胰岛素抵抗与心血管病危险因素聚集性关系研究

为观察胰岛素抵抗与心血管病危险因素聚集性的关系，分析了１０６例高血压及冠心病病人和３２例正常人的胰岛素水平及胰岛素敏感性。结果显示：（１）无心血管病危险因素时，胰岛素敏感性指数为－１．４８±０．０９，随着危险因素聚集程度增加，轻度聚集（２项危险因素）时为－１．９５±０．１７，重度聚集（≥３项危险因素）达－２．１４±０．２１。与正常组比差异有显著性（Ｐ＜０．０１）。提示随着危险因素逐渐聚集增加，胰岛素抵抗加重；（２）女性病人胰岛素抵抗与血尿酸呈正相关（ｒ＝０．３７８，Ｐ＜０．０５），男性病人无明显相关（ｒ＝０．３４，Ｐ＝０．１４５）；（３）绝经前后妇女相比，敏感性指数分别为－１．７３±０．１３和－２．２３±０．２９（Ｐ＜０．０５）。绝经后胰岛素敏感性下降。以上结果表明胰岛素抵抗与心血管病危险因素聚集性呈正相关。     

我国中年人群糖尿病和空腹血糖异常对心血管病发病的预测价值

目的 采用前瞻性研究分析糖尿病在我国中年人群中是否心血管病发病的独立危险因素。方法 中国和美国心血管病和心肺疾病流行病学合作研究1983—1984年在北京和广州工农人群(35—54岁)中用国际标准化的方法进行了心血管病危险因素基线调查。对10076人的队列按照统一的方案每2年随访一轮到1997年底，根据美国糖尿病协会空腹血糖的分类标准对于基线血糖水平进行分层，用Cox回归调整年龄和调整相关因素后，计算糖尿病和空腹血糖异常对于冠心病和脑卒中发病的相对危险。结果 在除外基线时有心肌梗死和脑卒中史资料完整的9111人中，按照世界卫生组织MONICA方案的诊断标准，共计发生冠心病事件72例，脑卒中事件259例。心血管病的其他危险因素在空腹血糖异常组和糖尿病组高于正常组。经年龄调整和多因素调整后，糖尿病对冠心病和脑卒中发病的相对危险在女性(3．78和4．20)和性别合并组(3．22和2．50)显著高于血糖正常组，男性未达到统计学显著水平，空腹血糖异常组未见相对危险的增高。糖尿病对于冠心病和脑卒中发病的相对危险度仅低于高血压而高于血清总胆固醇和吸烟。结论 在我国中年人群中糖尿病是冠心病和脑卒中发病的重要危险因素之一。     

空腹血糖升高对心血管病危险因素聚集的影响——1503例调查分析

采用分层随机抽样方法对1503名北京市成人进行心血管病危险因素的横断面调查，结果显示，随FPG水平增加，腹型肥胖、高血压、高脂血症等患病率呈线性增加，以代谢综合征（MS）为因变量的logistic回归分析显示自变量FPG的标准化p值为0．698。提示FPG水平升高与心血管病危险因素聚集相关。     

父母高血压史与心血管病发病关系的前瞻性研究

目的探讨我国人群中父母高血压史与子代心血管病发病的关系。方法1992—1994年在全国12组人群中分别整群随机抽取1000—2000人进行心血管病危险因素调查,并对心血管事件的发生情况进行随访观察,随访至2005年6月,平均随访10．8年。结果15131例随访对象共发生心血管事件448例,其中冠心病事件82例,脑卒中事件370例,4例既发生冠心病事件又发生脑卒中事件。在控制了年龄、吸烟、饮酒后,男性和女性父母双方均无高血压史者、仅父母一方有高血压史者、父母双方均有高血压史者发生心血管病的相对危险分别为：男性：1．00,1．34（1．01—1．78）,2．58（1．62—4．11）;女性：1．00,1．77（1．27—2．45）,2．55（1．44—4．54）。在进一步控制了总胆固醇、高密度脂蛋白胆固醇、空腹血糖、体重指数和收缩压后,男性和女性上述各组发生心血管病的相对危险分别为：男性：1．00,1．01（0．76—1．35）,1．72（1．07—2．75）;女性：1．00,1．31（0．94—1．84）,1．76（0．98—3．15）。结论父母有高血压史者具有较高的发生心血管病的危险性,父母双方均有高血压史者心血管病发病危险的增加尤为显著。遗传因素对子代的影响在很大程度上是通过我们目前已知的危险因素而起作用。因而父母有高血压史者强化对传统的危险因素的控制,对于预防心血管病发病、提高生活质量可能具有更重要的意义。     

