血脂与冠心病关系的性别差异

The gender difference in the association of blood lipid with coronary heart disease

目的：评价血脂水平与冠心病（ＣＨＤ）关系的性别差异。方法：检测４０３例受检者的血脂质、载脂蛋白水平，其中ＣＨＤ组２３３例和正常对照组１７０例，并各以性别进一步划分亚组。结果：男性和女性ＣＨＤ组的ＴＣ、ＴＧ、ＬＤＬ－Ｃ、Ｌｐ（ａ）明显高于相应的正常对照组，ＬＤＬ－Ｃ明显为低。除男女性正常对照组间ＬＤＬ－Ｃ水平差异无显著性意义外，女性的ＴＣ、ＬＤＬ－Ｃ、ＨＤＬ－Ｃ均显著高于男性，因而ＴＣ／ＨＤＬ－Ｃ比值无性别差异。男性中ＬＤＬ－Ｃ、ＴＣ、高血压病、年龄和ａｐｏＢ以依次递减的强度对ＣＨＤ有独立作用，女性中仅以ＨＤＬ－Ｃ和高血压为ＣＨＤ的独立危险因素。结论：男女性别间血脂质水平的差异，使血脂指标对女性ＣＨＤ危险性的预测意义可能有所不同于男性。在评价女性ＣＨＤ危险性时，需重视ＨＤＬ－Ｃ水平对女性ＣＨＤ的独立作用。

Objective:The blood levels of lipid and apolipoprotein were determined in 403 subjects for the sake of evaluating the gender differene in the association of blood lipid with coronary heart disease.Methods:In the total subjects studied, there were 233 cases with coronary heart disease (CHD group) and 170 healthy individuals (control group). Gender subgroups were further divided in each group. Results:(1) Blood levels of TC, TG, LDLC and Lp(a)were significantly higher,and HDLC level was lower in both female and male CHD groups compared with the corresponding gender control group. (2) In comparison with males, the blood levels of TC,LDLC and HDLC were significantly higher in females in both CHD cases and healthy controls, but the difference in the ratio of TC to HDLC was not significant. (3)The indices such as HDLC,TC, hypertension, age and apoB were the independent predictors for the risk of CHD in males, while only HDLC and hypertension were the independent risk factors for CHD in females.Conclusion:The gender difference of blood lipids mades the association of lipied with CHD somewhat different in females from in males. In the evaluation of CHD risk in females, special attention should be paid to blood HDLC level, because it is usually higher than that in males.