is associated more strongly with carotid plaques than intimal-medial thickening. Our cross-sectional data do not support association between hypertension and either manifestation of carotid atherosclerosis.     

阿托伐他汀不同用法降低血清总胆固醇和低密度脂蛋白胆固醇效果观察

目的 探讨社区高胆固醇血症患者隔日与每日口服阿托伐他汀20 mg治疗3个月对降低血清总胆固醇(total cholesterol , TC)和低密度脂蛋白胆固醇( low density lipoprotein cholesterol , LDL-C )浓度的影响。方法 连续入选2014年1月至2017年5月门诊收治的高胆固醇血症患者158例,按电脑随机数字表法分为隔日口服阿托伐他汀组(79例,阿托伐他汀20mg隔天口服1次)和每日口服阿托伐他汀组(79例,阿托伐他汀20 mg每天口服1次),疗程均为3个月,所有患者在治疗前、治疗3个月后分别测定血清三酰甘油(triacylglycerol , TG)、TC、LDL-C 、高密度脂蛋白胆固醇(high density lipoprotein cholesterol , HDL-C )浓度,同时对2组的血糖、肝功能、肾功能、肌酸激酶进行检测比较。结果 2组在治疗3个月后的TG、TC、LDL-C与治疗前比较,均有明显降低,差异均有统计学意义(P<0.05 ; P<0.01);2组间比较,差异无统计学意义(P>0.05)。结论 隔日口服与每日口服阿托伐他汀20 mg降低血清总胆固醇和低密度脂蛋白胆固醇浓度疗效相似,隔日口服不良反应少,减少了服药次数,节约了药费开支。     

Effectiveness of individualized long-term therapy with niacin and probucol in reduction of serum cholesterol

A retrospective analysis was made of the results of the individualized office management of hypercholesterolemia in 37 patients (25 male, 12 female) with severe atherosclerosis (n = 35) or a predisposition to it (n = 2). The effects of diet instruction, diet and a niacin supplement, and diet plus the niacin supplement and probucol were assessed. Diet alone (n = 37) was prescribed for an average of 4.8 years; diet plus niacin (n = 37) for an average of 2.0 years; and diet plus niacin and probucol (n = 19) for an average of 2.9 years. Each patient served as his or her own control. The maximum serum cholesterol at the beginning of the diet period was 8.69 +/- 2.15 mmol/L (336 +/- 83 mg/dL) (mean plus or minus standard deviation; n = 37). The goal cholesterol was less than 5.20 mmol/L (200 mg/dL). On diet alone the cholesterol level fell to 7.21 +/- 1.27 mmol/L (279 +/- 49 mg/dL) (P less than .001); and goal cholesterol was reached by 12 of 37 patients (32.4 percent), but was maintained in none. On adding niacin, the mean cholesterol fell to 6.21 +/- 1.16 mmol/L (240 +/- 45 mg/dL) (P less than .001). The goal cholesterol was reached in 22 of 37 patients (59.4 percent), but was maintained in only 7 of 37 (18.9 percent). Nineteen of 37 patients on diet plus niacin also received probucol. Goal cholesterol was reached in 14 of 19 patients (73.6 percent), and was maintained in 11 of 19 (57.9 percent).(ABSTRACT TRUNCATED AT 250 WORDS)     

Unexpected decrease in plasma high density lipoprotein cholesterol with weight loss.

High density lipoprotein (HDL) cholesterol is inversely related to coronary heart disease prevalence. Despite the fact that obese patients have lower plasma HDL-cholesterol concentrations, there are few prospective studies on the effect of weight loss on HDL-cholesterol. Consequently, plasma lipoprotein levels were measured in 15 obese females before and after a 10 week weight loss program. Mean weight loss was 8.6 +/- 3.9 kg (P less than 0.001). Total plasma cholesterol and low density lipoprotein-cholesterol did not change significantly. Plasma triglyceride levels decreased (P less than 0.05) as did HDL-cholesterol (P less than 0.02). A subgroup of 11 of the subjects had repeat lipid measurements 8 months after the start of treatment. Mean weight loss at this time was 12.8 +/- 0.8 kg (P less than 0.01). No subject had returned to her pretreatment weight but mean weight loss was not significantly different from the 10 week value. At 8 months all lipid values, including HDL-cholesterol, had returned to their pretreatment value. By multiple regression analysis HDL-cholesterol decreased with increasing relative weight but also decreased with increasing rate of weight loss. These results suggest that negative caloric balance produces a decrease in HDL-cholesterol that in prospective studies may obscure the inverse relationship between HDL-cholesterol and indices of obesity.     

