鲨烯、苔条、紫菜、花菜对大鼠血清胆固醇的作用

通过喂养试验,观察了11种食物和1种食物提取物(鲨烯),对大鼠血清胆固醇浓度的作用。结果发现,鲨烯、苔条、紫菜、花菜均有降低血清T-C的作用,其中鲨烯和苔条还能促进HDL-C的增高。与对照组相比,鲨烯组大鼠血清T-C,LDL-C和VLDL-C分别下降50.5％、60.8％和53.7％,而HDL-C则增高56.5％。苔条组大鼠血清T-C,LDL-C和VLDL-C分別下降34.9％,42.7％、和31.4％,而HDL-C增高58.3％。紫菜组和花菜组大鼠血清T-C则分别下降29.4％和36.7％。     

脂蛋白(a)与年轻人脑梗死

目的 研究脂蛋白(a)与年轻人脑梗死发病的关系。方法 检测90例发病年龄16—45岁脑梗死患者脂蛋白(a)与甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A—I、载脂蛋白B等，同时分析患者的高血压、吸烟、饮酒、卒中家族史等因素。结果 与对照组相比，脑梗死患者的脂蛋白(a)无显著性增高。而甘油三酯、载脂蛋白B在脑梗死患者中却显著增高。相关分析显示，脂蛋白(a)与血清总胆固醇和低密度脂蛋白胆固醇正相关(P＜0．01)。logistic回归分析示高脂蛋白(a)的相对危险度比值比(OR)为0．74，95％CI：0．27一1．98。高甘油三酯对于脑梗死的OR值为3．57，95％CI：1．34—9．49；高血压对于脑梗死的OR值为8．18，95％CI：2．54—26．33；心脏病对于脑梗死的OR值为8．5l，其95％CI：2．27—31．85；吸烟的OR值为3．2l，95％CI：1．27—8．13。结论 脂蛋白(a)可能不是年轻人脑梗死的危险因素。高甘油三酯、高血压、心脏病和吸烟是年轻人脑梗死重要的危险因素。     

Description of a large pedigree with an adverse lipoprotein cholesterol phenotype: the Bogalusa Heart Study

A large pedigree (N = 356) with a high prevalence of heart disease and associated adverse lipoprotein phenotype was studied. The adverse lipoprotein phenotype is characterized by both low levels of high-density-lipoprotein cholesterol (HDL-C) alone (16.3%) and in combination with other adverse lipoprotein levels (12.8%). In all, 44.2% of all pedigree members had at least one adverse lipoprotein level. Analysis of mating types showed that all lipids and lipoproteins possess familial clustering with 25-36% of offspring above median levels when both parents had levels below the median, while 67-83% had levels above the median when both parents had levels above the median. Using adjusted lipid and lipoprotein levels, a statistically significant linear trend was found between the degree of relationship to pedigree members with heart disease, and both the low-density-lipoprotein cholesterol/high-density-lipoprotein cholesterol (LDL-C/HDL-C) ratio (P less than .05), and the very-low-density-lipoprotein cholesterol (VLDL-C; P less than .01) level. A similar analysis using the prevalence of adverse lipoprotein levels as the dependent variable and degree of relationship to heart diseased pedigree numbers as the independent variable showed significant (P less than .05) relationships with VLDL-C and the LDL-C/HDL-C ratio. Further genetic analyses of this pedigree may reveal genetic mechanisms responsible for the familiality of lipoprotein levels in this pedigree.     

A pooled analysis of the association of isolated low levels of high-density lipoprotein cholesterol with cardiovascular mortality in Japan

Low levels of serum high-density lipoprotein cholesterol (HDL-C) have been shown to be associated with increased risk of coronary heart disease (CHD). However, because this is usually observed in the context of other lipid abnormalities, it is not known whether isolated low serum HDL-C levels are an independent risk factor for CHD. We performed a large pooled analysis in Japan using data from nine cohorts with 41,206 participants aged 40–89 years who were free of cardiovascular disease at baseline. We divided participants into three groups: isolated low HDL-C, non-isolated low HDL-C, and normal HDL-C. Cohort-stratified Cox proportional hazards models were used to estimate multivariate-adjusted hazard ratios (HRs) for death due to CHD, ischemic stroke, and intracranial cerebral hemorrhage; during a 12.9-year follow-up, we observed 355, 286, and 138 deaths, respectively, in these groups. Non-isolated low HDL-C was significantly associated with increased risk of CHD compared with normal HDL-C (HR 1.37, 95 % confidence interval (CI) 1.04–1.80); however, isolated low HDL-C was not. Although isolated low HDL-C was significantly associated with decreased risk of CHD (HR 0.51, 95 % CI 0.29–0.89) in women, it was significantly associated with increased risk of intracranial cerebral hemorrhage in all participants (HR 1.62, 95 % CI 1.04–2.53) and in men (HR 2.00, 95 % CI 1.04–3.83). In conclusion, isolated low HDL-C levels are not associated with increased risk of CHD in Japan. CHD risk may, therefore, be more strongly affected by serum total cholesterol levels in this population.     

