Modification of the relationship between simple anthropometric indices and risk factors by ethnic background

Current targets for body mass index (BMI) and waist circumference (WC) may not be appropriate for those of South Asian origin. The objectives of this study were to determine whether the relationship between BMI and WC with risk factors for cardiovascular disease (CVD) is the same for men and women of South Asian and European descent. Apparently healthy men and women of European (n = 88) and South Asian (n = 93) descent were recruited from 3 hospital communities and assessed for BMI, WC, waist-to-hip ratio (WHR), blood pressure (BP), lipids, insulin, glucose, and CRP. The study cohort was stratified by sex, and regression analyses were performed with individual risk factors as outcomes and ethnicity with either BMI or WC as predictors adjusting for age and height (WC only). BMI and WC were similar between the European and South Asian men and women. South Asian men had significantly higher values for total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), total cholesterol:high-density lipoprotein-cholesterol (HDL-C) and CRP, and significantly lower values of HDL-C. South Asian women had significantly higher values for TG, TC:HDL-C and CRP and significantly lower values of HDL-C, glucose, systolic BP and diastolic BP. In men, ethnicity was an independent predictor for all risk factors except for glucose and insulin, after adjusting for either BMI or WC independent of age and height. For women, ethnicity was an independent predictor for all risk factors except for total cholesterol (WC model only) and insulin (BMI model only), after adjusting for either BMI or WC independent of age and height. The relationship between BMI or WC and risk factors is such that men and women of South Asian descent present with a more adverse risk profile than those of European descent at the same BMI and/or WC.     

The relationship between high-sensitivity C-reactive protein and ApoB, ApoB/ApoA1 ratio in general population of China

Inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) is considered as a major predictor of cardiovascular events. Apolipoprotein B (ApoB) directly reflects the number of plasma atherogenic lipoproteins, and may play a major role in vascular inflammation. We aimed to assess whether an association between ApoB and hsCRP exists and, furthermore, to examine whether ApoB is more predictive of the inflammatory status than other cardiovascular risk factors. This was a cross-sectional study, with 511 apparently healthy adult subjects enrolled. Waist circumference (WC), body mass index (BMI), and blood pressure (BP) were measured. Plasma glucose levels, hsCRP, lipid profile, and insulin were collected after 10-14 h fasting. From the lowest to the highest quartile of hsCRP, the values for BMI, WC, BP, HOMA-IR, insulin, glucose level, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), ApoB and the ApoB/apolipoprotein A1 (ApoA1) ratio were increased as the hsCRP level increased (P < 0.01), and high-density lipoprotein cholesterol (HDL-C) and ApoA1 levels declined as hsCRP level increased (P < 0.0001). Pearson's correlation analysis demonstrated that hsCRP correlated with all variables (P < 0.01), except for total cholesterol (TC) (P = 0.154) and LDL-C (P = 0.087). According to forward stepwise regression analysis with hsCRP as the dependent variable, WC was the only variable entered the regression model. ApoB level correlated with hsCRP level but was not the major determinant of hsCRP. WC was stronger than other cardiovascular risk factors in the associations with hsCRP. Abdominal obesity rather than atherogenic dyslipidemia was the primary cause of chronic inflammatory status.     

Prevalence and risk factors of peripheral arterial obstructive disease in Taiwanese type 2 diabetic patients

The aim of this study was to evaluate the prevalence and risk factors of peripheral arterial obstructive disease (PAD) in Taiwanese type 2 diabetic patients. A total of 610 patients (268 men and 342 women), aged 63.3 +/- 10.8 years, were recruited from a diabetic clinic in a teaching hospital. PAD was diagnosed by an ankle-brachial index (ABI) < 0.9 on either leg. Risk factors studied were age, sex, body mass index (BMI), smoking, diabetes duration, hypertension, insulin therapy, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), serum total cholesterol (TC), and triglyceride (TG). Overall prevalence of PAD was 10.0% without significant sexual difference. Univariate analyses disclosed age, BMI (inverse association), diabetes duration, hypertension, insulin therapy, and SBP as significant risk factors. In stepwise logistic regression, age, SBP, BMI, and insulin therapy were independent risk factors with respective odds ratios (95% confidence intervals, CI) of 1.09 (1.05-1.13), 1.02 (1.01-1.04), 0.88 (0.80-0.96), and 3.37 (1.83-6.19). In conclusion, prevalence of PAD in Taiwanese type 2 diabetic patients was 10.0% and the major risk factors were older age, lower BMI, higher SBP, and insulin therapy. The inverse association between PAD and BMI is contradictory to the general impression that obesity is a risk factor for PAD.     