中国11省市队列人群基线血压和7年累积心血管病发病危险的前瞻性研究

目的：以较大人群、较广的地理覆盖面的前瞻性队列研究结果提供中国人血压水平与心血管病发病危险最化关系的数据;探讨收缩压和舒张压作为危险因素标识或致病因素在与心血管病的发病危险的关系上存在的差别;分析血压对急性脑卒中和冠心病事件发病的影响是否存在差别及控制血压对预防这两种疾病的公共卫生意义;初步评价现行的高血压诊断、治疗和分级标准。方法：对1992年建立的11省市35－64岁队列人群共29488人基线血压水平和1992－1999年共138177．1观察人年中生心血管病（包括脑卒中和冠心病）事件发病的数据进行单因素和多因素分析。结果：对收缩压和舒张压分别进行的单因素和多因素分析显示,两均可作为预测生心血管病事件发病危险的有效标识,但收缩压水平对急性心血管病事件,特别是脑卒中危险的影响强度明显大于舒张压,收缩压≥180mmHg（1mmHg=0.133kPa)组与收缩压＜120mmHg组人群相比,生心血管事件发病危险单因素分析时高22倍（脑座中31倍,冠心病8倍）,多因素分析时高11倍（脑卒中16倍,冠心病4倍）。血压对于与急性脑卒中事件和急性冠心病事件的影响无论在强度、影响方式和预防的公共卫生意义上存在明显差别,人群中79．7％的脑卒中事件可归因于血压的升高,但只有36．6％的冠心病事件可归因于血压的增高因血压各分级中,心血管事件的发病危险随其他危险因素存在的数量而上升。结论：高血压是目前中国人群最重要的心血管病危险因素,有效的防治高血压是减少我国心血管病负担最重要和最关键的环节。     

中国35～64岁人群胆固醇水平与10年心血管病发病危险的前瞻性研究

目的探讨我国35～64岁人群血清总胆固醇（TC）水平与心血管病（包括急性冠心病事件和急性脑卒中事件）发病危险的关系。方法采用前瞻性队列研究的方法,对1992年建立的11省市35—64岁队列人群共30384人的基线TC水平和1992-2002年发生的急性冠心病事件和急性脑卒中事件的关系进行分析。应用Cox比例风险模型对TC水平与心血管病发病危险进行多因素分析。结果（1）以TC〈3．64mmol／L（140mg／d1）组为对照,随着TC水平的增加,缺血性心血管病发病危险呈持续增加变化。（2）TC水平与不同类型的心血管病的关系有所差别：缺血性脑卒中事件发病危险从TC很低水平（〈3．64mmol／L）开始,随着TC水平的增加呈持续上升的变化;而出血性脑卒中事件与TC水平的关系缺乏一致性。多因素分析结果显示：与TC〈5．72mmol／L（220mg／d1）相比,TC≥5．72mmol／L时急性冠心病发病危险增加74％（RR=1．743,P〈0．01）,缺血性脑卒中发病危险增加12％（RR=1．119,P〉0．05）。（3）在缺血性心血管病事件中,5．9％可归因于高TC血症;其中11．7％的急性冠心病事件和2．9％的急性缺血性脑卒中事件可归因于高TC血症。（4）不同TC水平时,随着合并其他心血管病危险因素个数的增加,10年心血管病发病的绝对危险增加。结论从TC低水平〈3．64mmol／L（140mg／dl）开始,随着TC水平的增加缺血性心血管病的发病危险持续上升。应该加强多重危险因素的综合干预,以减少心血管病的综合危险。     

北京市首都钢铁公司男工冠心病危险因素前瞻性研究——血压、血清总胆固醇及吸烟与冠心病关系

本文用Cox回归分析首都钢铁公司5 298名男工随访8.38年冠心病发病及其危险因素的研究结果,得出冠心病发病和死亡率随血压和血清总胆固醇水平升高而增加;在胆固醇浓度>5.3mmol/L(200mg/dl)情况下,冠心病危险还随每日吸烟支数增加而增加。     

