低血清胆固醇和死亡率. 哪一个是原因,哪一个是后果?
C Iribarren1, D M Reed, R Chen
1Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA.
Circulation
|November 1, 1995
概括
总胆固醇 (TC) 的下降可能表明潜在的疾病,而不是直接的风险因素. 降低TC水平与日裔美国男性因某些癌症和非癌症原因的死亡率增加有关.
科学领域:
- 流行病学 流行病学
- 老年学是一门学科.
- 生物标志物 生物标志物
背景情况:
- 研究表明,低总胆固醇 (TC) 和非动脉样硬化疾病之间存在关联.
- 低TC与疾病之间的因果关系尚不清楚:这是一个风险因素还是结果?
研究的目的:
- 分析TC随时间变化和随后的死亡率之间的关系.
- 为了调查下降的TC是隐性疾病的标志物的假设.
主要方法:
- 在日本裔美国男性 (n=5941) 中,分析了6年时间内的TC变化.
- 使用生存分析检查了与16年死亡率相关的TC变化.
- 参与者在基线时年龄在45-68岁之间,没有主要疾病.
主要成果:
- 降低TC水平与特定癌症 (造血,食道,前列腺癌) 和非癌症原因 (肝病) 的死亡风险增加有关.
- 在从中低TC水平下降的男性中,全因死亡风险高出30%.
- 在稳定低TC水平的男性中没有观察到增加的死亡风险.
结论:
- 这些发现支持反向因果关系假设:催化剂疾病可能导致TC水平下降.
- 降低TC可能是潜在疾病的结果,而不是死亡的独立风险因素.
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