The relationship between waist circumference and metabolic risk factors: cohorts of European and Chinese descent

Waist circumference (WC) may be the best anthropometric index for identifying individuals at risk for cardiovascular disease (CVD) and diabetes mellitus (DM). The objectives of this study were to determine if the relationship between WC and metabolic risk factors is similar in men and women of Chinese and European descent, and to assess the effect of ethnicity on these relationships. Apparently healthy men and women of Chinese (n = 92) and European (n = 99) descent were recruited from hospital staff and assessed for anthropometric variables and blood pressure (BP), lipids, insulin, and glucose. The study cohort was stratified by sex, and regression analyses were performed with the various metabolic risk factors as the outcome and WC and ethnicity as predictors. Chinese men and women had significantly lower WC than European men and women. Age and metabolic risk factors were similar between the 2 ethnic groups except for BP. Metabolic risk factors significantly correlated with WC within each gender and ethnic cohort. In men, ethnicity was an independent predictor for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and the ratio of TC to high-density lipoprotein cholesterol (HDL-C) after controlling for WC. In women, ethnicity significantly interacted with WC as an independent predictor of TG, TC:HDL-C ratio, insulin, and glucose. As ethnic descent modifies the relationship between WC and metabolic risk factors, current WC targets derived from relationships in European populations are not applicable to Chinese men and women. Therefore, ethnic background should be considered when using WC as a marker of cardiovascular risk.     

Lipids, lipoproteins, lifestyle, adiposity and fat-free mass during middle age: the Fels Longitudinal Study

INTRODUCTION: Although lipid profiles tend to worsen with age, it is not fully known if such age-related changes are influenced primarily by body composition and lifestyle or by other aspects of aging. OBJECTIVE: We investigated the extent to which the fat and fat-free components of body mass index (BMI) and lifestyle factors influence patterns of change in lipids independent of age. DESIGN: Serial data were analyzed using sex-specific longitudinal models. These models use serial data from individuals to assume a general pattern of change over time, while allowing baseline age and the rate of change to vary among individuals. SUBJECTS: Serial data were obtained from 940 examinations of 269 healthy white participants (126 men, 143 women), aged 40-60 years, in the Fels Longitudinal Study. MEASUREMENTS: Measurements included age, the fat (FMI) and fat-free mass (FFMI) components of BMI, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), triglycerides (TG), total cholesterol (TC), fasting glucose and insulin, physical activity, alcohol use and smoking, and women's menopausal status and estrogen use. RESULTS: In both sexes, increased FMI was significantly associated with increased LDL-C, TG and TC, and decreased HDL-C. Increased FFMI was significantly related to decreased HDL-C and increased TG. Independent age effects remained significant only for LDL-C and TC in men and TC in women. Increased insulin was significantly related to increased TG in women. Moderate alcohol consumption was associated with higher HDL-C in men. Physical activity lowered male LDL-C and TC levels, and increased female HDL-C levels. Menopause was associated with increases in LDL-C. Premenopausal women not using estrogen had significantly lower HDL-C, TG, and TC than postmenopausal women taking estrogen. CONCLUSIONS: (1) Age is an important independent predictor for LDL-C and TC in men, and TC in women, but it is not as influential as body composition and lifestyle on HDL-C and TG in men and women, and LDL-C in women. (2) Increasing FMI is the major contributor to elevated TC, LDL-C and TG levels, and decreased HDL-C levels in men and women. (3) FFMI significantly influences HDL and TG levels in both sexes. (4) Maintaining a lower BMI via a reduced fat component may be more beneficial in lowering CVD risks than other factors.     