调脂药物在防治冠心病中的规范应用及其进展

血脂异常是动脉粥样硬化的重要危险因素。血脂异常主要包括高胆固醇血症、高甘油三酯血症、混合性高脂血症、高脂蛋白血症和高密度脂蛋白低水平。高胆固醇血症是冠心病的独立危险因素，血清胆固醇（TC）的水平与冠心病的发病呈线数对数关系，降低TC与低密度脂蛋白胆固醇（LDL—C）可显著减少心血管事件的发生，降低幅度越大，获益越大。高甘油三酯也是冠心病的一个独立危险因素，而且甘油三酯（TG）升高伴TC升高或高密度脂蛋白胆固醇（HDL—C）水平低下会明显增加冠心病的发病危险。HDL—C水平与冠心病发病呈负相关，研究显示：HDL—C水平每增加0．03mmol／L（1mg／dl），冠心病的危险就降低2％～3％。降低TG与升高HDL—C与心血管事件减少相关。     

中国35～64岁人群血清甘油三酯与心血管病发病危险的关系

目的 探讨我国35～64岁人群血清甘油三酯(TG)与心血管病发病危险的关系.方法 采用前瞻性队列研究的方法,利用中国多省市心血管病危险因素队列研究30 378人的资料,通过对基线血清TG不同水平人群12年间(1992-2004年)急性冠心病事件、缺血性脑卒中事件和出血性脑卒中事件发病风险进行比较,研究TG对各类心血管病发病风险的影响.结果 (1)TG与急性冠心病事件的发病危险有明确的关系.急性冠心病事件的人年发病率在TG水平较低时(TG≥1.15mmol/L)开始增加,TG水平上四分之一分位组(TG≥1.60 retool/L)人群的急性冠心病事件人年发病率是TG水平下四分之一分位组(TG＜0.81 retool/L)的2.7倍(168.4/10万,62.6/10万).(2)应用COX回归分析调整了多种其他危险因素后,TG水平对12年间急性冠心病的发病风险有独立的预测作用.分析未发现TG与缺血性脑卒中和出血性脑卒中的发病危险存在关联.结论 在35～64岁中国人群中,TG是急性冠心病事件发病的独立危险因素.急性冠心病事件的发病危险从TG≥1.15mmot/L即开始升高.     

近6年冠心病患者危险因素变化调查

目的评价近6年在浙江大学医学院附属第一医院住院的冠心病患者合并心血管病危险因素的变化情况。方法对2000年和2006年因冠心病住院的患者的住院资料进行分析比较。统计分析7个主要的危险因素。结果与2000年相比,2006年冠心病患者中(1)高血压患病率在男性和女性患者中分别升高了7.8%(P>0.05)和4.5%(P>0.05);男性患者入院时收缩压、舒张压水平分别下降4.3mmHg(P<0.05)和2.8mmHg(P<0.01)。(2)血脂异常在男女两组患者分别升高10.3%和7.1%(P<0.01);血清总TC水平分别下降了0.7mmol/L(P<0.01)和0.4mmol/L(P>0.05);血清TG水平分别上升了0.2mmol/L(P>0.05)和0.2mmol/L(P>0.05);血清HDL-C水平男性组下降了0.1mmol/L(P<0.05)。(3)糖尿病患病率男女分别上升10.3%(P<0.01)和17.7%(P<0.05);空腹血糖水平在男性患者中下降了0.2mmol/L(P>0.05)。(4)有心血管病家族史的比例分别上升11.5%(P<0.01)和12.7%(P<0.05)。结论与2000年相比,2006年冠心病患者合并心血管病危险因素明显增加。男性患者一些危险因素水平基本控制在正常范围,女性患者各个危险因素则未得到控制。     

Vascular function correlates with risk factors for cardiovascular disease in a healthy population of 35-year-old subjects

OBJECTIVE: To investigate whether, in a healthy, randomly selected population of 35-year-old men and women, there is a relation between vascular function and conventional risk factors for cardiovascular disease such as gender, smoking, elevated blood-lipids, high blood pressure and heredity for cardiovascular disease, and to blood glucose. DESIGN: Basal brachial artery diameter was measured. Endothelial function was measured as flow mediated dilation (FMD) in response to reactive hyperaemia. The nonendothelial dependent dilation was measured after sublingual nitro-glycerine (NTG). SETTING: A research centre of general medicine and a university hospital. SUBJECTS: One hundred men and 100 women all 35 years old, were invited by letter. Sixty-six of the 92 men (72%) living in the community and 74 of the 88 women (84%) participated. RESULTS: Gender had the largest influence on FMD and NTG induced arterial dilation, probably reflecting the larger vessel diameters in the men as FMD and NTG induced dilation is inversely related to basal vessel size (r = -0.55, P < 0.001 and r = -0.40, P < 0.001). In women basal vessel diameter was positively correlated to blood glucose (r = 0.35, P = 0.009) and BMI (r = 0.34, P = 0.012) and negatively correlated to HDL cholesterol (r = -0.43, P = 0.001). FMD and NTG induced arterial dilation correlated with a combined risk factor score (r = -0.32, P = 0.019 and r = -0.31, P = 0.024). The men with the highest risk factor scores had larger vessel size and higher blood flow at rest compared to men without risk factors (4.8 +/- 0.6 mm, 240 +/- 84 mL min-1 and 4.0 +/- 0.8 mm, 139 +/- 72 mL min-1, respectively, P = 0.014 and P = 0.016). FMD or NTG induced dilation did not correlate to any of the risk factors in men. CONCLUSIONS: There are correlations between vascular reactivity and risk factors for IHD in women and correlations between vessel diameter and risk factors for IHD in both men and women already in a healthy population 35-year-old subjects. Further studies are needed to determine if the vessel diameter in itself, in a healthy population, is a sign of attenuated endothelial function.     

