血清胆固醇和低胆固醇度的美洲原住民人口的死亡率:一个U形的关联
A Fagot-Campagna1, R L Hanson, K M Narayan
1National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Ariz 85014, USA. fax@cu.nih.gov
Circulation
|October 7, 1997
概括
低血清胆固醇可能不会直接导致死亡. 相反,疾病可能会降低胆固醇水平,导致观察到的与比马印第安人死亡率更高的相关性.
科学领域:
- 流行病学 流行病学
- 生物化学 生物化学
背景情况:
- 低血清胆固醇有争议地与癌症,创伤和感染的死亡率增加有关.
- 低胆固醇与死亡率之间的因果关系需要进一步研究.
研究的目的:
- 评估低血清胆固醇是否是所有原因或特定原因死亡的因果因素.
- 探索皮马印第安人群中胆固醇水平和死亡率之间的复杂关系.
主要方法:
- 对4553名皮马印第安人 (年龄>=20) 的纵向研究,随访时间中位数为12.8年.
- 每两年测量血清胆固醇;使用比例危险模型分析死亡率.
- 在统计分析中调整了潜在的混因素.
主要成果:
- 在血清胆固醇和全因死亡率之间观察到U形关系.
- 发现胆固醇和心血管疾病/糖尿病死亡率之间的积极关联.
- 胆固醇与癌症/与酒精有关的疾病死亡率之间发现了负面关联; 传染病的U形.
结论:
- 低胆固醇和高死亡率之间观察到的关联很可能是由于降低胆固醇的疾病,而不是低胆固醇导致疾病.
- 这表明反向因果关系,即疾病先发并影响胆固醇水平.
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