Possible risk factors of carotid artery atherosclerosis in the Japanese population: a primary prevention study in non-diabetic subjects

OBJECTIVE: Hyperinsulinemia has been associated with the risk of coronary heart disease, stroke, and renal disease in nondiabetic subjects. However, direct evidence that hyperinsulinemia per se is directly associated with atherosclerosis has been conflicting. The present study was designed to investigate the cross-sectional association of carotid artery atherosclerosis with insulin, independent of well-known cardiovascular risk factors, in nondiabetic subjects. METHODS AND SUBJECTS: Between 1996 and 1997, 1,335 subjects (620 men and 715 women) were recruited from one Japanese community, interviewed, and examined. Clinical measurements in the study included intimal-medial thickness (IMT) of the carotid artery, fasting plasma insulin, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), hemoglobin type HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI). We divided the subjects of both genders into three subgroups according to age (40-49 years of age; 50-59; and 60-69). RESULTS: Using simple regression analysis, we found that IMT was significantly correlated with at least one of TC, LDL-C, HbA1c, SBP, DBP, and BMI in each subgroup. The results of multivariate analysis showed that IMT was independently correlated with TC, HDL-C, LDL-C, SBP and BMI in males and with TC, TG, HDL-C, LDL-C, HbA1c, SBP, DBP, and BMI in females. Insulin levels showed no correlation with IMT in either males or females. CONCLUSION: Fasting hyperinsulinemia does not appear to be correlated with carotid artery atherosclerosis based on the present cross-sectional results.     

外周血血脂水平与老年性白内障相关性研究

目的 探讨外周血血脂水平与年龄相关性白内障(age-related cataract,ARC)的相关性.方法 采用回顾性病例对照设计,选取2018年1月-2019年12月于复旦大学附属眼耳鼻喉科医院就诊并确诊为ARC的患者280例作为观察组,其中男性140例,女性140例.同时选取同期217例正常健康体检者作为对照组,...     

Interactions of the apolipoprotein A5 gene polymorphisms and alcohol consumption on serum lipid levels

Objectives Apolipoprotein(Apo) A5 gene poly-morphisms and alcohol consumption have been associated with increased serum triglyceride(TG) levels,but little is known about their interactions on serum lipid levels.The present study was undertaken polymorphismsand alcohol consumption on serum lipid levels.Methods A total of 516 unrelated nondrinkers and 514 drinkers aged 15 -89 were randomly selected from our previous stratified randomized cluster samples.Genotyping of the ApoA5was performed by polymerase chain reaction and restriction fragment length polymorphism,and then confirmed by direct sequencing.Interactions of the ApoA5alcohol consumption were assessed by using a cross-product term between genotypes and the aforementioned factor.Results The levels of total cholesterol (TC),TG,high-density lipoprotein cholesterol(HDL-C), ApoA1 and ApoB were higher in drinkers than in nondrinkers (P<0.05-0.001).The genotypic and allelic frequencies of the three single nucleotide polymorphisms(SNPs) were not different between the two groups.The levels of TG in non-drinkers, and TC,TG,low-density lipoprotein cholesterol (LDL-C)and ApoB in drinkers were different among the three -1131T>C genotypes(P<0.05-0.001).The -1131C allele carriers had higher serum TC,TG,LDL-C and ApoB levels than the allele noncarriers.The levels of TG,HDL-C and ApoB in nondrinkers,and TG and HDL-C in drinkers were different between the two c.553G>T genotypes(P<0.05-0.01).The C.553T allele carriers had higher serum TG and ApoB levels,and lower HDL-C levels than the allele noncarriers.Serum lipid levels in nondrinkers were not different among the three c.457G>A genotypes(P<0.05 for all), but the levels of HDL-C,LDL-C,ApoA1 and ApoB in drinkers were different between the GG and GA/AA geno-types (P<0.05-0.001).The C.457A allele carriers had lower serum HDL-C,LDL-C,ApoAl and ApoB levels than the allele noncarriers.We also observed four haplotypes:G-G-T, G-G-C,G-A-T,and T-G-C with frequencies ranging from 0.06 to 0.87,representing 100%o     

高脂血症与血清载脂蛋白含量关系的研究

目的　探讨高脂血症与载脂蛋白的关系。方法　对杭州市 6 6 9名高脂血症患者和 2 6 2名健康人 ,用全自动生化分析仪测定TC、TG、HDL -C、LDL -C、ApoAⅠ、AⅡ、B、CⅡ、CⅢ、E。结果　与健康对照组比较 (1)高胆固醇血症组 ,HDL -C、LDL -C明显升高 (P <0 0 1) ,各类载脂蛋白均升高 ,尤以ApoAⅠ升高最明显。 (2 )高甘油三酯血症组 ,HDL-C低于正常对照组 (P <0 0 1) ,LDL -C无显著性差异 (P >0 0 5 ) ,ApoAⅠ降低 (P <0 0 1) ,ApoB、ApoCⅡ、ApoCⅢ、ApoE均有明显升高 (P <0 0 1)。 (3)混合型高脂血症组 ,LDL -C升高 (P <0 0 1) ,ApoAⅡ、ApoB、ApoCⅡ、ApoCⅢ、ApoE升高最明显 (P <0 0 1)。结论　高脂血症ApoAⅡ、B、CⅡ、CⅢ、E水平均升高 ;高胆固醇血症ApoAⅠ、B和HDL -C、LDL -C可同时升高 ;ApoCⅢ是高甘油三酯的重要影响因素 ;混合型高脂血症高甘油三酯伴LDL -C/HDL -C比值升高 ,可视为CHD的高危人群     

