Hierarchical modelling of blood lipids’ profile and 10-year (2002–2012) all cause mortality and incidence of cardiovascular disease: the ATTICA study

Lipids in Health and Disease

Christos Pitsavos³  Christodoulos Stefanadis³  Dimitrios Tousoulis³  Smaragdi Antonopoulou¹  Ioannis Skoumas³  Christina Chrysohoou³  Vassiliki Metaxa³  Ekavi Georgousopoulou¹  Demosthenes Panagiotakos²  Tzortzis Nomikos¹ 

[1] Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece;46 Paleon Polemiston St., Glyfada 166 74, Attica, Greece;First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

关键词: Epidemiology;    Apolipoproteins;    Lipoproteins;    Lipids;    All cause mortality;    Cardiovascular disease;   

Others  :  1234431
DOI  :  10.1186/s12944-015-0101-7

 received in 2015-08-07, accepted in 2015-08-20,  发布年份 2015

【 摘 要 】

Background

The traditional view on the relationship between lipid biomarkers and CVD risk has changed during the last decade. However, it is not clear whether novel lipid biomarkers are able to confer a better predictability of CVD risk, compared to traditional ones.Under this perspective, the aim of the present work was to evaluate the predictive ability of blood lipids’ profile on all cause mortality as well as 10-year incidence of CVD, in a sample of apparently healthy adults of the ATTICA epidemiological study. 

Methods

From May 2001 to December 2002, 1514 men and 1528 women (>18 y) without any clinical evidence of any other chronic disease, at baseline, were enrolled. In 2011–12, the 10-year follow-up was performed in 2583 participants (85 % follow-up participation rate). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. Baseline serum blood lipids’ profile (Total-C, HDL-, non HDL-, LDL-cholesterol, triglycerides (TG), apolipoprotein (Apo)A1 and B, and lipoprotein–(a) levels were also measured.

Results

The 10-year all-cause mortality rate was 5.7 % for men and 2.0 % for women (p = 0.55). The, 10-year CVD incidence was 19.7 % in men and 11.7 % in women (p < 0.001). Multi-adjusted analysis revealed that TC, non-HDL-C, TG and TG/HDL-C ratio, were independent predictors of all cause mortality (RR per 1 mg/dL or unit (95 % CI): 1.006 (1.000–1.013), 1.006 (1.000–1.013), 1.002 (1.000–1.004), 1.038 (1.001–1.077), respectively). Moreover, TC, HDL-, LDL-, non-HDL-cholesterol, TG, apoA1, TC/HDL-C and TG/HDL-C were independently associated with CVD risk. Among all lipid indices the ratio of apoB/apoA1 demonstrated the best correct reclassification ability, followed by non-HDL-C and TC/HDL-C ratio (continuous Net Reclassification Index 26.1 and 21.2 %, respectively).

Conclusion

Elevated levels of lipid biomarkers are independently associated with all-cause mortality, as well as CVD risk. The ratio of apoB/apoA1, followed by non-HDL-C, demonstrated the best correct classification ability of the developed CVD risk models.

【 授权许可】

   
2015 Nomikos et al.

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