禁食与非禁食脂质和阿波利波蛋白相比,用于预测发生的心血管事件
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
概括
除了甘油三脂之外,非禁食的脂质水平提供了比禁食水平更弱的心血管疾病 (CVD) 风险预测. 准则可能需要修订,以反映总胆固醇,LDL和其他关键脂质的这些发现.
科学领域:
- 心血管医学 心血管医学
- 临床化学 临床化学
- 流行病学 流行病学
背景情况:
- 目前的指导方针建议禁食脂质资料用于心血管疾病 (CVD) 查.
- 新出现的证据表明,非禁食的甘油三可能比禁食水平更有效地评估心脏病风险.
- 禁食状态对非三糖脂与心血管疾病相关性的影响尚不清楚.
研究的目的:
- 调查禁食状态是否影响各种脂质参数与发生心血管疾病之间的关联.
- 为了比较禁食与非禁食脂质测量对心血管疾病风险的预测能力.
主要方法:
- 对26330名健康妇女进行了前性研究,随访时间为11年.
- 基线脂质特征 (禁食和非禁食) 和心血管疾病事件的分析.
- 检查脂质水平与心血管疾病风险之间的关联,使用危险比率,将禁食状态视为变量.
主要成果:
- 脂质度,不包括甘油三,在禁食和非禁食状态之间显示微小 (<5%) 的差异.
- 禁食测量显示,总胆固醇,LDL胆固醇,非脂蛋白B-100和非脂蛋白B-100/A-1比率与心血管疾病的相关性更强.
- 不禁食的高密度胆固醇,阿波利波蛋白A-1和总胆固醇/高密度胆固醇比率显示了类似的心血管疾病关联,而非禁食的甘油三与禁食水平相比,关联性更强.
结论:
- 高密度胆固醇,甘油三,总胆固醇/高密度胆固醇比率和阿波利波蛋白A-1在测量非禁食时有效预测心血管疾病.
- 总,LDL和非HDL胆固醇,以及阿波利波蛋白B-100及其与A-1的比率,在非禁食状态下提供不太强大的心血管疾病风险信息.
- 当前的脂质查指南可能需要更新,以考虑到禁食测量与非禁食测量的不同预测值.
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