文化程度与血压水平的关系:中国心血管病流行病学多中心协作研究

目的研究不同类型中国人群文化程度与血压水平的关系.方法分析数据来自1998年对15组中年人群(35～59岁)进行的抽样调查,包括城市居民、工人、农民和渔民.调查项目均采用国际标准化方法,由合作中心进行统一培训、考核和质量控制.资料完整可供分析者共计15570人.结果 (1)文化程度构成存在显著的年龄差异、性别差异和地区差异.各人群文化程度与SBP、DBP水平的关联方向及强度也各不相同.(2)根据文化程度构成将人群分成Ⅰ、Ⅱ两类,大专以上学历在人群中所占的比例分别为男性25.8%(95%CI 24.2%～27.4%)、2.0%(95%CI 1.6%～2.6%),女性11.7%(95%CI 10.5%～12.9%)、0.3%(95%CI 0.28%～0.32%).Ⅰ类人群SBP均值及女性DBP均值随文化程度增加而明显降低,Ⅱ类人群男性DBP则随之上升.(3)分析BMI、体力活动强度、业余不活动时间、新鲜水果摄入量、过量饮酒等因素在两类人群中随文化程度变化的趋势,发现Ⅰ类人群出现血压保护因素水平上升而有害因素水平下降的趋势,Ⅱ类人群则出现相反趋势.结论中国人群的个体文化程度与血压水平有关,其关联方向受人群总体文化程度高低的显著影响.生活方式、膳食模式可能是导致该关联产生的部分中介因素.     

文化程度与血压水平的关系:中国心血管病流行病学多中心协作研究

目的　研究不同类型中国人群文化程度与血压水平的关系。方法　分析数据来自 1998年对 15组中年人群 (35～ 5 9岁 )进行的抽样调查 ,包括城市居民、工人、农民和渔民。调查项目均采用国际标准化方法 ,由合作中心进行统一培训、考核和质量控制。资料完整可供分析者共计 15 5 70人。结果　 (1)文化程度构成存在显著的年龄差异、性别差异和地区差异。各人群文化程度与SBP、DBP水平的关联方向及强度也各不相同。 (2 )根据文化程度构成将人群分成Ⅰ、Ⅱ两类 ,大专以上学历在人群中所占的比例分别为男性 2 5 .8% (95 %CI:2 4 .2 %～ 2 7.4 % )、2 0 % (95 %CI:1.6 %～ 2 .6 % ) ,女性 11.7% (95 %CI:10 5 %～ 12 .9% )、0 3%(95 %CI:0 2 8%～ 0 32 % )。Ⅰ类人群SBP均值及女性DBP均值随文化程度增加而明显降低 ,Ⅱ类人群男性DBP则随之上升。(3)分析BMI、体力活动强度、业余不活动时间、新鲜水果摄入量、过量饮酒等因素在两类人群中随文化程度变化的趋势 ,发现Ⅰ类人群出现血压保护因素水平上升而有害因素水平下降的趋势 ,Ⅱ类人群则出现相反趋势。结论　中国人群的个体文化程度与血压水平有关 ,其关联方向受人群总体文化程度高低的显著影响。生活方式、膳食模式可能是导致该关联产生的部分中介因素。     

冠心病患者年龄与血脂异常的关系

目的:探讨不同年龄冠心病病人血脂水平的差异,为临床更合理地调脂治疗提供依据。方法:采用回顾性方法对120例70～86岁(A组)和 162例 35～60岁(B组)的冠心病病人的血脂水平进行对比分析。结果:老年冠心病病人的血清总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平略高于中年组,但无统计学意义;高密度脂蛋白胆固醇(HDL-C)老年组高于中年组(P<0.05);而血清甘油三酯(TG)水平则中年组非常显著高于老年组(P<0.01)。结论:在各年龄组都要严格控制TC和LDL-C水平以预防冠心病,对于中年人群还需注意降低过高的TG水平,提高HDL-C水平。     

老年人血脂水平的季节性变化研究

为探讨普通老年人群血脂季节性变化的规律,兹对２００例老年人血脂水平进行了为期１年的定期测定分析。对象与方法：基本按照居住顺序,随机抽取山东文登地区城乡居民男、女各１００例,年龄６０～７４岁。人员构成主要为军地离退休干部、工人、农民和渔民。每个受试者分...     

