The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Impact of Isolated Low HDL Cholesterolemia on the Risk of Coronary Artery Disease: A 4-Year Community-Based Prospective Study

저 HDL 콜레스테롤혈증이 관상동맥 질환에 미치는 영향: 4년의 전향적 지역 기반 코호트 연구

  • Koo, Bo Kyung (Department of Internal Medicine, Seoul National University College of Medicine, Department of Internal Medicine, Boramae Medical Center) ;
  • Moon, Min Kyong (Department of Internal Medicine, Seoul National University College of Medicine, Department of Internal Medicine, Boramae Medical Center)
  • 구보경 (서울대학교 의과대학 내과학교실, 서울특별시 보라매병원 내과) ;
  • 문민경 (서울대학교 의과대학 내과학교실, 서울특별시 보라매병원 내과)
  • Received : 2012.12.17
  • Accepted : 2013.01.03
  • Published : 2013.02.01
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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.

목적: 많은 역학 연구에서 낮은 HDL 콜레스테롤 농도가 관상동맥 질환의 위험을 높임이 보고되었으나, HDL 콜레스테롤이 직접적으로 관상동맥 질환 위험을 낮추는 역할을 하는지에 대해서는 아직 밝혀지지 않았다. 본 연구에서는 저 HDL 콜레스테롤혈증이 독립적으로 관상동맥 질환 발생을 높이는지를 전향적인 대규모 코호트에서 알아보고자 하였다. 방법: 안성, 안산 코호트는 한국인에서 만성 질환의 역학연구를 위해 수립된, 대규모의 지역기반 전향적 코호트로서, 2000-2001년에 기초조사를 시작하였고 2년마다 추적 조사를 시행하였다. 본 연구는 3기까지의 총 4년의 조사 결과를 대상으로 분석을 시행하였다. HDL 콜레스테롤의 역할에 대한 교란변수를 제거하기 위해 기초 조사 당시 당뇨병이 있거나, 이전 관상동맥 질환 병력이 있는 대상자는 연구에서 제외하였다. 결과: 총 8,438명의 연구 대상자의 0.8%에서 4년간의 추적관찰 기간 동안 관상동맥 질환이 발생하였다. 관상동맥 질환이 발생한 경우는 그렇지 않은 대상자에 비해 나이가 많고(p < 0.001), 체질량지수가 높았으며(p = 0.003) 고혈압(p = 0.005) 및 고중성지방혈증(p = 0.045) 유병률이 높았다. Cox 회귀분석 결과 고중성지방혈증은 유의하게 추적관찰 기간 동안의 관상동맥 질환 위험도를 높였다(hazard ratio, 1.822; 95% confidence interval, 1.029-3.225). 기저 HDL 콜레스테롤 농도는 기저 중성지방 혈중 농도와 유의한 상관관계에 있었으나(r = (남자) 0.404, (여자) 0.460; p < 0.001), 향후의 관상동맥 질환 위험도에 영향을 주지 못했다. 결론: 대규모 지역기반 코호트에서 저 HDL 콜레스테롤혈증은 독립적으로 4년 관상동맥 질환 위험을 높이지 않았다.

Keywords

References

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