脂蛋白胆固醇和载脂蛋白水平对乳腺癌发生及预后的预测价值

目的 探讨脂蛋白胆固醇和载脂蛋白水平对乳腺癌发病风险及预后的预测价值。方法 收集病例组418例首诊乳腺癌女性患者初次入院时和对照组418例正常女性健康体检时的高密度脂蛋白胆固醇（HDL - C）、低密度脂蛋白胆固醇（LDL - C）、载脂蛋白A1（ApoA1）和载脂蛋白B（ApoB）等资料,并对所有乳腺癌病例进行76个月的随访。采用logistic和cox回归模型分析脂蛋白胆固醇和载脂蛋白与乳腺癌风险和预后的相关性。结果 HDL - C（OR = 3.70, 95%CI:2.29～5.96）的增加与乳腺癌发生的风险相关,而LDL - C（OR = 0.47, 95%CI:0.39～0.58）则可降低风险。ROC曲线显示HDL - C与LDL - C联合时,AUC为0.702,对罹患乳腺癌的预测能力优于单一指标。50岁以下乳腺癌患者ApoA1水平与乳腺癌的预后有关,高ApoA1（≥1.32 g/L）可降低50岁以下乳腺癌患者的死亡风险。结论 脂蛋白胆固醇和载脂蛋白的水平变化在乳腺癌发生发展中具有重要作用,与乳腺癌的发病风险和预后有关。     

Lipids and pulmonary function in the Third National Health and Nutrition Examination Survey

Studies considering the association between total cholesterol and noncardiovascular mortality, particularly from respiratory disease, yield inconclusive findings. To explore this question, the relation of lipids to pulmonary function, specifically forced expiratory volume in 1 second (FEV(1)), was investigated in the Third National Health and Nutrition Examination Survey. Conducted in the United States in 1988-1994 among adults aged > or =17 years, this survey measured serum lipids, FEV(1), and confounding factors including smoking and antioxidants. Multiple linear regression analysis explored the relation of FEV(1)/height(2) to low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and their respective apolipoproteins (apo) B and A-I. A standard deviation increase in HDL cholesterol or apo A-I was associated with an FEV(1) increase of 43 ml (95% confidence interval (CI): 30, 56) or 29 ml (95% CI: 11, 47), respectively, for an average-height adult. A standard deviation increase in LDL cholesterol or apo B was associated with an FEV(1) decrease of -24 ml (95% CI: -43, -5) or -53 ml (95% CI: -74, -32), respectively, adjusted for serum antioxidant status. The lipid subfractions were differentially associated with FEV(1) consistent with the possibility that LDL cholesterol contributes to endogenous oxidative burden while HDL cholesterol attenuates inflammatory tissue damage. Whether these associations are causal remains to be determined.     

Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. The Bogalusa Heart Study

The relation of obesity to clustering of systolic blood pressure, fasting insulin, and ratio of low and very low density lipoprotein cholesterol to high density lipoprotein cholesterol [LDL-C + VLDL-C)/HDL-C) was investigated in 3,503 subjects aged 5-24 years in Bogalusa, Louisiana, from September 1981 to September 1983. Risk ratios (RR) were calculated as the number of subjects with risk factor variables in the upper tertile divided by the expected number. The variables showed strong clustering (RR = 3.1); however, after adjusting for obesity, clustering of systolic pressure, (LDL-C + VLDL-C)/HDL-C, and insulin was reduced (RR = 1.3). Lean subjects (lower tertile of obesity) showed less clustering than expected (RR = 0.4), while more obese subjects (upper tertile of obesity) had greater clustering than expected (RR = 3.1). Furthermore, trunk fat deposition (subscapular skinfold) had a greater impact on clustering at high levels than limb fat deposition (triceps skinfold). Since obesity is related to clustering of risk factor variables in children and young adults, the prevention of the onset of obesity in early life may be important to reducing the risk of coronary heart disease in later life.     

