血リポプロテインの上昇 (a) 55歳以下男性における冠動脈疾患 展望的な研究である
A G Bostom1, L A Cupples, J L Jenner
1Framingham Study, Epidemiology and Biometry Program, Framingham, Mass., USA.
JAMA
|August 21, 1996
まとめ
増加したリポプロテイン (Lp) は,男性における早発性冠動脈疾患 (CHD) の重要な独立リスク因子です. この発見は,高コレステロールまたは低いHDLレベルと比較され,Lp (a) を重要な心血管リスク指標として強調しています.
科学分野:
- 心血管医学 心血管医学
- リピドロジーは,脂質学です.
- 予防性心臓病学 予防性心臓病学
背景:
- リポプロテイン (Lipoprotein) [Lp(a) ]は,心血管疾患のリスクと関連づけられているリポプロテイン粒子である.
- 以前の研究で,Lp (a) 濃度の上昇と冠動脈疾患 (CHD) の間の潜在的な関連が示唆されていた.
- Lp (a) によってもたらされる独立したリスクを理解することは,心血管リスク評価戦略の精錬に不可欠です.
研究 の 目的:
- 男性における早発性冠動脈疾患 (CHD) の独立した危険因子であるかどうかを判断する.
- 増加したLp (a) と関連したリスクを,他の確立されたCHDリスク因子と比較する.
主な方法:
- フレーミングハムの子どものコホートを使用して前向きな研究が行われました.
- 2191人の20~54歳の男性を追跡し,ベースライン (1971~1975) 時の心血管疾患のない男性を追跡した.
- インシデントCHDイベントは55歳まで追跡され,リスク推定には比例リスクモデルが使用されました.
主要な成果:
- 平均15.4年の追跡期間を経て,129件のCHDイベントが発生しました.
- 増加したLp (a) は,早発性CHDの相対リスク (RR) 1.9 (95%CI,1.2-2.9) を示した.
- 増加したLp (a) のRRは,高総コレステロール (RR 1.8) と低HDL (RR 1.8) と比較することができました.
結論:
- 血Lp (a) の上昇は,男性における早発性心血管疾患の独立した危険因子として確認されています.
- 増加したLp (a) から生じるリスクの大きさと頻度は,高総コレステロールまたは低HDLレベルと比較できます.
- Lp (a) は,早発性心血管疾患を発症する個人のリスクを評価する際に重要な要因とみなされるべきである.
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