期刊
ATHEROSCLEROSIS
卷 246, 期 -, 页码 36-43出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2015.12.039
关键词
HDL; Cholesterol; Human migration; Mortality; Myocardial infarction; Stroke
资金
- Wellcome Trust Master Research Training Fellowship
- Wellcome Trust [GR074833MA]
- Universidad Peruana Cayetano Heredia (Fondo Concursable) [20205071009]
- United States National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services [HHSN268200900033C]
- MRC [MR/K007467/1, MR/M007405/1] Funding Source: UKRI
- Medical Research Council [MR/K007467/1, MR/M007405/1, MR/K006584/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0510-10090] Funding Source: researchfish
Introduction: Whilst the relationship between lipids and cardiovascular mortality has been well studied and appears to be controversial, very little has been explored in the context of rural-to-urban migration in low-resource settings. Objective: Determine the profile and related factors for HDL-c patterns (isolated and non-isolated low HDL-c) in three population-based groups according to their migration status, and determine the effect of HDL-c patterns on the rates of cardiovascular outcomes (i.e. non-fatal stroke and non-fatal myocardial infarction) and mortality. Methods: Cross-sectional and 5-year longitudinal data from the PERU MIGRANT study, designed to assess the effect of migration on cardiovascular risk profiles and mortality in Peru. Two different analyses were performed: first, we estimated prevalence and associated factors with isolated and non-isolated low HDL-c at baseline. Second, using longitudinal information, relative risk ratios (RRR) of composite outcomes of mortality, non-fatal stroke and non-fatal myocardial infarction were calculated according to HDL-c levels at baseline. Results: Data from 988 participants, rural (n = 201), rural-to-urban migrants (n = 589), and urban (n = 199) groups, was analysed. Low HDL-c was present in 56.5% (95% CI: 53.4% - 59.6%) without differences by study groups. Isolated low HDL-c was found in 36.5% (95% CI: 33.5-39.5%), with differences between study groups. In multivariable analysis, urban group (vs. rural), female gender, overweight and obesity were independently associated with isolated low HDL-c. Only female gender, overweight and obesity were associated with non-isolated low HDL-c. Longitudinal analyses showed that non-isolated low HDL-c increased the risk of negative cardiovascular outcomes (RRR = 3.46; 95% CI: 1.23-9.74). Conclusions: Isolated low HDL-c was the most common dyslipidaemia in the study population and was more frequent in rural subjects. Non-isolated low HDL-c increased three-to fourfold the 5-year risk of cardiovascular outcomes. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.
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