Risk factors and incident coronary heart disease in Chinese, Malay and Asian Indian males: the Singapore Cardiovascular Cohort Study.

OBJECTIVE: This prospective study in Singapore investigated the relationships of established coronary risk factors with incident coronary heart disease (CHD) for Chinese, Malay, and Asian Indian males. SUBJECTS: A cohort (consisting of 2879 males without diagnosed CHD) derived from three previous cross-sectional surveys. METHODS: Individual baseline data were linked to registry databases to obtain the first event of CHD. Hazard ratios (HR) or relative risks for risk factors were calculated using Cox's proportional hazards model with adjustment for age and ethnic group and adjustment for age, ethnic group and all other risk factors (overall adjusted). RESULTS: There were 24,986 person-years of follow-up. The overall adjusted HR with 95% CI are presented here. Asian Indians were at greatest risk of CHD, compared to Chinese (3.0; 2.0-4.8) and Malays (3.4; 1.9-3.3). Individuals with hypertension (2.4; 1.6-2.7) or diabetes (1.7; 1.1-2.7) showed a higher risk of CHD. High low density lipoprotein cholesterol (LDL-C) (1.5; 1.0-2.1), high fasting triglyceride (1.5; 0.9-2.6) and low high density lipoprotein cholesterol (HDL-C) (1.3; 0.9-2.0) showed a lesser but still increased risk. Alcohol intake was protective with non-drinkers having an increased risk of CHD (1.8; 1.0-3.3). Obesity (body mass index > or =30) showed an increased risk (1.8; 0.6-5.4). An increased risk of CHD was found in cigarette smokers of > or =20 pack years (1.5; 0.9-2.5) but not with lesser amounts. CONCLUSIONS: The increased susceptibility of Asian Indian males to CHD has been confirmed in a longitudinal study. All of the examined established risk factors for CHD were found to play important but varying roles in the ethnic groups in Singapore.     

Systematic Review and Meta-Analysis of the Prognostic Value of Serum High-Density Lipoprotein Cholesterol Levels for Solid Tumors

Numerous studies have demonstrated that serum high-density lipoprotein cholesterol (HDL-C) levels correlate strongly with cancer patient survival. However, other studies have had the opposite results. We therefore conducted a systematic review and meta-analysis to assess the prognostic value of HDL-C levels in people with cancer. We searched PubMed, Embase, and the Cochrane Library (last update by December 28, 2017) for studies evaluating the effect of serum HDL-C levels on cancer patient prognosis. Data from 25 studies covering13,140 patients were included. Combined hazard ratios (HRs) for overall survival (OS) and disease-free survival (DFS) were assessed using fixed-effects and random-effects models. High serum HDL-C levels were associated with better OS (pooled HR = 0.70; 95% confidence interval (CI) (0.60–0.82). In the subgroup, the relative high level of HDL-C yielded a favorable outcome in most of tumor types. However, in the nasopharyngeal carcinoma subgroup, the correlation was not significant (combined HR = 1.31; 95% CI (0.91–1.90)). High serum HDL-C levels were associated with better DFS (pooled HR = 0.64; 95% confidence interval (CI) (0.50–0.81)). This meta-analysis demonstrates that high serum HDL-C levels are associated with better OS in patients with solid tumors, but not nasopharyngeal carcinoma; and high serum HDL-C levels are associated with better DFS.     

