HDL和冠心病PPT课件.ppt

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1、HDLandCoronaryHeartDiseaseEpidemiologyofCHDHDL-CDistributioninUSAdultsRF=riskfactorsDatafromNHANESIII,1988–1994HDL-C(mg/dL)<3535–<4545–<6060CHD02468101214162RF,noCHDNo.ofUSadults(millions)CHDRiskAccordingtoHDL-CLevelsFraminghamStudy4.03.02.01.0254565HDL-

2、C(mg/dL)CHDriskratioKannelWB.AmJCardiol1983;52:9B–12B.Copyright©1983,withpermissionfromExcerptaMedicaInc.2.01.004.0CHDRiskAccordingtoTotal-C/HDL-CRatioFraminghamStudy(Men)KannelWB.AmJCardiol1987;59:80A–90A3.02.52.01.51.00.52.04.06.08.010.012.0Total-C/HDL-C

3、ratioCHDriskratio3.44.49.6CHDRiskAccordingtoHDL-CLevelsProspectiveCardiovascularMünsterStudy1103021020406080100120<3535–55>55Incidenceper1,000(in6years)HDL-C(mg/dL)AssmannG,ed.LipidMetabolismDisordersandCoronaryHeartDisease.Munich:MMVMedizinVerlag,1993186e

4、ventsin4,407men(aged40–65y)LowHDL-CLevelsIncreaseCHDRiskEvenWhenTotal-CIsNormal(Framingham)RiskofCHDbyHDL-CandTotal-Clevels;aged48–83yCastelliWPetal.JAMA1986;256:2835–283802468101214<4040–4950–5960<200230–259200–229260HDL-C(mg/dL)Total-C(mg/dL)14-yincide

5、ncerates(%)forCHD11.2411.9112.5011.916.564.679.055.534.854.153.772.782.063.8310.76.6HypertriglyceridemiaIncreasesCHDRiskinPatientswithLowHDL-CLevelsProspectiveCardiovascularMünsterStudy*Barrepresents5%ofsubjectsinwhich25%ofCHDeventsoccurred.AssmannG,Schul

6、teH.AmJCardiol1992;70:733–737.Copyright©1992,withpermissionfromExcerptaMedicaInc.24311162450501001502002505.0>5.0*LDL-C/HDL-CratioIncidenceper1,000(in6years)TG<200mg/dLTG200mg/dLFrequencyofLowHDL-CComparedWithOtherRiskFactorsinMenWithPrematureCHDCasesCo

7、ntrols(n=321)Riskfactor(n=601)NotadjustedAdjustedCigarettesmoking29%67%*—HDL-C35mg/dL19%63%*57%*Hypertension(BP150/90)21%41%*—LDL-C160mg/dL26%26%34%*Diabetesmellitus1%12%*—*Significantlydifferentfromcontrols(P<0.001)GenestJJetal.AmJCardiol1991;67:1185–1

8、189DistributionofHDL-CLevelsinMenWithCHDVA-HITStudyGroupHDL-ClevelWhitesBlacksAllsubjects(mg/dL)(n=2,891)(n=572)(n=8,578)<3542%20%38%35–4025%23%25%>4032%57%36%RubinsHBetal.AmJCardiol1995;75:1196–1201}63%CHDI