EPIDEMIOLOGY OF COAGULATION FACTORS, INHIBITORS AND ACTIVATION MARKERS: THE THIRD GLASGOW MONICA SURVEY II. RELATIONSHIPS TO CARDIOVASCULAR RISK FACTORS AND PREVALENT CARDIOVASCULAR DISEASE

Coagulation factor activity (fibrinogen, VII, VIII and IX), coagulation inhibitor activity (antithrombin, protein C, protein S), and coagulation activation markers (prothrombin fragment F1, 2; thrombin–antithrombin complexes) were measured in 746 men and 816 women aged 25–74 years, randomly sampled from the north Glasgow population in the Third MONICA Survey. After age-adjustment, significant associations with cardiovascular risk factors were observed. Serum cholesterol and triglyceride were associated with increases in factors VII and IX, as well as antithrombin, protein C and protein S; and with increased fibrinogen and factor VIII in women. Apart from factor VIII (related to blood pressure in men, but not in women), similar associations were observed for blood pressure and body mass index. Smoking status and/or smoking markers were related to fibrinogen, factor IX, antithrombin and protein S. Alcohol intake was related to protein S, and inversely to fibrinogen and antithrombin in men. Low social class was associated with fibrinogen, factor VIII, factor IX, and with antithrombin, protein S, and low protein C in men. Serum vitamin C was associated inversely with coagulation factors and coagulation inhibitors. The only associations of activation markers were with low serum vitamin C, and with alcohol consumption and low social class in men. Prevalent cardiovascular disease was associated only with fibrinogen.
These associations of coagulation factors and inhibitors with cardiovascular risk factors are plausibly relevant to thrombotic risk in cardiovascular disease. In general, 'worse' values of risk factors are associated with increased plasma levels of both coagulation factors and inhibitors, without significant increase in coagulation activation markers. However, the association of lower serum vitamin C with increased coagulation activation markers is of potential therapeutic interest.     

Vascular compliance versus flow-mediated vasodilation: correlation with cardiovascular risk factors

Cardiovascular risk factors are associated with impaired endothelium dependent vasodilation and reduced vascular compliance. In this study, the correlation with cardiovascular risk factor score of two common techniques for assessing vascular function was compared. Risk factors and vascular function were evaluated in a study population of 122 people with peripheral arterial disease (PAD) or with risk factors for PAD (73 men and 49 women; mean age 69 years). A risk factor score was determined using Framingham criteria. Vascular compliance was assessed by pulse waveform analysis and simultaneous blood pressure measurement. Flow-mediated vasodilation of the brachial artery was measured using duplex ultrasonography. Participants with a high risk factor score had significantly reduced vascular compliance of large and small vessels. By contrast, the difference in flow-mediated vasodilation between those with a high or low risk factor score did not reach statistical significance. There was a significant negative correlation between vascular compliance and risk factor score. There was a similar trend between flow-mediated vasodilation and risk factor score, but this did not reach statistical significance. A measure of vascular compliance was more significantly correlated with cardiovascular risk factor score than was a measure of flow-mediated vasodilation in the study population. Neither technique provided values that were highly correlated with risk factor burden. Although flow-mediated vasodilation is a preferred research tool for assessing vascular function, technical limitations and biological variability may reduce its clinical application in assessing individual cardiovascular risk.     