Establishing the benefit of statins in low-to-moderate--risk primary prevention: the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)

AFCAPS/TexCAPS was the first prevention trial of a statin conducted in a low-to-moderate-risk cohort that included men (> or =45 years) and women (> or =55 years) with no evidence of atherosclerotic cardiovascular disease. At study entry, LDL-C had to be 130-190 mg/dL and HDL-C < or =45 mg/dL for men and < or =47 mg/dL for women. Participants were randomized to either lovastatin 20-40 mg/day (n=3304) or placebo (n=3301) for a mean follow-up period of 5.2 years. At 1 year, in the lovastatin group TC, LDL-C, and TG were reduced by 18.4%, 25.0%, and 15%, respectively. HDL-C increased by 6.0%. At 5 years, there was a 37% decrease in the relative risk for having a first acute coronary event in the lovastatin versus placebo group. Women showed similar relative risk reduction as men. Older individuals benefited as much as younger ones from lovastatin. Subjects with > or =2 risk factors benefited more from statin than those with <2 risk factors. At baseline, HDL-C but not TC or LDL-C was determined a significant predictor of risk. On treatment, ApoB and ApoA1 were the best predictors. Based on AFCAPS/TexCAPS, a simple heuristic could be that individuals with "age plus one other risk factor" may benefit from statin therapy in primary prevention.     

Apolipoprotein A1 is a stronger prognostic marker than are HDL and LDL cholesterol for cardiovascular disease and mortality in elderly men

The aim of this study was to compare apolipoprotein A1 (ApoA1) and B (ApoB) with high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) as markers for cardiovascular mortality and morbidity in elderly men. We analyzed serum ApoA1, ApoB, total cholesterol, HDL-C, and LDL-C in a group of 77-year-old men (n = 785). The results were correlated with data from the Swedish cause of death registry. Receiver-operating characteristic curves showed that, of the studied serum markers, ApoA1 was the best predictor for ischemic heart disease mortality (area under the curve = 0.724, 95% confidence interval, 0.691-0.755). There were also significant correlations between the apolipoproteins and other known risk markers for cardiovascular disease such as triglycerides, high-sensitivity C-reactive protein (hsCRP), and cystatin C. Serum ApoA1 is a better risk marker than are ApoB, ApoB/ApoA1 ratio, HDL-C, and LDL-C for cardiovascular disease and mortality in elderly men.     

Effects of menopause on intraindividual changes in serum lipids, blood pressure, and body weight--the Chin-Shan Community Cardiovascular Cohort study

In Taiwan, the Chin-Shan Community Cardiovascular Cohort (CCCC) was assessed prospectively to determine whether the changes in cardiovascular risk factors for women age 45--54 years are due to menopause. The average paired percentage changes that occurred between baseline (1990-1991) and follow-up (4 years later) in fasting serum lipids were compared in three groups of women including groups of 59 and 224 who were pre- and postmenopausal, respectively, and a group of 118 who had spontaneously stopped menstruating. Postmenopausal women had the least gain in body mass index (BMI), whereas, mainly premenopausal women had increased systolic blood pressure (P<0.05). All women had elevated total cholesterol (TC) levels, with the greatest elevation in women transitioning into menopause (P<0.001). Low-density lipoprotein cholesterol (LDL-C) levels increased before and during the transition to menopause, but decreased after menopause (P<0.01). Age had significant association with changes in TC, triglyceride (TG) and LDL-C levels, whereas BMI had significant association with changes in TG, LDL-C, and high-density lipoprotein cholesterol (HDL-C) levels (P<0.05). After controlling for age and BMI, only differences in TC remained significant, with the greatest gain in women who stopped menstruating (12.9%) followed by pre- (6.5%) and postmenopausal women (4.8%). Changes in both systolic and diastolic blood pressures, and TG and HDL-C levels were not significantly different, but HDL-C levels declined between 11.5 and 14.7% in all groups. This study suggests an unfavorable effect of menopause on lipid metabolism, especially on the TC level, which was predominantly elevated during the transition to menopause. The decline of HDL-C is of concern.     

