Serum Total and Non-High-Density Lipoprotein Cholesterol and the Risk Prediction of Cardiovascular Events - The JALS-ECC

被引：73

作者：

Tanabe, Naohito ^{[1
]}

Iso, Hiroyasu ^{[2
]}

Okada, Katsutoshi ^{[3
]}

Nakamura, Yasuyuki ^{[4
]}

Harada, Akiko ^{[5
]}

Ohashi, Yasuo ^{[6
]}

Ando, Takashi ^{[8
]}

Ueshima, Hirotsugu ^{[7
]}

机构：

[1] Niigata Univ, Grad Sch Med & Dent Sci, Div Hlth Promot, Chuo Ku, Niigata 9518510, Japan

[2] Osaka Univ, Grad Sch Med, Dept Social & Environm Med, Suita, Osaka, Japan

[3] Ehime Univ, Acad Gen Hlth Ctr, Matsuyama, Ehime, Japan

[4] Kyoto Womens Univ, Fac Home Econ, Kyoto, Japan

[5] Chiba Prefectural Inst Publ Hlth, Div Hlth Promot, Chiba, Japan

[6] Univ Tokyo, Sch Hlth Sci & Nursing, Dept Biostat Epidemiol & Prevent Hlth Sci, Tokyo, Japan

[7] Shiga Univ Med Sci, Lifestyle Related Dis Prevent Ctr, Otsu, Shiga 52021, Japan

[8] Lund Univ, Sch Econ & Management, Dept Econ Hist, Lund, Sweden

来源：

CIRCULATION JOURNAL | 2010年 / 74卷 / 07期

关键词：

Cholesterol; Cohort study; Myocardial infarction; Prediction; Stroke; CORONARY-HEART-DISEASE; ISCHEMIC-STROKE SUBTYPES; ACUTE MYOCARDIAL-INFARCTION; CEREBRAL INFARCTION; GENERAL-POPULATION; BLOOD-PRESSURE; JAPANESE; PREVENTION; MORTALITY; SURVIVAL;

D O I：

10.1253/circj.CJ-09-0861

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Few Japanese studies have compared serum non-high-density lipoprotein (non-HDL) cholesterol with serum total cholesterol as factors for predicting risk of cardiovascular events. Currently, few tools accurately estimate the probability of developing cardiovascular events for the Japanese general population. Methods and Results: A total of 22,430 Japanese men and women (aged 40-89 years) without a history of cardiovascular events from 10 community-based cohorts were followed. In an average 7.6-year follow up, 104 individuals experienced acute myocardial infarction (AMI) and 339 experienced stroke. Compared to serum total cholesterol, serum non-HDL cholesterol was more strongly associated with risk of AMI in a dose-response manner (multivariable adjusted incidence rate ratio per 1 SD increment [95% confidence interval]=1.49 [1.24-1.79] and 1.62 [1.35-1.95], respectively). Scoring systems were constructed based on multivariable Poisson regression models for predicting a 5-year probability of developing AMI; the non-HDL cholesterol model was found to have a better predictive ability (area under the receiver operating curve [AUC]=0.825) than the total cholesterol model (AUC=0.815). Neither total nor non-HDL serum cholesterol levels were associated with any stroke subtype. Conclusions: The risk of AMI can be more reliably predicted by serum non-HDL cholesterol than serum total cholesterol. The scoring systems are useful tools to predict risk of AMI. Neither total nor non-HDL serum cholesterol can predict stroke risk in the Japanese general population. (Circ J 2010; 74: 1346-1356)

引用

页码：1346 / 1356

页数：11