Association of myeloperoxidase with cardiovascular disease risk factors in prediabetic subjects

IntroductionPrediabetes is a chronic low-grade inflammatory disease and considered as a risk factor for the development of diabetes mellitus and cardiovascular disease. Myeloperoxidase (MPO) is a leukocyte-derived enzyme, linked to both oxidative stress and inflammation and has been proposed as a possible mediator of atherosclerosis, the major cause of cardiovascular disease. The objective of the present study was to evaluate the level of MPO in prediabetic subjects and correlate it with other cardiovascular disease risk factors.Materials and methodsIn this cross-sectional study, a total of 400 subjects were recruited. Of them, 200 were prediabetic subjects and 200 were age and gender-matched controls. For each subject, blood pressure, weight, height, waist circumference, hip circumference and lipid parameters were measured. In addition, MPO was determined.ResultsMPO was significantly increased in prediabetic subjects as compared to controls. In correlation analysis, MPO was found to be significantly and positively correlated with all the cardiovascular disease risk factors i.e. age, body mass index (BMI), waist-to-hip ratio (WHR), blood pressure [both systolic blood pressure (SBP) and diastolic blood pressure (DBP)], lipid parameters except high density lipoprotein (HDL) to which it was negatively correlated.ConclusionIn conclusion, MPO is well correlated with cardiovascular disease risk factors in prediabetes. Hence, MPO could be used to detect cardiovascular risk among prediabetic subjects and also can be used as an early biomarker of oxidative stress and inflammation in prediabetes.     

上海心脏健康研究队列中40～70岁女性年龄、绝经年限与心血管病危险因素聚集关系探讨

目的:探讨女性年龄、绝经年限与血脂异常、高血压、糖尿病、肥胖等心血管病危险因素聚集之间的关系。方法:利用上海心脏健康研究队列2010年6月至7月所做的4 049名40～70周岁女性居民的心血管病危险因素横断面调查资料,将研究对象分成6个年龄组,分析年龄、绝经年限与危险因素之间的相关性。结果:年龄与心血管病危险因素聚集程度高度正相关(P<0.01),年龄越大,危险因素聚集程度越高;在控制年龄因素后,绝经年限与心血管病危险因素聚集程度高度正相关(P<0.01),绝经年限越长,危险因素聚集程度越高。结论:需加强绝经期前后女性心血管疾病的防控工作,同一年龄阶段妇女中尤其需针对早绝经者加强预防措施。     

我国中年人群QT间期与出生体重及心血管危险因素的相关性研究

目的:探讨中国中年人群QT间期与出生体重及心血管危险因素的关系。方法:对974例“宫内发育与成人疾病”队列人群进行流行病学调查、身体测量、血生化指标检测,记录标准12导联心电图,用Bazett公式计算校正的QT间期(QTc),设定QTc>0.41s为QT延长,采用Logisiti回归方法分析中年人群QT间期与出生体重及心血管危险因素的关系。结果:人群QT间期延长者262例(27.0%),男女QT间期延长检出率分别为21.6%,32.6%,心血管危险因素聚集的总检出率分别为64.85%,36.33%(均P<0.01),且男性随着出生体重的增加其检出率和患病危险度呈下降趋势。单项TG升高或心血管危险因素异常聚集与QT间期延长检出率有显著相关关系(均P<0.05)。结论:在中年期,男性心血管危险因素聚集检出率明显高于女性;心血管危险因素聚集与QT间期延长有明显相关性;中年女性的QT间期延长检出率明显高于男性,且可能与出生体重低有关。     

Short duration of reactive hyperemia in the forearm of subjects with multiple cardiovascular risk factors.

BACKGROUND: Peripheral vascular endothelial dysfunction is an independent predictor of cardiovascular events, and can be assessed noninvasively by measuring reactive hyperemia, either by vascular ultrasound measurement of flow-mediated vasodilatation or, less commonly, by measurement of blood flow using plethysmography. In the present study reactive hyperemia was measured using plethysmography in healthy subjects with multiple cardiovascular risk factors. METHODS AND RESULTS: Reactive hyperemia was measured following 5-min occlusion of the upper arm in 449 healthy subjects (302 men, 147 women, age range 20-70 years) with (n=352) and without (n=97) risk factors such as smoking, hypertension, diabetes mellitus, hypercholesterolemia, obesity, family history of cardiovascular disease, and menopause. Maximum blood flow and minimum vascular resistance in reactive hyperemia did not differ between subjects with and without risk factors regardless of gender. Duration of reactive hyperemia, however, was significantly shorter in subjects with risk factors. Age-adjusted mean value of duration of reactive hyperemia was significantly smaller in men with a smoking habit, diabetes mellitus, hypercholesterolemia or obesity, and in women with smoking habit, hypertension, diabetes mellitus or obesity. The number of risk factors significantly correlated with the duration of reactive hyperemia in both men (r=-0.56, p<0.001) and women (r=-0.62, p<0.001), suggesting that endothelial dysfunction increases with the number of risk conditions clustering in a single individual. CONCLUSIONS: Duration of reactive hyperemia reflects cardiovascular risk factors and decreases with the number of risk conditions. These findings suggest that the duration of reactive hyperemia measured with plethysmography is potentially useful for assessing endothelial dysfunction.     