Effects of similarities in lifestyle habits on familial aggregation of high density lipoprotein and low density lipoprotein cholesterol: the NHLBI Family Heart Study.

It is generally assumed that familial aggregation of lipids relates to both genetic and shared environmental factors. To determine the degree to which familial similarities in lifestyle habits explain familial aggregation of high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, the authors analyzed 1994-1996 data from 2,284 US adult participants in the National Heart, Lung, and Blood Institute Family Heart Study. For men and women, respectively, HDL cholesterol correlated with alcohol consumption (r = 0.27, p < 0.001; r = 0.21, p < 0.001), exercise (r = 0.06, p = 0.05; r = 0.10, p = 0.002), and smoking (r = -0.09, p = 0.005; r = -0.13, p < 0.001). There was strong familial aggregation of HDL cholesterol (parent-child, r = 0.32; sibling-sibling, r = 0.29), but less than 10% was explained by lifestyle habits. For LDL cholesterol, weak correlations were found for intake of total fat (r = 0.06, p = 0.07) and fruits/vegetables (r = -0.09, p = 0.005) among men and for smoking (r = 0.10, p = 0.002) among women. LDL cholesterol correlated strongly among family members (parent-child, r = 0.24; sibling-sibling, r = 0.31), but essentially none of this aggregation related to the lifestyle factors studied. This study suggests that lifestyle factors have little effect on the familial aggregation of HDL and LDL cholesterol.     

Effects of exposure to carbon disulphide on low density lipoprotein cholesterol concentration and diastolic blood pressure.

The relation of carbon disulphide (CS2) exposure to risk factors for ischaemic heart disease was recently examined using data from a 1979 cross sectional study of 410 male textile workers, of whom 165 were exposed and 245 were unexposed to CS2. Average eight hour CS2 exposure concentrations ranged from 0.6 to 11.8 ppm by job title category among the exposed workers. A significant and positive linear trend in low density lipoprotein cholesterol concentration (LDLc) and diastolic blood pressure with increasing CS2 exposure was found after adjustment for potential confounders. When exposure was examined as a categorical variable (none, low, moderate, and high), the high exposure group had an adjusted mean LDLc that was 0.32 mmol/l greater than the non-exposed group (p = 0.02), and an adjusted mean diastolic blood pressure that was 3.16 mm Hg greater than the non-exposed group (p = 0.09). The effect of CS2 on diastolic blood pressure was strengthened in analyses limited to exposed workers: the high exposure group had an adjusted mean diastolic blood pressure that was 5 mm Hg greater than that of the low exposed group (p = 0.03). Triglyceride, high density lipoprotein cholesterol, and fasting glucose concentration, and systolic blood pressure were not affected by exposure. Blood lead concentration was positively associated with systolic and diastolic blood pressure. The results indicate that relatively modest exposure to CS2 may raise LDLc concentration and diastolic blood pressure and suggest mechanisms by which exposure to CS2 may influence risk of ischaemic heart disease. Also the results provide further support for the hypothesis of a possible association between blood lead concentration and blood pressure.     

Effects of exposure to carbon disulphide on low density lipoprotein cholesterol concentration and diastolic blood pressure.

The relation of carbon disulphide (CS2) exposure to risk factors for ischaemic heart disease was recently examined using data from a 1979 cross sectional study of 410 male textile workers, of whom 165 were exposed and 245 were unexposed to CS2. Average eight hour CS2 exposure concentrations ranged from 0.6 to 11.8 ppm by job title category among the exposed workers. A significant and positive linear trend in low density lipoprotein cholesterol concentration (LDLc) and diastolic blood pressure with increasing CS2 exposure was found after adjustment for potential confounders. When exposure was examined as a categorical variable (none, low, moderate, and high), the high exposure group had an adjusted mean LDLc that was 0.32 mmol/l greater than the non-exposed group (p = 0.02), and an adjusted mean diastolic blood pressure that was 3.16 mm Hg greater than the non-exposed group (p = 0.09). The effect of CS2 on diastolic blood pressure was strengthened in analyses limited to exposed workers: the high exposure group had an adjusted mean diastolic blood pressure that was 5 mm Hg greater than that of the low exposed group (p = 0.03). Triglyceride, high density lipoprotein cholesterol, and fasting glucose concentration, and systolic blood pressure were not affected by exposure. Blood lead concentration was positively associated with systolic and diastolic blood pressure. The results indicate that relatively modest exposure to CS2 may raise LDLc concentration and diastolic blood pressure and suggest mechanisms by which exposure to CS2 may influence risk of ischaemic heart disease. Also the results provide further support for the hypothesis of a possible association between blood lead concentration and blood pressure.     