通辽地区1996—2007年梅毒流行特征

目的了解通辽地区梅毒在不同人群中的分布特征和流行趋势，找出防治工作中的薄弱环节，为制定有效的防治对策提供依据。方法分析1996—2007年梅毒的疫情分布情况。结果自1996年开始梅毒在通辽地区的发病率呈逐年上升的趋势，1999年达到4．85／10万，较1996年的0．14／10万上升了34．6倍；2000年开始梅毒的发病率呈逐年下降的趋势，2005年降至0．17／10万；2006年起又有上升的趋势。1996—2001年，男性的发病率高于女性，2002年后为女性发病率高于男性（除2005年外）。1996—2005年，梅毒病例以I期和Ⅱ期为主，I期梅毒发病构成大于Ⅱ期；2006—2007年以隐性梅毒为主。I期和Ⅱ期在30岁～组最高，分别为43．18％和41．55％，20岁～组次之，分别为33．15％和34．10％；隐性梅毒以30岁～组最高（35．48％），40岁～组次之（29．03％）。胎传梅毒均在10岁以下。职业居前三位的：Ⅰ期和Ⅱ期梅毒分别为个体、无业、工人，隐性梅毒为无业、农民、个体，在学生中存在隐性梅毒。结论加强人群的健康教育和性病防治知识宣教，加强重点人群监测及规范诊治综合措施，开展对重点人群的检测，做到早期诊断、早期治疗，对控制梅毒的传播、降低发病有重要意义。     

凉山彝族血脂状况及其载脂蛋白AI基因启动子嘌呤置换突变限制？…

目的 为探讨凉山彝族农民血脂水平与心血管病发生率低的原因，通过流行病学调查采集６９１份（人）血样，确定彝族农民，彝族移民，当地城市汉族居民三组人群的各项血脂水平，并探讨载脂蛋白基因多态性人群血脂水平变异中的作用，方法 血脂测定，从凝血块中分离ＤＮＡ，ＤＮＡ聚合酶链反应－限制片段长度多态性分析。结果 （１）彝族农民各基血脂（ＴＣ，ＴＧ，ＨＤＬ－Ｃ，ａｐｏ，ＡＩａｐｏＢ）水平显著低于彝族移民和汉族居工     

106260例广州体检人群空腹血糖受损和糖尿病患病率变化趋势

目的通过对2002—2005年广州地区体检人群的FPG数据回顾分析，探讨空腹血糖受损（IFG）和糖尿病（DM）变化趋势。方法106260例体检人群按体检年度分组，按年龄分层，分别统计各组IFG和DM人数。结果男女IFG和DM检出率均呈显著增高趋势（P〈0.05），各年度男性IFG和DM患病率均明显高于女性。男性大多数年龄组及女性45岁～至65岁～年龄组的IFG都有10％以上的绝对增幅。结论广州地区体检人群中IFG和DM检出率呈显著增高趋势，尤其男性人群的增幅更为显著。广州地区DM的一级预防重点应放在IFG人群。     

1981～2001年北京市职业人群血清总胆固醇水平的变动

分析1981年至2001年20年间北京市部分职业人群血清总胆固醇水平的变化。在力求做到血脂测定标准化的基础上，回顾性分析20年来北京市部分机关和企事业单位工作人员47434人次总胆固醇水平的变化，按年度、性别、年龄分组统计，结果发现，总胆固醇水平从1981年至1988年间上升幅度较大，年龄调整均值男性上升0．73mmol／L(28m/dL)，女性上升0．62mmol／L(24mg/dL)。至1990年已达最高值，2001年低于1991年，男、女年龄调整均值分别回落0．21mmol/L(8mg/dL)及0．23mmol/L(9mg/dL)。男女总胆固醇水平随年龄上升，从青年至老年，男性上升约20％，而女性升高达35％，上升趋势基本一致。不同年龄组间上升幅度有明显的男女差异，青年期男性大于女性，中年以后女性上升幅度增大，从40～49岁至50～59岁组男性平均上升3％．而女性上升达14％．60岁以后上升很少。所以总胆固醇水平在50岁以前男性高于女性，50岁以后女性高于男性。以1985年、1991年和2001年为例，无论男女，年龄标化的高胆固醇检出率[总胆固醇≥5．17mmol／L(200mg/dL)、≥5．69mmol/L(220mg/dL)及≥6．02mmol／L(240mg/dL)]1991年比1985年明显增高，而2001年与1991年相差不多且有所回落。目前北京市职业人群的总胆固醇年龄调整均值男性4．86mmol/L(188mg/dL)，女性4．78mmol/L(185mg/dL)，年龄标化高胆固醇检出率≥5．7mmol／L者约20％，≥6．2mmol/L者约10％。结果提示，北京市职业人群血清总胆固醇水平及年龄标化的高胆固醇检出率在80年代升幅较大．90年代不再升高且有所回落。     

