中国汉族人群高密度脂蛋白胆固醇水平与冠心病的关系

目的 探讨中国汉族人群高密度脂蛋白胆固醇（HDL-C）与冠心病的关系。 方法 收集2008年8月~2009年8月入住西安交通大学医学院第一附属医院心内科冠心病患者375例，和健康对照者348例，清晨抽取空腹静脉血，检测总胆固醇（TC）、三酰甘油（TG）、HDL-C、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白（Apo）A-I和ApoB，并计算TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和ApoB/ApoA-I比值。通过logistic回归分析和ROC曲线分析各血脂指标与冠心病的关系和诊断价值。 结果 与对照组相比，冠心病组患者TG、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C、ApoB/ApoA-I水平显著增高，而HDL-C、ApoA-I较对照组显著降低。在校正年龄、性别、吸烟史、高血压病史和糖尿病史后，经多变量logistic回归分析，发现TG、HDL-C、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和ApoB/ApoA-I进入回归模型，回归系数分别为:0.222、-1.878、0.258、0.248、0.657和1.566，经ROC曲线分析发现，上述各指标的曲线下面积分别为0.612（P<0.01）、0.717（P<0.01）、0.680（P<0.01）、0.653（P<0.01）、0.661（P<0.01）、0.616（P<0.01），提示HDL-C水平降低对冠心病的诊断价值最大。 结论 HDL-C水平与中国汉族人群冠心病有相关性。

Relationship between high density lipoprotein-cholesterol level and coronary heart disease in Chinese Han population

AIM To investigate the correlation between high density lipoprotein-cholesterol (HDL-C) level and coronary heart disease (CHD) in Chinese Han population. METHODS In the study, 723 consecutive subjects, who were admitted into the Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University from August 2008 to August 2009, were recruited. Plasma total cholesterol, triglycerides (TG), HDL-C, LDL-C, apoA-I and apoB concentrations were measured enzymatically. The logistic model was used to evaluate the associations between CHD and lipid variables. Receiver operating characteristic (ROC) curve analysis was used to determine the area under the curve (AUC) for lipid parameters. RESULTS The CHD patients had higher levels of TG, TG/HDL-C, total cholesterol/HDL-C, LDL-C/HDL-C, and apoB/apoA-I, but lower levels of HDL-C and apoA-I compared with those in controls. The concentrations of total cholesterol, LDL-C and ApoB were similar between the two groups. With adjustment for age, gender, smoking history, hypertension history and diabetes history, it was found that TG, HDL-C, LDL-C, TG/HDL-C, total cholesterol/HDL-C, LDL-C/HDL-C and apoB/apoA-I entered the regression model with regression coefficients of 0.23, -1.91, 0.27, 0.27, 0.26, 0.67 and 1.60, respectively. The regression coefficient of HDL was -1.91 and was the most highly associated among the lipid parameters studied. The ROC method showed that the AUC of HDL-C was 0.717 (P<0.01), indicating that the AUC of low HDL-C was 0.717 (P<0.01), which was higher than the AUC values of other lipid parameters. CONCLUSION Low HDL-C is associated with the risk CHD in Chinese Han population.