Effect of relative handgrip strength on cardiovascular disease among Korean adults aged 45 years and older: Results from the Korean Longitudinal Study of Aging (2006–2016)

BackgroundAging causes both structural and functional changes in the skeletal muscle, and is associated with changes in body composition form, which results in an increased incidence of cardiovascular death. Handgrip strength (HGS) is a simple, fast, reliable, and cost-effective tool for measuring muscle strength.ObjectiveWe aimed to investigate which index was most suitable for predicting cardiovascular disease (CVD), and suggested the optimal cut-off points based on the handgrip strength index. In addition, we aimed to identify the effects of weak HGS, as determined by applying the optimal cut point on the occurrence of CVD.MethodA total of 8494 older men and women aged over 45 years from the Korean Longitudinal Study of Aging (KLoSA) were included in this study at baseline. We performed general estimating equations (GEE) with independent correlation structure to assess whether handgrip strength is longitudinally related to occurrence of CVDs such as heart disease or stroke reported from 1 st to 6th wave of KLoSA.ResultsThe relative HGS was strongly associated with CVD in both sexes, and the best fit model was in that in comparison to dominant HGS and absolute HGS. In addition, we calculated the optimal cut point for CVD based on the relative HGS in this study (men: 2.52 and women: 1.55, respectively), and demonstrated that low HGS, as determined by applying relative HGS cut points, was associated with a higher OR for CVD compared to normal HGS; the associations observed were consistent between the sexes.ConclusionsOur findings suggest that HGS has the potential to be a valuable screening tool for cardiovascular risk in clinical settings; this is advantageous in situations where blood sampling is not possible since HGS is easily measured and highly reproducible. It is necessary to pay attention to weak grip strength against body size in the elderly population.     

2型糖尿病患者代谢紊乱与血管并发症的关系

目的探讨2型糖尿病患者代谢紊乱与大血管并发症之间的关系.方法分析了641例2型糖尿病住院患者和59例健康体检者体质指数（BMI）、血压、血脂、血糖、外周白细胞计数（WBC）和尿蛋白排泄率（UAER）,采用稳态模式（HOMA）评价胰岛素抵抗.结果随着代谢紊乱数目增多,大血管病变的患病率明显上升.各种代谢紊乱成分之间呈正相关（P＜0.05）.Logistic回归分析显示,年龄、高密度脂蛋白-胆固醇（HDL-C）和收缩压（SBP）是影响2型糖尿病大血管病变主要的危险因素.结论2型糖尿病患者代谢紊乱成分相互影响,积极治疗任何一个危险因素,均有利于减少代谢紊乱簇集和心脑血管事件的发生.     

Lipoprotein(a) as a risk factor associated with ischemic heart disease: Ouro Preto Study

Evidences suggest that lipoprotein(a) [Lp(a)] is an important risk factor for cardiovascular disease. However, literature has been controversial in confirming its role as an independent risk factor for cardiovascular disease. The objective of the present study is to evaluate the association between serum levels of Lp(a) and ischemic heart disease as well as other cardiovascular risk factors in a population-based study conducted on a local cohort of the Brazilian population. Lp(a) serum levels were measured in 400 individuals selected from a larger sample of a populational survey carried out in Ouro Preto, a city in the southeast of Brazil. Lipid profile, fasting blood glucose, anthropometric and clinical parameters were analyzed. Lp(a) levels were significantly associated with the presence of ischemic heart disease. In relation to other cardiovascular risk factors, it was verified that Lp(a) levels were statistically associated with age, total cholesterol, LDL-cholesterol and percentage of body fat determined by bioelectric impedance. Lp(a) was also highly associated with the Framingham risk score (p=0.003). In a multivariate analysis two significant interactions were revealed; one involving ischemic heart disease, sex and age and other associating ischemic heart disease, age and total cholesterol. In summary, in the present analysis Lp(a) serum levels were correlated with the occurrence of ischemic heart disease and other cardiovascular risk factors.