原发性肾病综合征患儿血清低密度脂蛋白胆固醇理论预测值与实测值的差异

目的:比较原发性肾病综合征(primary nephrotic syndrome,PNS)患儿血清低密度脂蛋白胆固醇(low densitylipoprotein-cholesterol,LDL-C)理论预测值与实测值之间的差异。方法:78例PNS患儿,血清甘油三酯(triglyeride,TG)浓度均小于4.5 mmol/L,根据血清总胆固醇(total cholesterol,TC)水平,将其分成TC<6.21mmol/L组(29例)和TC≥6.21 mmol/L组(49例);液体双试剂法直接检测血清LDL-C浓度,并与Friedewald公式及Planella公式计算结果进行比较。结果:①PNS患儿LDL-C浓度三种测算方法之间存在显著性差异(P<0.05);②TC≥6.21 mmol/L时,Friedewald公式预测值与实测值之间未见显著性差异(P>0.05);③两种公式预测值与实测值均存在显著正相关,当TC≥6.21 mmol/L时,Friedewald公式预测值与实测值相关性最明显(R=0.79,P=0.00)。结论:当TC≥6.21 mmol/L且TG<4.5 mmol/L时,Friedewald公式预测值与实测值最为接近,可以为临床评价PNS患儿血清LDL-C水平提供参考。     

Determinants of high density lipoprotein and total cholesterol in women.

An epidemiological study was carried out among a random sample of women aged 18 to 69 years to examine possible determinants of plasma high density lipoprotein and total cholesterol (HDL-C and T-C). In a multiple regression analysis consumption of alcohol, fatty fish, and parental longevity showed positive associations with HDL-C, which were statistically significant. Smoking habit, sucrose consumption, and a family history of ischaemic heart disease showed significantly negative associations. In contrast, T-C was associated significantly only with age and Quetelet's index of body mass. Five variables having significant associations with HDL-C explained only 8% of the total variance; in the case of T-C 17% of the variance was explained by age and body mass.     

秦皇岛地区青少年高非高密度脂蛋白胆固醇血症危险因素分析

探讨高非高密度脂蛋白胆固醇(non-HDL-C)血症在青少年中的检出率及相关危险因素,为探讨儿童高脂血症的有效控制方法提供基础数据.方法 使用分层整群随机抽样方法,对秦皇岛地区3 136名13~ 17岁汉族青少年的non-HDL-C水平进行横断面调查.结果 高non-HDL-C血症检出率为1.2%.三酰甘油和腰围正常组青少年高non-HDL-C血症检出率为0.5%,而HTWC组青少年检出率为9.8%.校正性别、年龄、糖尿病家族史和高血压家族史后,HTWC组青少年高non-HDL-C血症检出率是三酰甘油和腰围正常组青少年的19.696倍(95%CI=8.325~46.595,P<0.01).结论 HTWC表型与青少年高non-HDL-C血症密切相关,为青少年高non-HDL-C血症的危险因素.     

Factors associated with high density lipoprotein cholesterol in Japanese and American telephone executives.

The association of plasma high density lipoprotein cholesterol (HDL cholesterol) with several factors was examined in a cross-sectional study of Japanese and American telephone executives. Mean HDL cholesterol levels were similar in both groups of men and were negatively associated with body mass index, smoking, and serum uric acid and positively associated with alcohol and exercise. These associations did not differ between the Japanese and the American men. The mean HDL cholesterol level was 4.2 mg/dl lower in the Japanese than in the American men after adjusting for age, body mass index, alcohol, smoking, exercise, and serum uric acid. The difference in HDL cholesterol between Japanese and American men in this study is inconsistent with the much lower coronary heart disease mortality in Japan and with previous comparison studies of these two populations. Most previous studies have not adjusted for important confounders, but the selective nature of our study groups may have also contributed to this inconsistency. These racial differences in HDL cholesterol may also be due to either genetic or unmeasured environmental and cultural differences. Given the similarity in HDL cholesterol levels between these two groups, our results suggest that HDL cholesterol does not play an important role in the lower coronary heart disease mortality in Japanese men.     