A prospective study of anthropometric and clinical measurements associated with insulin resistance syndrome and colorectal cancer in male smokers

Type 2 diabetes mellitus shares risk factors for and has shown a positive association with colorectal cancer. Anthropometric measures (height, weight, and body mass index (weight (kg)/height (m)(2)) and metabolic abnormalities associated with insulin resistance syndrome (IRS) (abnormalities in measured blood pressure, high density lipoprotein (HDL) cholesterol, and total cholesterol) were prospectively evaluated for associations with incident colon (n = 227), rectal (n = 183), and colorectal (n = 410) cancers diagnosed between 1985 and 2002 in 28,983 Finnish male smokers from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals. In comparison with the lowest quintile, the highest quintile of body mass index was significantly associated with colorectal cancer (hazard ratio (HR) = 1.70, 95% confidence interval (CI): 1.01, 2.85; p-trend = 0.01), particularly colon cancer. Subjects with a cluster of three IRS-related conditions (hypertension, body mass index >/=25 kg/m(2), and HDL cholesterol level <40 mg/dl (<1.55 mmol/liter)), compared with those with fewer conditions, had a significantly increased risk of colorectal cancer (HR = 1.40, 95% CI: 1.12, 1.74), particularly colon cancer (HR = 1.58, 95% CI: 1.18, 2.10), but not rectal cancer. These results support the hypothesis that the significant association observed between IRS-defining metabolic abnormalities and colorectal cancer is determined primarily by adiposity.     

1310例体检人群血清脂蛋白胆固醇与年龄、性别及血糖水平的相关性研究

目的探讨成人血清脂蛋白胆固醇与年龄、性别及空腹血糖水平的关系。方法选择1310名体检健康人作为研究对象,根据年龄分为6组,测定其血清脂蛋白胆固醇及空腹血糖,比较各年龄组及性别间脂蛋白胆固醇变化和差异,并行相关分析。结果极低密度脂蛋白胆固醇(VLDL-C)及低密度脂蛋白胆固醇(LDL-C)有随年龄增长而升高的趋势(r=0.19及0.25,均P=0.000),但60岁后男性VLDL-C有所下降。60岁前各年龄段男性VLDL-C结果均显著高于女性(P=0.000),60岁后男女间无差别(P>0.05)。50岁前男性LDL-C水平均高于女性(P<0.05),50岁以后男女间无差别(P>0.05)。高密度脂蛋白胆固醇(HDL-C)随年龄增长变化不明显(P>0.05),但女性各年龄段HDL-C结果均显著高于男性(P=0.000)。相关分析显示随空腹血糖水平升高VLDL-C升高趋势不明显(r=0.08,P=0.004),但LDL-C有所升高(r=0.13,P=0.000)且HDL-C明显降低(r=-0.18,P=0.000)。结论随年龄增长健康人群有发生脂蛋白代谢紊乱的倾向,且男性趋势更明显;空腹血糖增高和脂代谢紊乱有一定的相关性。     

Factors associated with metabolic syndrome among Korean office workers

To assess the prevalence of metabolic syndrome (MetS) and identify risk factors associated with MetS among Korean office workers, this cross-sectional study was conducted with 776 office workers. The prevalence of MetS was 13.5%; elevated waist circumference (27.5%), elevated fasting glucose (23.1%), elevated triglycerides (22.2%), low high-density lipoprotein cholesterol (HDL-C) (13.4%), and elevated BP (9.4%). Having any medical health problems (OR = 3.98, 95% CI: 2.01–7.85), more knowledge of MetS (OR = 1.26, 95% CI: 1.02–1.56), higher BMI (OR = 1.42, 95% CI: 1.30–1.57), current smoking (OR = 3.78, 95% CI: 1.04–13.73), and physical inactivity (OR = 3.22, 95% CI: 1.21–8.58) were significantly associated with increased likelihood of MetS. Addressing the influence of these factors on MetS could lead to the development of workplace-based intervention strategies to encourage lifestyle changes and prevent the risk of MetS among Korean office workers.     

Prospective associations between serum biomarkers of lipid metabolism and overall,breast and prostate cancer risk