老年人代谢综合征危险因素分析

目的 对老年代谢综合征(metabolic syndrome,MS)患者的查体资料进行分析,探讨老年人MS的危险因素. 方法按照2004年中华医学会糖尿病分会推荐的MS诊断标准,将568例老年人分为对照组(不符合MS诊断标准者)、代谢异常1组(符合MS诊断标准1项者)、代谢异常2组(符合MS诊断标准2项者)及MS组.比较各组体质指数、收缩压、舒张压、空腹血糖、胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、谷丙转氨酶(ALT)、糖化血红蛋白(HbA1c)、血尿酸等指标. 结果 MS组、代谢异常2组、代谢异常1组体质指数、收缩压、舒张压、空腹血糖、三酰甘油及血尿酸水平均显著高于对照组,而HDL-C显著低于对照组,差异有统计学意义(均为P<0.05),MS组,代谢异常2组总胆固醇、LDL-C、HbA1c及ALT水平显著高于对照组.差异均有统计学意义(P<0.05);但代谢异常1组与对照组比较,差异无统计学意义(P>0.05).体质指数与舒张压(r=0.231)、HbA1c(r=0.195)、血尿酸(r=0.152)、ALT(r=0.211)呈正相关,与HDL-C负相关(r=-0.156),差异均有统计学意义(P<0.05). 结论符合MS诊断标准1项及2项者是老年人MS的高危人群,超体质量或肥胖、高血压、高血糖、血脂异常、ALT和血尿酸升高等是老年人MS的危险因素.     

首诊老年高血压患者血脂水平分析

目的:探讨老年高血压患者的血脂水平特点。方法:首诊老年高血压患者常规化验总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB),以健康体检老年人为对照组,两组进行比较。结果:高血压组TC、TG、LDL-C、ApoB水平较对照组显著升高(P<0.05~<0.001),ApoA1、HDL-C较对照组显著降低(P<0.05~<0.001)。高血压组的血脂水平不受年龄、性别和高血压分级的影响。结论:老年高血压患者血脂水平存在明显异常,但血脂水平与年龄、性别、血压无关。     

老年2型糖尿病患者颈动脉粥样硬化与相关危险因素分析

目的 探讨老年2型糖尿病患者颈动脉硬化与其相关危险因素.方法 老年2型糖尿病组(260例)和对照组(206例),分别记录两组患者的年龄、性别、体重指数(BMI)、血压(BP)、糖尿病病程、空腹血糖(FPG)、餐后2 h血糖(PPG)、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆同醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)等,并同时进行颈动脉彩色多普勒超声检查,测量颈动脉内膜.中层厚度及动脉粥样硬化斑块的大小、位置及数量.采用Logistic回归模型分析颈动脉粥样硬化与各因素的相关性.结果 (1)糖尿病组颈动脉内膜-中层明显增厚者241例(92.6%),对照组43例(20.8%);糖尿病组颈动脉粥样硬化斑块者212例(81.3%),对照组42例(20.3%);糖尿病组颈动脉狭窄为89例(34.2%),对照组3例(0.01%).糖尿病组颈动脉血管病变与对照组比较差异有统计学意义(χ2值分别为249.06、173.32、77.92,均P<0.01);(2)糖尿病组FPG、PPG、TC、TG、LDL-C、ApoB和CRP与对照组比较差异有统计学意义(t值分别为16.99、15.82、15.92、6.43、10.84、3.69、17.09,均P<0.05);而HDL-C、ApoA则降低(t值分别为4.54、37.74,均P<0.05).糖尿病合并颈动脉病变较无颈动脉病变者HbA1c、TG、LDL-C、ApoB和CRP升高(t值分别为3.02、3.26、3.79、9.06、2.50,均P<0.01);(3)Logistic分析显示年龄、性别、病程、LDL-C、HDL-C、TG、收缩压和CRP等因素是老年2型糖尿病患者颈动脉病变发生的独立危险因素(OR值分别为1.063、1.925、1.081、1.039、0.138、1.865、5.145、5.663,均P<0.05).结论 老年2型糖尿病颈动脉病变与多种危险因素有关,早期较好地干预、控制这些危险因素对预防及治疗具有重要的临床意义.     