文化程度与血压水平关系：中国心血管病流行病学多中心协作研究

目的 研究不同类型中国人群文化程度与血压水平的关系。方法 分析数据来自1998年对15组中年人群（35－59岁）进行的抽样调查，包括城市居民，工人，农民和渔民。调查项目均采用国际标准化方法，由合作中心进行统一培训，考核和质量控制。资料完整可供分析者共计15570人。结果 （1）文化程序构成存在显著的年龄差异，性别差异和地区差异。各人群文化程度与SBP，DBP水平的关联方向及强度也各不相同。（2）根据文化程度构成将人群分为Ⅰ，Ⅱ两类，大专以上学历在人群中所占的比例分别为男性25．8％（95％CI：24．2％－27．4％），2．0％（95％CI：1．6％－2．6％）,女性11．7％（95％CI：10．5％－12．9％），0．3％（95％CI：0．28％－0．32％）。I类人群SBP均值及女性DBP均值随文化程度增加而明显降低，Ⅱ类人群男性DBP则随之上升。（3）分析BMI，体力活动强度，业余不活动时间，新鲜水果摄入量，过量饮酒等因素在两类人群中随文化程度变化的趋势，发现I类人群出现血压保护水平上升而有害因素水平下降的趋势，Ⅱ类人群则出现相反趋势。结论 中国人群的个体文化程度与血压水平有关，其关联方向受人群总体文化程度高低的显著影响。生活方式，膳食模式可能是导致该关联产生的部分中介因素。     

北京和广州工农人群中营养因素与血脂水平的关系

本文应用中美心血管病流行病学合作研究在北京和广州35～54岁工人农民中进行心血管病基线调查时的膳食调查813例资料,对比分析北京和广州工农男女共八个组的营养素摄入量和血脂水平,并在北京和广州两大组人群内分析有关营养因素和血脂的关系。结果表明,在控制年龄、性别、工农、体重指数及饮酒量等混杂变量的条件下,“膳食脂质分值”与血清总胆固醇及高密度脂蛋白胆固醇均呈显著正关联,饱和脂肪酸在北京人群内、膳食胆固醇在广州人群内与血清总胆固醇呈显著正关联。饱和及单不饱和脂肪酸与高密度脂蛋白胆固醇呈正关联,而碳水化合物则呈负关联。未见上述各营养素与血清甘油三酯有显著关联。     

Serum lipid comparison in patients treated by statins or fibrates: existence of bad HDL-C responders to statins

INTRODUCTION: Major cardiac events are strongly associated with high levels of low-density lipoprotein cholesterol (LDL-C) and low levels of high-density lipoprotein cholesterol (HDL-C). The HDL-C target level (40 mg/dl) is often not achieved with statins. The aim of this study was to compare the proportions of patients achieving the HDL-C target levels after one year of treatment with statins or fibrates. Furthermore, a subgroup with low HDL-C levels during statin treatment was investigated and suggestions are made for a better management of these patients. METHODS: A survey of lipid levels, cardiovascular disease and risk factors in 120 outpatients treated with a statin or a fibrate for hyperlipidaemia (total cholesterol (TC) > 250 mg/dl or triglycerides (TG) > 200 mg/dl after diet). After one year of treatment the proportions of patients achieving the target levels for TC, LDL-C, HDL-C,TG,TC/HDL-C and LDL-C/HDL-C are compared for statins and fibrates. RESULTS: The proportions of patients achieving the target lipid levels with statins or fibrates are comparable except for HDL-C. Compared to the baseline, the proportion of patients achieving the HDL-C target level of 40 mg/dl increases only by 8.3% for statins and by 42.9% for fibrates. In total, 38.5% of the statin group had low HDL-C-levels after one year of treatment. Among these patients, eight were treated with a fibrate before the statin and six were treated with a fibrate afterwards. In those 14 patients, mean HDL-C increased during fibrate treatment by 48.5% and TC/HDL-C and LDL-C/HDL-C decreased by 25.7 and 26.5%, respectively as compared with statins. CONCLUSIONS: Patients with low levels of HDL-C during statin treatment had far better levels of HDL-C, TC/HDL-C and LDL-C/HDL-C with fibrates. A randomised double-blind crossover trial with simvastatin and fenofibrate has been initiated to corroborate these findings.     

