低密度脂蛋白胆固醇与心血管病发病关系的前瞻性研究

目的研究我国人群低密度脂蛋白胆固醇(LDL-C)的分布特征及其与心血管病发病的关系.方法采用前瞻性队列研究方法,对11省市队列人群(35～64岁)共29564人于1992年进行基线调查.对1992～1999年共129350观察人年中发生的心血管病事件进行登记.分析人群基线调查的LDL-C分布特征及其与心血管病发病的关系.结果(1)男女两性LDL-C均值分别为2.65mmol/L和2.70mmol/L(P＜0.01).LDL-C随年龄的增加而升高,女性50～54岁组升高最多;(2)LDL-C超过中位数(2.60mmol/L)时男性缺血性心血管病发病率明显升高;(3)甘油三酯升高(男性≥1.24mmol/L;女性≥1.13mmol/L)合并LDL-C升高者,男女冠心病发病率分别是单纯LDL-C升高者的3倍和2倍;(4)C0x回归显示本研究人群LDL-C每升高1mmol/L可使男性冠心病增加36%,缺血性卒中增加31%.结论我国人群的LDL-C处于较低水平,但LDL-C仍是男性缺血性心血管病(冠心病、缺血性脑卒中)的"独立”危险因素.心血管病防治中不应"独立”地看待某一因素,更应注重多因素的协同作用.

Association of low density iipoprotein cholesterol with cardiovascular disease in a prospective study

Objective To study the distribution of low density lipoprotein cholesterol (LDL-C) in Chinese population and its association with cardiovascular disease (CVD). Methods In this prospective study, the baseline survey was carried out in 1992 in 29 564 subjects from 11 provinces, aged 35-64. All new CVD events and deaths occurring within 1992 to 1999 in 129 350 person years were registered. Results (1) The mean level of LDL-C in Chinese male and female were 2.65mmol/L and 2.70mmol/L, respectively. LDL-C level increased with age. In female aged 50-54, LDL-C level increased faster than in other age groups. (2) The incidence of CVD in men increased significantly when LDL-C level exceeded the median (2.60mmol/L). (3) Compared with those with elevated LDL-C level only, the incidence of coronary heart disease (CHD) in those who had elevated LDL-C combined with elevated triglyceride level (higher than 1.24mmol/L in male or 1.13mmol/L in female) were 3 times higher in male and 2 times higher in female. (4) In this cohort,1mmol/L increase in LDL-C would subsequently increase the incidence of CHD by 36%, and ischemic stroke by 31% in man. Conclusion LDL-C was still in a low level in Chinese population. LDL-C was the 'independent' risk factor for ischemic CVD (CHD and ischemic stroke) in man. However, any risk factor should not be treated "independently". More attention should be paid to the interaction of the risk factors in CVD prevention.