저 HDL 콜레스테롤혈증이 관상동맥 질환에 미치는 영향: 4년의 전향적 지역 기반 코호트 연구 = Impact of Isolated Low HDL Cholesterolemia on the Risk of Coronary Artery Disease: A 4-Year Community-Based Prospective Study

다국어 초록 (Multilingual Abstract)

Background/Aims: We investigated the effect of an isolated low high-density lipoprotein (HDL) cholesterol level on the risk of coronary artery disease (CAD) in a prospective cohort. Methods: The Ansung-Ansan cohort was established for inclusion in a prospective, large-scale, community-based epidemiologic study to investigate chronic diseases in Korea. The data from a baseline survey performed from 2000 to 2001 and two subsequent prospective biennial surveys were analyzed. We included subjects without diabetes mellitus or a history of CAD at the baseline. Results: Among 8,438 total subjects, 0.8% reported newly developed CAD events during 4 years of follow-up. The subjects who experienced CAD events were significantly older (p<0.001), had a higher body mass index (p=0.003), and had a higher prevalence of hypertension (p=0.005) and hypertriglyceridemia (p=0.045) at the baseline. However, there was no significant difference in the baseline HDL cholesterol level between subjects with or without CAD events. Furthermore, although the baseline triglyceride level was significantly correlated with the baseline HDL cholesterol level (r=-0.404 in men and -0.460 in women; p<0.001 in both), and Cox regression analysis showed that hypertriglyceridemia at the baseline was significantly associated with an increased hazard ratio for CAD events (hazard ratio, 1.822; 95% confidence interval, 1.029-3.225), low HDL cholesterolemia was not associated with a risk of CAD events. Conclusions: Low HDL cholesterolemia did not independently increase the subsequent 4 years` risk of CAD events in this community-based Korean cohort. (Korean J Med 2013;84:229-237)

참고문헌 (Reference)

1 D'Agostino RB Sr, "Validation of the Framingham coronary heart disease prediction scores : results of a multiple ethnic groups investigation" 286 : 180-187, 2001

2 Wild S, "Time to rethink high-density lipoprotein?" 94 : 692-694, 2008

3 Vergeer M, "The HDL hypothesis: does high-density lipoprotein protect from atherosclerosis?" 51 : 2058-2073, 2010

4 Brown BG, "Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease" 345 : 1583-1592, 2001

5 Kauma H, "Sex difference in the regulation of plasma high density lipoprotein cholesterol by genetic and environmental factors" 97 : 156-162, 1996

6 Moriarity JT, "Serum uric acid and risk of coronary heart disease : Atherosclerosis Risk in Communities(ARIC)Study" 10 : 136-143, 2000

7 Lamarche B, "Prevalence of dyslipidemic phenotypes in ischemic heart disease(prospective results from the Québec Cardiovascular Study)" 75 : 1189-1195, 1995

8 Hansel B, "One third of the variability in HDL-cholesterol level in a large dyslipidaemic population is predicted by age, sex and triglyceridaemia: the Paris La Pitié Study" 22 : 1149-1160, 2006

9 Boden WE, "Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy" 365 : 2255-2267, 2011

10 Di Angelantonio E, "Major lipids, apolipoproteins, and risk of vascular disease" 302 : 1993-2000, 2009

11 Tai ES, "Isolated low HDL cholesterol : an insulin-resistant state only in the presence of fasting hypertriglyceridemia" 48 : 1088-1092, 1999

12 Lim S, "Increasing prevalence of metabolic syndrome in Korea : the Korean National Health and Nutrition Examination Survey for 1998-2007" 34 : 1323-1328, 2011

13 Hayek T, "Hypertriglyceridemia and cholesteryl ester transfer protein interact to dramatically alter high density lipoprotein levels, particle sizes, and metabolism: studies in transgenic mice" 92 : 1143-1152, 1993

14 Gordon DJ, "High-density lipoprotein cholesterol and cardiovascular disease : four prospective American studies" 79 : 8-15, 1989

15 Gordon T, "High density lipoprotein as a protective factor against coronary heart disease : the Framingham Study" 62 : 707-714, 1977

16 Choi SH, "Hemoglobin A1c as a diagnostic tool for diabetes screening and new-onset diabetes prediction : a 6-year communitybased prospective study" 34 : 944-949, 2011

17 Castelli WP, "HDL cholesterol and other lipids in coronary heart disease : the cooperative lipoprotein phenotyping study" 55 : 767-772, 1977

18 Kontush A, "Functionally defective highdensity lipoprotein: a new therapeutic target at the crossroads of dyslipidemia, inflammation, and atherosclerosis" 58 : 342-374, 2006

19 Tunstall-Pedoe H, "Estimation of contribution of changes in coronary care to improving survival, event rates, and coronary heart disease mortality across the WHO MONICA Project populations" 355 : 688-700, 2000

20 Rashid S, "Effect of obesity on high-density lipoprotein metabolism" 15 : 2875-2888, 2007

21 Grundy SM, "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement" 112 : 2735-2752, 2005

22 Chahil TJ, "Diabetic dyslipidemia" 35 : 491-510, 2006

23 Criqui MH, "Cigarette smoking and plasma high-density lipoprotein cholesterol: the Lipid Research Clinics Program Prevalence Study" 62 (62): 70-76, 1980

24 Cho NH, "Abnormal liver function test predicts type 2 diabetes : a community-based prospective study" 30 : 2566-2568, 2007