Lipid profile of women qualifying for hypolipidaemic treatment

OBJECTIVE: Death rates from coronary heart disease continue to rise in women despite a marked decrease in men for the past two decades. Our study aimed to evaluate essential risk factors in high-risk adult women. METHODS: Lipid profiles of 547 dyslipidaemic adult women aged 57.5 +/- 10.6 years (mean +/- standard deviation) were evaluated and stratified according to fasting plasma lipid levels. Classification of the cohort was performed based on triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) levels and correlations between TG and HDL-C were estimated. RESULTS: Patients with TG > or =150 mg/dl had lower HDL-C levels compared to those with TG <150 mg/dl (p < 0.001). Patients with HDL-C <40 mg/dl had lower TC levels and higher TG levels compared to those with HDL-C > or =40 mg/dl (p = 0.012 and p < 0.001, respectively). In the cohort and the subgroups an inverse correlation between TG and HDL-C was observed (r = -0.428, slope = -0.048, p < 0.001). CONCLUSIONS: The expected inverse correlation between fasting high TG and low HDL levels was confirmed.The novelty of the study is that this correlation persists even in the case of low fasting TG levels.     

Lipoprotein lipids in older people. Results from the Cardiovascular Health Study. The CHS Collaborative Research Group.

BACKGROUND. Cardiovascular disease is the leading cause of death and disability in older people. There is little information about the distributions of risk factors in older populations. This article describes the distribution and correlates of lipoprotein lipids in people greater than or equal to 65 years old. METHODS AND RESULTS. Lipoprotein lipid concentrations were measured in 2,106 men (M) and 2,732 women (F) who were participants in the Cardiovascular Health Study, a population-based epidemiological study. Distributions of lipids by age and sex and bivariate and multivariate relations among lipids and other variables were determined in cross-sectional analyses. Mean concentrations of lipids were cholesterol: M, 5.20 +/- 0.93 mmol/l (201 +/- 36 mg/dl) and F, 5.81 +/- 0.98 mmol/l (225 +/- 38 mg/dl); triglyceride (TG): M, 1.58 +/- 0.85 mmol/l (140 +/- 75 mg/dl) and F, 1.57 +/- 0.78 mmol/l (139 +/- 69 mg/dl); high density lipoprotein cholesterol (HDL-C): M, 1.23 +/- 0.33 mmol/l (48 +/- 16 mg/dl), and F, 1.53 +/- 0.41 mmol/l (59 +/- 16 mg/dl); low density lipoprotein cholesterol (LDL-C): M, 3.27 +/- 0.85 mmol/l (127 +/- 33 mg/dl) and F, 3.57 +/- 0.93 mmol/l (138 +/- 36 mg/dl). The total cholesterol to HDL-C ratios were M, 4.49 +/- 1.29 and F, 4.05 +/- 1.22. TG, total cholesterol, and LDL-C concentrations were lower with increasing age, the last more evident in men than in women. TG concentration was positively associated with obesity (in women), central fat patterning, glucose intolerance, use of beta-blockers (in men), and use of estrogens (in women) and negatively associated with age, renal function, alcohol use, and socioeconomic status. In general, HDL-C had opposite relations with these variables, except that estrogen use was associated with higher HDL-C concentrations. LDL-C concentration was associated with far fewer variables than the other lipids but was negatively associated with age in men and women and positively correlated with obesity and central fat patterning and negatively correlated with renal function and estrogen use in women. There were no differences in total cholesterol and LDL-C concentrations among participants with and without prevalent coronary heart disease and stroke, but TG concentration was higher and HDL-C lower in men with both coronary heart disease and stroke and in women with coronary heart disease. CONCLUSIONS. Cholesterol and cholesterol/HDL-C ratio were lower and HDL-C higher than previously reported values in older people, suggesting that lipid risk profiles may be improving in older Americans. TG and HDL-C concentrations, and to a lesser extent LDL-C, were associated with potentially important modifiable factors such as obesity, glucose intolerance, renal function, and medication use.     

