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目的探讨中国汉族人群高密度脂蛋白胆固醇(HDL-C)与冠心病的关系。方法收集2008年8月~2009年8月入住西安交通大学医学院第一附属医院心内科冠心病患者375例,和健康对照者348例,清晨抽取空腹静脉血,检测总胆固醇(TC)、三酰甘油(TG)、HDL-C、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白(Apo)A-I和Apo B,并计算TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和Apo B/Apo A-I比值。通过logistic回归分析和ROC曲线分析各血脂指标与冠心病的关系和诊断价值。结果与对照组相比,冠心病组患者TG、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C、Apo B/Apo A-I水平显著增高,而HDL-C、Apo A-I较对照组显著降低。在校正年龄、性别、吸烟史、高血压病史和糖尿病史后,经多变量logistic回归分析,发现TG、HDL-C、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和Apo B/Apo A-I进入回归模型,回归系数分别为:0.222、-1.878、0.258、0.248、0.657和1.566,经ROC曲线分析发现,上述各指标的曲线下面积分别为0.612(P<0.01)、0.717(P<0.01)、0.680(P<0.01)、0.653(P<0.01)、0.661(P<0.01)、0.616(P<0.01),提示HDL-C水平降低对冠心病的诊断价值最大。结论 HDL-C水平与中国汉族人群冠心病有相关性。
Objective To investigate the relationship between high-density lipoprotein cholesterol (HDL-C) and coronary heart disease in Chinese Han population. Methods A total of 375 coronary heart disease patients admitted to the First Affiliated Hospital of Xi’an Jiaotong University School of Medicine between August 2008 and August 2009 were enrolled in the study. 348 healthy subjects were enrolled in the study. Fasting venous blood samples were taken for determination of total cholesterol (TC) TG, HDL-C, LDL-C, Apo AI and Apo B were calculated and the levels of TG / HDL-C, TC / HDL- HDL-C and Apo B / Apo AI ratios. Logistic regression analysis and ROC curve were used to analyze the relationship between serum lipids and coronary heart disease and their diagnostic value. Results Compared with the control group, the levels of TG, TG / HDL-C, TC / HDL-C, LDL-C / HDL-C and Apo B / Apo AI were significantly increased in patients with coronary heart disease Control group decreased significantly. After multivariate logistic regression analysis, TG, HDL-C, TG / HDL-C, TC / HDL-C, LDL-C / HDL-C were found after adjusting for age, sex, smoking history, history of hypertension and history of diabetes And Apo B / Apo AI entered the regression model with the regression coefficients of 0.222, -1.878, 0.258, 0.248, 0.657 and 1.566, respectively. The ROC curves showed that the area under the curve of each index was 0.612 (P <0.01) 0.717 (P <0.01), 0.680 (P <0.01), 0.653 (P <0.01), 0.661 (P <0.01), 0.616 (P <0.01), suggesting that the decrease of HDL-C level has the highest diagnostic value for coronary heart disease. Conclusion The level of HDL-C is associated with coronary heart disease in Chinese Han population.