女性血脂水平与缺血性卒中风险

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女性血脂水平与缺血性卒中风险

Author：Kurth T;Everett BM;Buring JE;Kase CS;Ridker PM;Gaziano JM
Brigham and Women's Hospital, Division of Preventive Medicine, Harvard Medical School, Boston, MA 02215, USA. tkurth@rics.bwh.harvard.edu
美国波士顿哈佛医学院预防医学部布莱根妇女医院

Resource: Neurology. 2007 Feb 20;68:556-62.
来源：《神经病学》2007年2月20;68:556-62。

Abstract：OBJECTIVE: To evaluate the association between total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol to HDL-C ratio, and non-HDL-C with the risk of ischemic stroke in a large cohort of apparently healthy women.
摘要：目的：评价貌似健康的女性群体的总胆固醇、低密度脂蛋白、高密度脂蛋白、总胆固醇/高密度脂蛋白及非高密度脂蛋白水平与缺血性卒中风险的关系。

METHODS: Prospective cohort study among 27,937 US women aged > or =45 years participating in the Women's Health Study who provided baseline blood samples. Stroke occurrence was self-reported and confirmed by medical record review. We categorized plasma lipid measurements into quintiles. We used Cox proportional hazards models to evaluate the association between lipids and risk of ischemic stroke.
方法：对参与妇女健康研究并提供基础血样的27,937位年龄大于或等于45岁的美国妇女进行前瞻性队列研究。卒中发生由自我报告、医疗记录回顾确认。我们采用五分位法对血脂检测结果进行排序，并利用Cox比例危险率模型对血脂与缺血性卒中风险之间的关系进行评估。

RESULTS: During 11 years of follow-up, 282 ischemic strokes occurred. All lipid levels were strongly associated with increased risk of ischemic stroke in age-adjusted models. The association attenuated particularly for HDL-C after adjustment for potential confounders. For the comparison of the highest to the lowest quintile, the multivariable-adjusted hazard ratios (95% CI; p for trend across mean quintile values) of ischemic stroke were 2.27 (1.43, 3.60; p(trend) < 0.001) for total cholesterol; 1.74 (1.14, 2.66; p(trend) = 0.003) for LDL-C; 0.78 (0.52, 1.17; p(trend) = 0.27) for HDL-C; 1.65 (1.06, 2.58; p(trend) = 0.02) for the total cholesterol to HDL-C ratio; and 2.45 (1.54, 3.91; p(trend) < 0.001) for non-HDL-C.
结果：在为期11年的跟踪随访中共发生282例缺血性卒中。在进行过年龄校正的模型中，所有的血脂水平均与缺血性卒中发生风险增加呈高度相关。调整混杂因素之后，高密度脂蛋白的相关性显著降低。以五分位的最低组做参比，总胆固醇高的人患缺血性卒中的多变量校正风险率（95%可信区间；趋势检验的p值）为2.27 (95%可信区间为1.43～3.60; p < 0.001)，低密度脂蛋白为1.74 (95%可信区间为1.14～2.66; p值= 0.003);高密度脂蛋白为 0.78 (95%可信区间为0.52～1.17; p值= 0.27) ; 总胆固醇与高密度脂蛋白比值为1.65 (95%可信区间为1.06～2.58; p= 0.02); 非高密度脂蛋白为2.45 (95%可信区间为1.54～3.91; p < 0.001)。

CONCLUSIONS: In this large cohort of apparently healthy women, total cholesterol, low-density lipoprotein cholesterol, the total cholesterol to high-density lipoprotein cholesterol ratio, and non-high-density lipoprotein cholesterol were significantly associated with increased risk of ischemic stroke.
结论：在表面看似健康的妇女群体中，总胆固醇、LDL-C、TC/HDL-C、non-HDLC的水平均与缺血性卒中风险增加呈高度相关。