Wives of patients with acute myocardial infarction are at an increased risk of developing coronary artery disease

BACKGROUND: The present study was carried out to investigate risk factors for developing coronary artery disease in wives of patients with acute myocardial infarction. SUBJECTS AND METHODS: Risk factors for developing coronary artery disease were investigated in 50 wives of patients who developed an acute myocardial infarction (group A) and were compared with those of 50 wives of normal healthy men (group B). The average age was 50.20 +/- 1.56 years (mean +/- SD) and 50.20 +/- 1.53 years for group A and group B respectively. The parameters assessed were: plasma cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure, smoking habits and body mass index (BMI). RESULTS: The levels of LDL-C in the wives of patients with myocardial infarction were higher than those of the wives of normal healthy men (167.8 +/- 5.84 mg/dl and 148.4 +/- 4.85 mg/dl, respectively, P < 0.01). Moreover, HDL-C concentrations were lower in the wives of the patients (51.34 +/- 0.92 mg/dl) than in the wives of the healthy men (58.14 +/- 1.39 mg/dl), (P < 0.001). Finally, TG levels were higher in the wives of the patients (132.2 +/- 7.9 mg/dl) than in the wives of the normal healthy men (96.9 +/- 5.94 mg/dl) (P < 0.01). CONCLUSIONS: Although plasma lipid levels themselves were not excessively high, the wives of patients with an acute myocardial infarction are at a higher risk of developing coronary artery disease than the wives of normal healthy men, in the long term, due to higher levels of LDL-C and TG as well as lower levels of HDL-C.     

Variable effects of weight loss on serum lipids and lipoproteins in obese patients

After a 500 calorie diet and 6 months of low fat, maintenance diet, weight, serum lipid, and lipoprotein levels were compared to baseline in 46 obese patients. Mean weight decreased by 25.9 percent (29.2 kg). Mean total (TC) and low density lipoprotein cholesterol (LDL-C), and triglycerides (TG) decreased by 5.5 percent (12.1 mg/dl), 11 percent (15.5 mg/dl) and 23.6 percent (34.5 mg/dl); mean high density lipoprotein cholesterol (HDL-C) increased by 20.6 percent (10.3 mg/dl) and TC/HDL-C decreased by 25 percent (1.2), P less than 0.01. Females and males had equal increases in HDL-C. The decrease in TG and TC in patients who continued to lose 4.2 kg during the 6 month maintenance period was significantly greater than in those who regained 7.8 kg (P less than 0.015). Greater changes in HDL-C and TC/HDL-C occurred in younger individuals (r = -0.35 and r = -0.37); in those with more abnormal initial values (r = -0.60, r = 0.64); and for HDL-C, a larger increase occurred in those with greater weight loss (r = 0.32; P less than 0.04).     

The Fuenlabrada study: lipids and lipoproteins in children and adolescents

Lipids and lipoproteins were studied in 2,153 healthy children, of both sexes, aged 0 to 18 years old, of Fuenlabrada, Madrid, population. We determined: Total Cholesterol (TC) and Triglycerides (TG) by automatized enzymatic techniques. C-HDL by precipitation method. C-LDL and C-VLDL were calculated by Friedewald-Fredrickson equation. Our laboratory have previously standardized the techniques of obtention of TC, TG and C-HDL using serums of reference. Mean values were: TC = 166 +/- 36 mg/dl, TG = 63 +/- 39 mg/dl, C-HDL = 53 +/- 13 mg/dl, C-LDL = 102 +/- 34 mg/dl, C-VLDL = 13 +/- 6 mg/dl. In our population 14% had TC greater than or equal to 200 mg/dl, 2.6% TG greater than or equal to 140 mg/dl and 15% C-HDL less than or equal to 40 mg/dl. During adolescence a significant change in the lipid and lipoprotein pattern in both sexes was observed. At the end of the adolescence, males had C-HDL lower and TG, C-LDL and C-VLDL higher than females. Correlations and associations of lipids and lipoproteins were similar in our population than in adult population. The mean finding of this study is the actual high level of TC in our children population.     

