血清高密度脂蛋白胆固醇水平与心脑血管疾病死亡的相关性

Association of high-density lipoprotein cholesterol with risk of cardiovascular disease mortality

目的分析血清高密度脂蛋白胆固醇(HDL-C)水平与心脑血管疾病死亡的相关性。方法选取2009—2014年在浙江省宁波市鄞州区卫生信息大数据平台建档的18岁以上且有完整基线资料的71618名居民作为研究对象。根据血清HDL-C水平将研究对象分组:低水平组(HDL-C<1.0 mmol/L);中水平组(1.0 mmol/L≤HDL-C<1.5 mmol/L);中高水平组(1.5 mmol/L≤HDL-C<2.0 mmol/L);高水平组(HDL-C≥2.0 mmol/L),利用Cox比例风险模型分析HDL-C不同水平组人群心脑血管疾病死亡的风险比。结果研究对象累计随访427989.4人年,随访时间(5.98±1.04)年,随访期间共有799例患者死于心脑血管疾病。调整混杂因素后,以HDL-C中高水平组为参照,低水平组患者心脑血管疾病死亡的HR(95%CI)为1.43(1.13~1.82),中水平组患者心脑血管疾病死亡的HR(95%CI)为1.22(1.02~1.46)。结论HDL-C<1.5 mmol/L会增加人群心脑血管疾病死亡的风险,HDL-C水平可作为监测心脑血管病情发展以及指导治疗的生物学指标。

Objective To analyze the association between high density lipoprotein cholesterol(HDL-C)and the risk of cardiovascular disease mortality.Methods A total of 71618 residents aged over 18 years with complete baseline data,who were filed on the health information big data platform of Yinzhou district,Ningbo city,Zhejiang Province from 2009 to 2014,were selected as the research population.The research population were divided into four groups according to the level of HDL-C:low-level group(HDL-C<1.0 mmol/L),intermediate-level group(1.0 mmol/L≤HDL-C<1.5 mmol/L),medium-high-level group(1.5 mmol/L≤HDL-C<2.0 mmol/L)and high-level group(HDL-C≥2.0 mmol/L).Cox proportional hazard model was used to calculate the risk ratio of cardiovascular diseases mortality in different groups.Results The study population was followed up for a total of 427989.4 person-years,follow-up time of(5.98±1.04)years.During the follow-up period,there were 799 deaths due to cardiovascular diseases.After adjusting for confounding factors,compared with the medium-high-level group as the reference group,the HR(95%CI)for cardiovascular diseases mortality was 1.43(1.13-1.82)in the low-level group and 1.22(1.02-1.46)in the high-level group.Conclusion The low level of HDL-C(<1.5 mmol/L)is associated with a higher risk of cardiovascular disease deaths.The level of HDL-C can be used as a biological indicator to monitor the development of cardiovascular diseases and guide treatment.