Dietary fish protein modulates high density lipoprotein cholesterol and lipoprotein lipase activity in rabbits.

To explore the pathways by which fish protein feeding influences HDL metabolism, postheparin plasma lipoprotein lipase and hepatic triglyceride lipase activities were measured in rabbits fed fish protein or soybean protein combined with corn oil or coconut oil in a 2 x 2 factorial arrangement. In addition to greater serum total and LDL-cholesterol concentrations, the elevated HDL cholesterol concentration caused by feeding fish protein, compared with soybean protein, was accompanied by lower VLDL triglycerides and parallel higher lipoprotein lipase activity in fish protein-fed rabbits. These results suggest an enhanced assembly of circulating HDL through promoted lipoprotein lipase activity in rabbits fed fish protein. Moreover, dietary proteins and lipids interacted with one another to alter HDL triglycerides and liver cholesterol concentrations. Diet-induced changes in lipoprotein lipase activity were, however, not related to insulinemia, which was unaltered by purified diet feeding. The present results suggest that fish protein may affect HDL metabolism through the modulation of lipoprotein lipase activity in rabbits.     

血清胆固醇和高密度脂蛋白比值的分析研究

目的评估总胆固醇与高密度脂蛋白的比值在冠心病风险性判断中的价值。方法筛选笔者所在医院2009年1月-2011年1月心血管内科住院的冠心病心绞痛患者125例,将所有患者分为稳定型心绞痛组、不稳定型心绞痛组和健康组,对实验室血脂检测结果和血脂指标异常率进行分析。结果稳定型心绞痛组和不稳定型心绞痛组研究的TC、TG、HDL—C、LDL—C和TC／HDL—c分别于健康组比较,差异有统计学意义（P〈0．05）;稳定型心绞痛组和不稳定型心绞痛组的血脂检测TC、TG、HDL—C、LDL—C和TC／HDL—C的异常率均高于健康组,差异有统计学意义（P〈0．05）。结论TC／HDL—C比值可作为判断冠心病风险性的重要参考指标,且灵敏度高于单项血脂指标。     

Increased dietary cholesterol does not increase plasma low density lipoprotein when accompanied by an energy-restricted diet and weight loss

BACKGROUND: Diets enriched with dietary cholesterol, frequently from eggs, have been shown to produce a small but variable increase in plasma low density lipoprotein (LDL) cholesterol. There is evidence to suggest that energy-restricted diets, that may contain a relatively high proportion of fat and cholesterol, can attenuate the cholesterol-raising effect of dietary cholesterol on plasma LDL. AIM OF THE STUDY: To determine the combined effects of increased dietary cholesterol and weight loss produced by energy restriction on plasma LDL cholesterol and lipoproteins. METHODS: A randomized, controlled, parallel study was performed in two groups of free-living volunteers on an energy-restricted diet for 12 weeks, one group was instructed to consume two eggs a day (n = 24), the other, to exclude eggs (n = 21). Dietary advice on energy restriction was based on the British Heart Foundation guidelines on how to lose weight for men and women. RESULTS: Energy intake fell by 25 and 29% in the egg-fed and non-egg-fed groups, resulting in a moderate weight loss of 3.4 kg (P < 0.05) and 4.4 kg (P < 0.05), respectively. The daily intake of dietary cholesterol increased significantly in the egg-fed group from 278 to 582 mg after 6 weeks. The concentration of plasma LDL cholesterol decreased in the non-egg-fed groups after 6 weeks (P < 0.01) and in the egg-fed and non-egg-fed at 12 weeks relative to baseline. There were no other significant changes in plasma lipoproteins or LDL particle size. CONCLUSIONS: An increased intake of dietary cholesterol from two eggs a day, does not increase total plasma or LDL cholesterol when accompanied by moderate weight loss. These findings suggest that cholesterol-rich foods should not be excluded from dietary advice to lose weight on account of an unfavorable influence on plasma LDL cholesterol.