Determinants of HDL-cholesterol and its prediction of coronary disease among Turks Türk toplumunda koroner risk faktörü olarak HDL-kolesterol: Öngördürücülüǧü, belirleyicileri ve i̇lişkileri


Onat A., Hergeņ G., Uzunlar B., Ceyhan K., Uyarel H., Yazici M., ...Daha Fazla

Turk Kardiyoloji Dernegi Arsivi, cilt.31, sa.1, ss.9, 2003 (SCI Expanded İndekslerine Giren Dergi) identifier

  • Cilt numarası: 31 Konu: 1
  • Basım Tarihi: 2003
  • Dergi Adı: Turk Kardiyoloji Dernegi Arsivi
  • Sayfa Sayıları: ss.9

Özet

The distribution of serum concentrations of HDL-cholesterol (HDL-C), its correlation with other risk factors, its determinants and its association with coronary heart disease (CHD) likelihood was studied cross-sectionally in 2350 persons constituting the 2001/02 cohort of the Turkish Adult Risk Factor Study. Moreover, the prediction of future fatal and nonfatal CHD was investigated in the 1997/98 cohort comprising 2362 men and women free of CHD. HDL-C was generally measured with dry chemistry method using a Reflotron apparatus, but utilizing the direct method without precipitation in year 2001 and was validated in over 6% of the cohort in a reference laboratory. Mean HDL-C was 38.0±10.0 and 45.3±11.3 mg/dl in men and women, respectively, whose mean age was 52±12 years in the cross-sectional analysis. HDL-C levels were under 40 mg/dl in 64% of men and in 35.5 of women. The inverse relationship between HDL-C and triglyceride concentrations was demonstrated in increasing deciles. In linear regression models comprising 11 variables, smoking habit, waist circumference and physical inactivity suppressed HDL-C, whereas alcohol use was associated with elevation of this level. The slope of the linear regression allowed following estimated independent changes (p<0.01) in HDL-C corresponding to an increment of 1 standard deviation: 80 mg/dl triglycerides 1.6 mg/dl decline in HDL-C, 12 cm waist circumference 1.33 mg/dl decline in HDL-C, smoking more than 10 cigarettes daily 3.16 mg/dl decline in HDL-C, apo B 40 mg/dl 2.76 mg/dl decline in HDL-C, 40 mg/dl total cholesterol 3.3 mg/dl rise in HDL-C. Alcohol use once a week or more frequently was associated with a rise of 3.5 mg/dl of HDL-C (p=0.064). Over a 4-year prospective study, logistic regression analysis comprising 10 variables including systolic blood pressure, smoking habit, total cholesterol and diabetes, revealed HDL-C to be an independent predictor of CHD with a relative risk of 0.971 in men (p<0.02) and of 0.980 in women (p=0.08). Among men and women combined, RR was 0.975 (p<0.002), which implied that a reduction of HDL-C by 12 mg/dl (=1 hazard ratio), would be associated with 36% increase of fatal and nonfatal events. The relative roles of main biochemical and lifestyle determinants of HDL-C levels in Turkish adults were thus established. The major dimensions of effects of obesity with associated hypertriglyceridemia, excessive smoking and abstinence of alcohol on HDL-C levels are apparent. HDL-C concentrations represent a significant independent predictor of future coronary events; however, its magnitude does not appear to be very strong.