Experimental studies provided evidence about mechanisms by which cholesterol, especially high density lipoprotein cholesterol (HDL-C), could influence carcinogenesis, notably through antioxidant and anti-inflammatory properties. However, prospective studies that investigated the associations between specific lipid metabolism biomarkers and cancer risk provided inconsistent results. The objective was to investigate the prospective associations between total cholesterol (T-C), HDL-C, low density lipoprotein cholesterol, apolipoproteins A1 (apoA1) and B, and triglycerides and overall, breast and prostate cancer risk. Analyses were performed on 7,557 subjects of the Supplémentation en Vitamines et Minéraux Antioxydants Study, a nationwide French cohort study. Biomarkers of lipid metabolism were measured at baseline and analyzed regarding the risk of first primary incident cancer (N = 514 cases diagnosed during follow-up, 1994–2007), using Cox proportional hazards models. T-C was inversely associated with overall (HR_{1mmol/L increment} = 0.91, 95 % CI 0.82–1.00; P = 0.04) and breast (HR_{1mmol/L increment} = 0.83, 95 % CI 0.69–0.99; P = 0.04) cancer risk. HDL-C was also inversely associated with overall (HR_{1mmol/L increment} = 0.61, 95 % CI 0.46–0.82; P = 0.0008) and breast (HR_{1mmol/L increment} = 0.48, 95 % CI 0.28–0.83; P = 0.009) cancer risk. Consistently, apoA1 was inversely associated with overall (HR_{1g/L increment} = 0.56, 95 % CI 0.39–0.82; P = 0.003) and breast (HR_{1g/L increment} = 0.36, 95 % CI 0.18–0.73; P = 0.004) cancer risk. This prospective study suggests that pre-diagnostic serum levels of T-C, HDL-C and ApoA1 are associated with decreased overall and breast cancer risk. The confirmation of a role of cholesterol components in cancer development, by further large prospective and experimental studies, may have important implications in terms of public health, since cholesterol is already crucial in cardiovascular prevention.     

Risk factors for abdominal aortic aneurysm: results of a case-control study

Abdominal aortic aneurysms (AAAs) have historically been considered to be a manifestation of atherosclerosis. However, there are epidemiologic and biochemical differences between occlusive atherosclerotic disease and aneurysmal disease of the aorta. A case-control study was performed to investigate risk factors for AAA at the two tertiary care hospitals in Winnipeg, Manitoba, Canada, between June 1992 and December 1995 to investigate risk factors for AAA. Newly diagnosed cases of AAA (n = 98) were compared with non-AAA controls (n = 102), who underwent ultrasound for indications similar to those of the cases. Compared with that for never smokers, the adjusted odds ratio (OR) was 2.75 (95% confidence interval (CI): 0.85, 8.91) for 1-19 pack-years, 7.31 (95% CI: 2.44, 21.9) for 20-34 pack-years, 7.35 (95% CI: 2.40, 22.5) for 35-49 pack-years, and 9.55 (95% CI: 2.81, 32.5) for 50 or more pack-years. Other factors significantly associated with AAA were male gender (OR = 2.68, 95% CI: 1.26, 5.73), diastolic blood pressure (OR per 10 mmHg = 1.88, 95% CI: 1.31, 2.69), and family history of AAA (OR = 4.77, 95% CI: 1.26, 18.1). There was an inverse association between diabetes mellitus and AAA (OR = 0.32, 95% CI: 0.12, 0.88). Neither clinical hypercholesterolemia nor serum levels of total cholesterol, low density lipoprotein cholesterol, and high density lipoprotein cholesterol was associated with AAA. The results of this study suggest that the risk factors for AAA differ from those for atherosclerosis and that atherosclerosis per se is not an adequate explanation as the cause of AAAs.     

Association of Coffee Consumption and Its Types According to Addition of Sugar and Creamer with Metabolic Syndrome Incidence in a Korean Population from the Health Examinees (HEXA) Study

Coffee is widely consumed worldwide, and numerous studies indicate that coffee consumption may potentially affect the development of chronic diseases. Metabolic syndrome (MetS) may constitute a risk factor for chronic diseases. We aimed to prospectively evaluate the association between coffee consumption and MetS incidence. All participants were selected from the Health Examinees study. MetS was defined by the Adult Treatment Panel III criteria of the National Cholesterol Education Program. A multivariate Cox proportional hazards regression model was used to assess the relationship between coffee consumption and MetS incidence. In comparison with non-consumers, male moderate consumers (≤3 cups/day) showed a lower risk for low high-density lipoprotein cholesterol (HDL-C) (≤1 cup/day, hazard ratio (HR): 0.445, 95% confidence interval (CI): 0.254–0.780; 1–3 cups/day, HR: 0.507, 95% CI: 0.299–0.859) and high fasting blood glucose (FPG) (≤1 cup/day, HR: 0.694, 95% CI: 0.538–0.895; 1–3 cups/day, HR: 0.763, 95% CI: 0.598–0.972). Male 3-in-1 coffee (coffee with sugar and creamer) consumers also showed a lower risk for low HDL-C (HR: 0.423, 95% CI: 0.218–0.824) and high FPG (HR: 0.659, 95% CI: 0.497–0.874). These findings indicate a negative association between moderate coffee consumption and low HDL-C and high FPG among Korean male adults.     