Triglyceride predicts cardiovascular mortality and its relationship with glycaemia and obesity in Chinese type 2 diabetic patients

BACKGROUND: To examine the lipid profile in Chinese type 2 diabetic patients and their relationship with anthropometric parameters, glycaemic control and cardiovascular mortality. METHODS: A consecutive cohort of 562 newly referred patients with type 2 diabetes to a hospital-based diabetes centre were examined in 1996. Subjects treated with lipid lowering drugs at the time of referral were excluded. A total of 517 subjects were followed up over a mean (+/-SD) period of 4.6 +/- 0.9 years. Glycated haemoglobin (HbA1c), fasting insulin and lipid profile and anthropometric parameters were documented at the time of recruitment. Cardiovascular mortality, mainly due to coronary heart disease and stroke, was ascertained using death registry and review of hospital case notes in 2001. RESULT: Of the 517 subjects (mean age of 54.0 +/- 14.0 years), 42.6% were men. In this cohort, 63.3% of subjects were either overweight (BMI > or = 23 kg/m2) or obese (BMI > or = 25 kg/m2) using Asian criteria. The mean (+/-SD) total cholesterol (TC), LDL-Cholesterol (LDL-C), HDL-Cholesterol (HDL-C) and geometric mean (x// antilog SD) of triglycerides (TG) were 5.6 +/- 1.3 mmol/L, 3.6 +/- 1.1 mmol/L, 1.3 +/- 0.3 mmol/L and 1.46x//1.90 mmol/L respectively. TC and LDL-C correlated positively with HbA1c, HDL-C negatively with BMI and WC (waist circumference), while TG positively with HbA1c, BMI, WC and HOMA (insulin resistance estimated using the homeostasis model assessment). During the 4.6 years follow-up period, there were 61 deaths giving a total mortality rate of 11.4%, of which 15 (25%) were because of cardiovascular events. Apart from age and disease duration, logarithm of TG was significantly associated with increased risk of cardiovascular mortality (p = 0.049, relative risk = 2.97, 95% CI 1.00-8.77). CONCLUSIONS: Chinese type 2 diabetic patients had a lower prevalence of obesity, lower TG and higher HDL-C than Caucasian patients. Despite the low incidence of cardiovascular death, TG, which was closely associated with obesity indexes, was significantly associated with cardiovascular death in these patients.     

Effects of menopause and obesity on lipid profiles in middle-aged Taiwanese women: the Chin-Shan Community Cardiovascular Cohort Study

In this cross-sectional study, we examined the associations between lipid profiles and menopausal status, age, and obesity in Taiwanese women. The study population, established in 1990-91, consisted of 671 premenopausal and 872 postmenopausal women from the Chin-Shan Community Cardiovascular Cohort (CCCC). The associations of age, body mass index (BMI), and menopausal status with serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), apoproteins (Apo) A-1 and B, and lipoprotein (a) [Lp (a)] were evaluated. The results showed that menopause was associated with significant increases in TC, LDL-C, TG, and Apo B levels (all P < 0.001). Total cholesterol, LDL-C, TG, and Apo B levels increased consistently with BMI in middle-aged women, regardless of menopausal status. Among women aged 45-49, menopausal women had significantly higher levels of TC and LDL-C than premenopausal women (P < 0.01). However, TG and Apo B levels were higher in postmenopausal than in premenopausal women aged 50-54 years (P < 0.05). Standardized regression analyses showed all lipid variables, except those of Apo A1 and Lp (a) before menopause and TC, LDL-C, and Lp (a) after menopause, were significantly associated with BMI (all P < 0.01). We conclude serum lipid levels in Taiwanese women are no more strongly associated with menopause and BMI than with age.     

Excess accumulation of body fat is related to dyslipidemia in normal-weight subjects