Diagnosis of families with familial hypercholesterolaemia and/or Apo B-100 defect by means of DNA analysis of LDL-receptor gene mutations

BACKGROUND: One major problem of using hypercholesterolaemia alone as a primary criterion for diagnosing familial hypercholesterolaemia (FH) is that 15-40% of relatives may be misdiagnosed because plasma lipid levels in FH heterozygotes overlap with those in the general population. SETTING: General Hospital/University of Vienna, Department of Pediatrics, Outpatient lipid clinic. METHODS: As a part of the MED-PED (make early diagnosis-prevent early death) project we are currently investigating children, adolescents and their relatives who are suspected to be affected with FH in our out-patient clinic for metabolic diseases using MED-PED inclusion criteria and confirming the diagnosis by means of DNA analysis. PATIENTS: 263 patients with premature atherosclerosis and/or hypercholesterolaemia: 116 children (mean age 11.6 +/- 4.1 years; 57 girls and 59 boys) and 147 adults (64 women, mean age 41.5 +/- 13.7 years; 83 men, mean age 42.8 +/- 10.8 years). RESULTS: 119 patients with mutations have been detected; 56 children with either low density lipoprotein receptor (LDLR) and/or ApoB mutations (27 girls and 29 boys; mean total cholesterol (TC) 275 +/- 71 mg/dl, triglycerides (TG) 101 +/- 57 mg/dl, high-density lipoprotein cholesterol (HDL-C) 49 +/- 12 mg/dl, low-density lipoprotein cholesterol (LDL-C) 198 +/- 67 mg/dl) and one boy with a homozygous. LDLR mutation. A further 62 adults with LDLR and/or ApoB mutations were documented; 33 women (mean age 36.9 +/- 11.1 years; mean TC 283 +/- 76 mg/dl, TG 137 +/- 78 mg/dl, HDL-C 55 +/- 17 mg/dl, LDL-C 210 +/- 67 mg/dl) and 29 men (mean age 45.0 +/- 10.6 years; mean TC 301 +/- 87 mg/dl, TG 163 +/- 112 mg/dl, HDL-C 42 +/- 12 mg/dl, LDL-C 233 +/- 83 mg/dl). In 32 of these subjects (11 children (21%), 21 adults (42%)), serum lipid levels were lower than the diagnostic MED-PED limits adopted, so that they might have been misclassified without an additional DNA analysis. CONCLUSION: In our study, diagnosis of FH and related disorders (ApoB-100 defect) by means of conventional laboratory methods missed at least 21% in children and 42% in adults affected with LDLR and/or ApoB gene mutations. Genetic FH diagnosis provides a tool for specific diagnosis of mutation carrier status.     

Ethnicity may be a reason for lipid changes and high Lp(a) levels in rheumatoid arthritis

There are so many studies that suggest the changes in lipid profiles and lipoprotein (a) [Lp(a)] are associated with early atherosclerosis in rheumatoid arthritis (RA). But there are some opposite studies also. Because of marked ethnicity differences in the distribution of Lp(a), we aimed to investigate the associations of Lp(a) levels and lipid changes in Turkish RA patients. There were 30 women and 20 men, a total of 50 patients with RA (mean age 47.6±13.2 years), included and 21 healthy women and 14 healthy men (mean age 45.7±14.5 years) were recruited as a control (C) group. Serum Lp(a), total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) levels were analysed for each group. Analysis of six different studies was performed. In the RA and C groups, mean serum Lp(a) levels were 39.7±64.4 and 10.5±13.4 mg/dl, respectively (P=0.001). Mean TC levels were 189.2±142.5 and 174.0±29.3 mg/dl (P=0.294), mean TG levels were 121.4±65.4 and 106.5±80.0 mg/dl (P=0.030), mean HDL-C levels were 44.5±10.0 and 47.7±4.8 mg/dl (P=0.014) and mean LDL-C levels were 94.3±35.3 and 102.0±24.6 mg/dl (P=0.98), respectively. Analysis of the six studies showed Lp(a) level was higher and HDL level was lower in RA patients than in healthy controls. Patients with RA may have altered lipid profiles from one country to another one. Especially in Turkey, higher serum Lp(a), lower HDL-C and higher TG levels may be found in RA patients instead of some findings of other countries showing different results. Ethnicity may be a reason for these findings.     

