禁食と非禁食の脂質とアポリポタンパク質を比較して,インシデント心血管イベントを予測するための禁食と非禁食の脂質とアポリポタンパク質の比較
Samia Mora1, Nader Rifai, Julie E Buring
1Donald W. Reynolds Center for Cardiovascular Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. smora@partners.org
Circulation
|August 20, 2008
まとめ
トリグリセリドを除く非断食の脂質レベルは,断食のレベルよりも弱い心血管疾患 (CVD) リスク予測を提供します. ガイドラインは,総コレステロール,LDL,その他の主要な脂質に関するこれらの発見を反映するために,改訂する必要があるかもしれません.
科学分野:
- 心血管医学は,心臓血管医学である.
- 臨床化学 臨床化学について
- エピデミオロジー エピデミオロジー
背景:
- 現在のガイドラインでは,心臓血管疾患 (CVD) のスクリーニングのために断食中の脂質プロフィールを推奨しています.
- 新興の証拠は,CVDリスク評価において,禁食中のトリグリセリドが,禁食中のトリグリセリドよりも効果的かもしれないことを示唆している.
- CVDとの非トリグリセリド脂質関連性に対する断食状態の影響は不明である.
研究 の 目的:
- 断食状態が,様々な脂質パラメータとインシデントCVDの間の関連性に影響するかどうかを調査する.
- CVDリスクに対する断食対非断食の脂質測定の予測力を比較するために.
主な方法:
- 11年間の追跡期間で26,330人の健康な女性を対象とした前向きな研究.
- ベースラインの脂質プロファイル (断食と断食なし) とCVDイベントの分析.
- 飢餓状態を変数として考慮して,危険比率を使用して,脂質レベルとCVDリスクの間の関連性の検討.
主要な成果:
- トリグリセリドを除く脂質濃度は,断食状態と非断食状態の間の微小な違い (<5%) を示した.
- 断食時の測定では,総コレステロール,LDLコレステロール,アポリポプロテインB-100,非HDLコレステロール,およびアポリポプロテインB-100/A-1比率がCVDとより強い関連性を示した.
- 禁食中のHDLコレステロール,アポリポプロテインA-1,総コレステロールとHDLコレステロールの比率は,CVDとの関連性が類似しており,禁食中のトリグリセリドは,禁食中のレベルと比較してより強い関連性を示しています.
結論:
- HDLコレステロール,トリグリセリド,総コレステロール/HDLコレステロール比,アポリポプロテインA-1は,非断食で測定すると,CVDを効果的に予測します.
- 総コレステロール,LDLコレステロール,HDLコレステロール以外のコレステロール,アポリポプロテインB-100とA-1との比率は,非断食状態でのCVDリスク情報はより堅くありません.
- 現在の脂質スクリーニングガイドラインは,断食と非断食の測定の異なる予測値を考慮するために更新する必要があるかもしれません.
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