Fruit, vegetable, and antioxidant intake and all-cause, cancer, and cardiovascular disease mortality in a community-dwelling population in Washington County, Maryland

Higher intake of fruits, vegetables, and antioxidants may help protect against oxidative damage, thus lowering cancer and cardiovascular disease risk. This Washington County, Maryland, prospective study examined the association of fruit, vegetable, and antioxidant intake with all-cause, cancer, and cardiovascular disease death. CLUE participants who donated a blood sample in 1974 and 1989 and completed a food frequency questionnaire in 1989 (N = 6,151) were included in the analysis. Participants were followed to date of death or January 1, 2002. Compared with those in the bottom fifth, participants in the highest fifth of fruit and vegetable intake had a lower risk of all-cause (cases = 910; hazard ratio (HR) = 0.63, 95% confidence interval (CI): 0.51, 0.78; p-trend = 0.0004), cancer (cases = 307; HR = 0.65, 95% CI: 0.45, 0.93; p-trend = 0.08), and cardiovascular disease (cases = 225; HR = 0.76, 95% CI: 0.54, 1.06; p-trend = 0.15) mortality. Higher intake of cruciferous vegetables was associated with lower risk of all-cause mortality (HR = 0.74, 95% CI: 0.60, 0.91; p-trend = 0.04). No statistically significant associations were observed between dietary vitamin C, vitamin E, and beta-carotene intake and mortality. Overall, greater intake of fruits and vegetables was associated with lower risk of all-cause, cancer, and cardiovascular disease death. These findings support the general health recommendation to consume multiple servings of fruits and vegetables (5-9/day).     

Alcohol consumption, metabolic cardiovascular risk factors and hypertension in women

BACKGROUND: Low to moderate alcohol consumption is associated with reduced mortality, primarily due to a reduction in coronary heart disease (CHD). Conversely, heavy drinking increases mortality, mainly due to haemorrhagic stroke and non-cardiovascular diseases. It is important to identify the threshold of alcohol consumption above which the balance of risk and benefit becomes adverse. We examine the relationship between reported alcohol consumption, cardiovascular disease (CVD) risk factors, a 10-year CHD risk score and hypertension in women. METHODS: In all, 14 077 female employees aged 30-64 years, underwent screening for CVD risk factors. Information was available on a range of personal and lifestyle factors, including height, weight, blood pressure, lipids, lipoproteins, apolipoproteins and blood glucose. Age-adjusted means were computed for the risk factors in each of five groups of reported alcohol intake: <1 (non-drinkers), 1-7, 8-14, 15-21, > or = 22 units/week. The relationships between alcohol and a derived coronary risk score and hypertension were also examined. RESULTS: Increasing consumption was associated with an age-adjusted increase in high density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (both P < 0.001), a decline in body mass index, total cholesterol (TC), TC/HDL-C ratio, low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (all P < 0.001), and no trend in triglycerides (P = 0.06), lipoprotein (a) (P = 0.09) or fasting glucose (P = 0.14). Except for LDL-C (P = 0.06) the relationships remained statistically significant after adjustment for possible confounders. Compared to non-drinkers, there was a decrease in 10-year CHD risk with increasing consumption, with the greatest reduction in risk in women consuming 1-7 units/week, odds ratio (OR) = 0.79, (95% CI: 0.72-0.87), and an increase in the prevalence of hypertension among those consuming 15-21 units/week, OR = 1.68, (95% CI: 1.14-2.46). CONCLUSIONS: This study provides biological support for an inverse association between alcohol intake and CHD in women, associated with favourable changes in lipid and lipoprotein risk factors. Women consuming 1-14 units/week had a reduction in CHD risk, but there was an increased prevalence of hypertension among those consuming > or = 15 units/week. These data suggest that, in terms of the reduced risk of CVD, women should be advised to restrict their alcohol consumption to < or = 14 units/week.     