Association between plasma lipids, and apolipoproteins and coronary artery disease: a cross-sectional study in a low-risk Korean population

BACKGROUND: Due to the lower level of the traditional lipid profiles in Koreans than in the series of patients from the western countries, the need to investigate other lipid parameters to help identify the individuals at high risk of CAD has been emphasized. AIM AND METHODS: To investigate whether apolipoprotein B (apo B), apolipoprotein A-I (apo A-I) and their ratio give additional information to the traditional lipid risk factors for discriminating the individuals at high-risk for coronary artery disease (CAD), 544 subjects, who met the lipid criteria of total cholesterol (TC) <230 mg/dl, low-density lipoprotein cholesterol (LDL-C) <120 mg/dl and high-density lipoprotein cholesterol (HDL-C) >40 mg/dl were recruited. Patients were considered to be CAD(+) if they had > or =50% stenosis in at least one coronary artery. RESULTS: In men, TC and apo B/apo A-I ratio were significantly different between groups with and without CAD after adjusting for age and diabetes (P = 0.037 and 0.035), and in women, triglyceride (TG), HDL-C and apo B/apo A-I ratio were significantly different after adjusting for age, diabetes and smoking status (P = 0.006, 0.007 and 0.030, respectively). In the lowest quartile of TC, TG and LDL-C, and the highest quartile of HDL-C, only apo B/apo A-I ratio was associated with CAD in both men and women. The only variable showing a significant difference between patients with and without CAD was apo B/apo A-I ratio. In models assessing whether apolipoproteins give additional information to traditional lipid risk factors, HDL-C, LDL-C, apo B/apo A-I ratio and in women but not in men, TG and apo B were all independent markers for the presence of CAD. Among the nontraditional lipid factors, only apo B/apo A-I ratio showed its additional value for identifying the presence of CAD. CONCLUSION: Apo B/apo A-I ratio is the only variable that differentiates the patients with CAD from those without and, furthermore, gives additional information to that supplied by traditional lipid risk factors in a low-risk Korean population.     

Relation of coronary artery calcium identified by electron beam tomography to serum lipoprotein levels and implications for treatment

This study was designed to determine whether the National Cholesterol Education Program (NCEP) lipid guidelines accurately identify subclinical atherosclerosis and whether low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels are related to the extent and prematurity of coronary artery disease (CAD) as determined by electron beam tomography (EBT). Out of personal concern for CAD risk, 930 consecutive asymptomatic subjects, without clinical CAD and on no lipid-lowering agents, underwent EBT. Calcium score and percentile were correlated with total cholesterol (TC), LDL-C, HDL-C, triglycerides, and demographic parameters. A calcium score of > 0 (EBT+) was found in 55% of patients; 45% of patients had a 0 score (EBT-). Mean age (58.0 +/- 10.5 vs 49.3 +/- 9.7 years, p = 0.0001), TC (218 +/- 39 vs 211 +/- 41 mg/dl, p = 0.006), LDL-C (136 +/- 36 vs 127 +/- 27 mg/dl, p = 0.005), and TC/HDL-C (4.6 +/- 1.4 vs 4.2 +/- 1.5, p = 0.0001) were significantly higher and HDL-C (52.2 +/- 17.6 vs 55.4 +/- 19.3 mg/dl, p = 0.008) lower in the EBT+ compared with EBT- group. In the EBT+ group, 75.1% of subjects had LDL-C < 160 mg/dl and would not be advised to use lipid-lowering medications according to NCEP guidelines. In subjects with LDL-C < 160 mg/dl, 51.8% of subjects were EBT+, as were 46.1% of those with LDL-C < 100 mg/dl. There were no significant differences in the calcium scores throughout the entire range of all lipid parameters; calcium percentiles were virtually identical within lipid value subgroups. We conclude that asymptomatic patients with EBT-defined subclinical atherosclerosis are not reliably identified by NCEP guidelines, and TC, LDL-C, HDL-C, TC/HDL-C, and triglyceride levels do not correlate with either the extent or prematurity of calcified plaque burden.