OBJECTIVE: To assess the relationship of fat mass (FM) and its distribution to hypertension and dyslipidemia in normal-weight Japanese individuals. DESIGN: Cross-sectional study. SUBJECTS: Apparently healthy Japanese subjects with a body mass index (BMI) between 20 and 23.5 kg/m(2) (265 males and 741 females, age 21-69 y). MEASUREMENTS: BMI, waist circumference (WC), waist-hip ratio (WHR), systolic and diastolic blood pressure, serum levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C) and triglyceride (TG) were measured. Low-density lipoprotein-cholesterol (LDL-C) was calculated by the Friedewald formula. Percentage fat mass (%FM) and trunk fat mass-leg fat mass ratio (FM(trunk)/FM(legs)) were obtained by dual-energy X-ray absorptiometry. RESULTS: WC, WHR, %FM and FM(trunk)/FM(legs) were significantly correlated with TC, LDL-C, HDL-C and TG with the tendency of FM(trunk)/FM(legs) to show the strongest correlations. For %FM and FM(trunk)/FM(legs) in both sexes, odds ratios (ORs) of the third tertiles with respect to the first tertiles increased for LDL-C elevation, TG elevation and dyslipidemia. In males, ORs of the third tertiles of WC were significantly high for LDL-C elevation and dyslipidemia whereas those of WHR were high for TG elevation and dyslipidemia. ORs of the third tertiles of WC and WHR were significantly high for TG elevation in females. BMI was not associated with the risk of abnormal lipid levels. ORs for hypertension showed significant increases in none of the variables of obesity. CONCLUSIONS: Excess accumulation of FM, especially to the upper body, was related to dyslipidemia in normal-weight subjects. Simple anthropometric variables, WC and WHR, may be useful for screening and management of dyslipidemia in these subjects.     

老年男性ApoA／ApoB与代谢综合征及其各组分相关性研究

目的探讨老年男性中载脂蛋白A／载脂蛋白B（ApoA／ApoB）与代谢综合征（metabolic syndrome，MS）及其相关组分的关系。方法采用横断面调查方法，选取2006年6月至2006年12月在我科进行体检的具有完整资料的老年男性共1729人，平均年龄（73．94±6．77）岁。测量身高、体质量、腰围、血压、血糖、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、ApoA、ApoB、ApoA／ApoB。根据ApoA／ApoB四分位值将人群分为4组，以Logistic回归分析ApoA／ApoB与MS及其组分的关系。结果（1）中心性肥胖、高TG、低水平HDL-C、高血糖、MS患病率随着ApoA／ApoB降低而逐渐升高（P〈0．01）。（2）有代谢异常患者ApoA／ApoB水平较无代谢异常者低（P〈0．01）。（3）ApoA／ApoB水平随代谢异常组分增多而降低（P〈0．01）。（4）ApoA／ApoB下四分位组发生MS是ApoA／ApoB上四分位组的4．126倍（P〈0．01）。去除高血脂影响后，ApoA／ApoB下四分位组发生MS是ApoA／ApoB上四分位组的2．651倍（P〈0．01）。结论ApoA／ApoB与MS及其相关组分有密切的关系，MS、代谢异常者ApoA／ApoB较低。而低ApoA／ApoB也较易出现MS。ApoA／ApoB对MS的影响是独立于TC、TG、HDL-C、LDL-C之外的。     

Total cholesterol/HDL cholesterol ratio vs LDL cholesterol/HDL cholesterol ratio as indices of ischemic heart disease risk in men: the Quebec Cardiovascular Study.

BACKGROUND: Total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)/HDL-C ratios are used to predict ischemic heart disease risk. There is, however, no consensus on which of these 2 indices is superior. The objective of the present study was to present evidence that the LDL-C/HDL-C ratio may underestimate ischemic heart disease risk in overweight hyperinsulinemic patients with high triglyceride (TG)-low HDL-C dyslipidemia. METHODS: A total of 2103 middle-aged men in whom measurements of the metabolic profile were performed in the fasting state were recruited from 7 suburbs of the Quebec metropolitan area. RESULTS: The relationship of LDL-C/HDL-C to TC/HDL-C ratios was examined among men in the Quebec Cardiovascular Study classified into tertiles of fasting TG levels. For any given LDL-C/HDL-C ratio, the TC/HDL-C ratio was higher among men in the top TG tertile (>168 mg/dL [>1.9 mmol/L]) than in men in the first and second TG tertiles. Adjustment of the TC/HDL-C ratio for LDL-C/HDL-C by covariance analysis generated significant differences in average TC/HDL-C ratios among TG tertiles (P<.001). Greater differences in features of the insulin resistance syndrome (insulinemia, apolipoprotein B, and LDL size) were noted across tertiles of the TC/HDL-C ratio than tertiles of the LDL-C/HDL-C ratio. CONCLUSION: Variation in the TC/HDL-C ratio may be associated with more substantial alterations in metabolic indices predictive of ischemic heart disease risk and related to the insulin resistance syndrome than variation in the LDL-C/HDL-C ratio.