Low-Density Lipoprotein Cholesterol and the Risk of Rheumatoid Arthritis: A Prospective Study in a Chinese Cohort

Objective: This study aimed to investigate whether low-density lipoprotein cholesterol (LDL-C) concentration was associated with the risk of rheumatoid arthritis (RA) in Chinese adults. Methods: The study included the 97,411 participants in the Kailuan Study without RA, with complete baseline LDL-C data, and who did not use lipid-lowering medications at baseline or during follow-up. We used Cox proportional hazards modeling to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) of RA according to baseline LDL-C tertiles, adjusting for age, sex, body mass index, HDL-C, triglycerides, diabetes, hypertension, alcohol consumption, and smoking. We also calculated the HR and 95% CI of RA using updated LDL-C measurements prior to the end of follow-up, adjusting for covariates. Results: We identified 97 incident RA cases between 2006 and 2018. After adjusting for potential confounders, updated LDL-C concentration—rather than baseline LDL-C—was inversely associated with RA risk. The adjusted HR of RA was 0.64 (95% CI: 0.38, 1.09; p-trend = 0.10) comparing the two extreme baseline LDL-C tertiles, and 0.38 (95% CI: 0.22, 0.64; p-trend < 0.01) comparing the two extreme tertiles of the updated LDL-C concentrations. Conclusions: In this prospective study, high LDL-C concentrations, when measured closest to RA diagnosis or the end of follow-up, were associated with a low risk of RA. These findings highlight the changes in LDL-C prior to RA diagnosis, and the importance of including lipid analyses into studies of the pathogenesis of RA.     

The effect of a home-based walking program on risk factors for coronary heart disease in hypercholesterolaemic men. A randomized controlled trial

BACKGROUND: Hypercholesterolaemia and physical inactivity significantly contribute towards risk of coronary heart disease. Increased physical activity may be an effective way to improve lipid profiles in hypercholesterolaemic individuals. The aim of this study was to investigate whether a home-based physical activity program meeting current guidelines improved the lipid profile of hypercholesterolaemic men. METHODS: Sixty-seven hypercholesterolaemic men (55.1 (4.9) years), from Bristol England, recruited between 2002-2004, were randomized to either 12 weeks of brisk walking sufficient to expend at least 300 kcal each walk or control condition. Fasting lipids including total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), glucose, insulin, blood pressure and anthropometric characteristics were measured at baseline and follow-up. Compliance was monitored using accelerometers and activity logs. RESULTS: After controlling for baseline differences, TC/HDL-C was significantly lower in the intervention group at follow-up (-0.28, 95% CI: -0.52, -0.03, p=0.03). An increase in HDL-C (0.07 mmol/l: -0.01, 0.12, p=0.07) and reduction in TG (-0.30 mmol/l: -0.64, 0.03, p=0.07) in intervention participants were of borderline statistical significance. Weight significantly decreased in intervention participants (-1.40 kg: -2.43, -0.38, p<0.01). No other significant between group effects were found. Compliance to the walking program was 97.6%. CONCLUSIONS: Twelve weeks of moderate intensity walking was sufficient to improve TC/HDL-C in hypercholesterolaemic men, primarily through improvement in HDL-C.     

Coronary heart disease risk: The importance of joint relationships among cholesterol levels in individual lipoprotein classes

Relationships among high-density lipoprotein cholesterol (HDL-C), low -density lipoprotein cholesterol (LDL-C), and very-low-density lipoprotein cholesterol (VLDL-C) were examined in 1,892 participants (aged 50–79 years) in the Framingham Heart Study cohort and in 4,245 of their offspring (aged 20–49 years). The effect of the relationships on the incidence of coronary heart disease (CHD) was further investigated in the cohort using multiple logistic regression models. The results indicate that even though a lipoprotein cholesterol does not have a significant independent association with CHD, there may still be an important link between the lipoprotein cholesterol and CHD risk even in a multivariate setting. For example, in all sex and age groups HDL-C is inversely related to VLDL-C. Furthermore, among females aged 50–59 years, neither HDL-C nor VLDL-C exhibits an independent significant association with CHD. If, however, the relationship between VLDL-C and HDL-C is taken into account, a significant positive association of VLDL-C with CHD emerges along with a significant negative association between HDL-C and CHD. Relationships among lipoprotein cholesterols should be considered when evaluating the association between lipoprotein cholesterols and CHD because certain combinations of lipoprotein cholesterol levels may be uncommon or more likely to be associated with disease than others. This result may imply that an important association between a lipoprotein cholesterol and CHD exists through relationships with other lipoprotein cholesterols even though an independent association with CHD cannot be demonstrated.