| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Pre-cholesterol precursors in gametogenesis Rozman, D., M. Seliskar, et al. (2005), Mol Cell Endocrinol 234(1-2): 47-56. Abstract: Meiosis activating sterols (MAS) are biologically active post-lanosterol intermediates of cholesterol biosynthesis that are synthetized primarily in the gonads, including the sperm. MAS reinitiate the meiosis of oocytes in vitro while in vivo they seem to contribute to the oocyte quality and the progression of meiosis. The mRNAs for the MAS-producing enzyme lanosterol 14alpha-demethylase (CYP51) arise by alternative poly (A) signal selection. Only signals with low cleavage activity are used in the testis. Translation of mammalian CYP51s starts at one of the tandem in-frame ATGs. CYP51 protein of the bull is shorter compared to the human due to the usage of a more downstream translation start site. CYP51 proteins are post-translationally modified by glycosylations in the Golgi and on acrosomal membranes of the sperm. Green fluorescence protein-based ex vivo system has been developed to aid studying the intracellular transport of the MAS-producing CYP51. The influence of the post-translational modifications on MAS-synthesizing capacity is under investigation. |
| Precipitation methods for high-density lipoprotein cholesterol measurement compared, and final evaluation under routine operating conditions of a method with a low sample-to-reagent ratio Demacker, P. N., M. Hessels, et al. (1997), Clin Chem 43(4): 663-8. Abstract: We evaluated six precipitation methods for high-density lipoprotein cholesterol (HDL-chol) determination: the heparin/Mn2+ precipitation reagent method (Hep), two variants of the phosphotungstic acid/Mg2+ method (Tung-L and Tung-B), the dextran sulfate 50,000/Mg2+ method (Dex), the PEG 6000 method (PEG), and the PEG 6000/dextran sulfate 15,000 (PEG/Dex) method. The Tung-B and PEG/Dex precipitation methods have a low sample/precipitation reagent volume ratio (< 0.4). The Tung-B, Dex, PEG, and PEG/Dex methods gave similar values, averaging within 0.1 mmol/L of each other, showing that the precipitation selectivity of these methods is comparable. The precipitation efficiency of Tung-B and Peg/Dex, however, was superior. Ultrafiltration of the supernatants was needed only at triglyceride concentrations > 16.4 mmol/L (undiluted sample) or > 28.0 mmol/L (sample diluted twofold); however, ultrafiltration without dilution was the most accurate method. Results of Tung-B under routine conditions (33 technicians) agreed well with those of the PEG method for 406 normo- and hyperlipidemic plasma samples. By comparison with the HDL-chol method from the Centers for Disease Control and Prevention, the Tung-B method showed a total error of 10.6% which fulfills the criteria of the National Cholesterol Education Program for HDL-chol analysis. In conclusion, with motivated personnel, Tung-B is a reliable, cost-effective method for routine HDL-chol analysis. |
| Precise quantitative determination of phytosterols, stanols, and cholesterol metabolites in human serum by capillary gas-liquid chromatography Phillips, K. M., D. M. Ruggio, et al. (1999), J Chromatogr B Biomed Sci Appl 732(1): 17-29. Abstract: Total lipid extraction, solid-phase extraction, saponification, derivatization to trimethylsilyl ether derivatives, then capillary gas-liquid chromatography were used for quantitative analysis of sitosterol, campesterol, stigmasterol, sitostanol, campestanol, lathosterol, desmosterol, and lanosterol in human serum. Details of quality control integral to the accuracy and precision of analyses are included. The method limits of detection and quantitation, respectively, ranged from 0.05 microg/ml and 0.2 microg/ml for sitostanol to 0.4 microg/ml and 1.2 microg/ml for campesterol and campestanol. Analytes were measured at concentrations of 120 ng/ml to 6 microg/ml with standard deviations of 0.02 to 0.12 microg/ml for 55 analyses of a control serum sample conducted over a 2-month period. |
| Precision and accuracy of a portable blood analyzer system during cholesterol screening Greenland, P., N. L. Bowley, et al. (1990), Am J Public Health 80(2): 181-4. Abstract: The precision and accuracy of two Kodak Ektachem DT-60 portable blood analyzers were assessed in a model (research) cholesterol screening program in Rochester, New York. Between June and October 1987, a total of 8,573 people underwent a cholesterol screening held in a movable trailer. A wide variety of temperature, humidity, and other potentially adverse conditions were encountered during the screening period. Between-run coefficients of variation ranged from 1.9 percent to 4.8 percent per month; average bias compared to a Reference Laboratory method ranged between +0.2 percent and +2.0 percent. Both precision and accuracy met currently recommended standards for cholesterol testing in the United States. |
| Precision and accuracy of the measurement of total cholesterol using the reflectometer Accutrend GC. Usefulness in primary care for diagnosis of hypercholesterolemia del Canizo, F. J., C. Froilan, et al. (1996), Aten Primaria 17(7): 463-6. Abstract: OBJECTIVES. To determine the accuracy and precision of the Accutrend GC (AGC) in measuring cholesterol totals (CT) and its use as a screening test to detect hypercholesterolaemia. DESIGN AND PARTICIPANTS. Venous blood was drawn from 104 patients to measure CT by an enzymatic method (Hitachi 717). At the same time, their capillary blood was also measured with the AGC on two consecutive occasions. Values were divided in three groupings: CT > 149 mg/dl and < or = 199 mg/dl (n = 27); CT > 199 mg/dl and < or = 249 mg/dl (n = 59); and CT > or = 250 mg/dl (n = 18). Accuracy was calculated by obtaining the mean differences (MD) and the confidence intervals of the values obtained with the AGC in the three groupings and comparing them with the values obtained by the laboratory method. Precision was assessed by correlation, the comparison of paired means and the mean coefficient of variation of the values obtained with the AGC in the two successive measurements. MAIN MEASUREMENTS AND FINDINGS. In each grouping the MD of the values obtained with the AGC were lower than those obtained by the laboratory method, respectively. CONCLUSIONS. The AGC is useful as a screening test to detect hypercholesterolaemia, because of its high accuracy and precision. As it also determines glucose it is very useful for diabetics. |
| Precision of blood cholesterol measurement and high blood cholesterol case-finding and treatment Weissfeld, J. L. and J. J. Holloway (1992), J Clin Epidemiol 45(9): 971-84. Abstract: Imprecise blood cholesterol measurement can be expected to adversely affect large scale efforts to detect and treat high blood cholesterol. Using protocols specified by the National Cholesterol Education Program (NCEP), we used computer simulation techniques to quantify the effects of blood cholesterol measurement variability on misclassification rates, costs, effectiveness, and cost-effectiveness of high blood cholesterol case-finding and treatment. At the time of initial case-finding, increased measurement variability was associated with a moderate decrease in the proportions assigned to a treatment state and in the positive predictive value of such an assignment. After 10 years of continual case-finding and treatment, measurement variability dramatically affected proportions assigned to drug treatment and diminished the percent on drugs with blood cholesterol levels truly above NCEP cutpoints. Extreme variability in blood cholesterol measurement increased per capita costs by 14-18% and diminished cost-effectiveness by at least 11-12%. The adverse effects of measurement variability on cost-effectiveness were much more pronounced if adjustments to life-expectancy were made to recognize the lower quality of life associated with drug treatment. Misclassification rates can be decreased and cost-effectiveness improved by performing repeated measurements of blood cholesterol before increasing intensity of treatment. Improvement in the precision of measurement are especially beneficial for low-risk individuals. |
| Preclinical pharmacology, toxicology and efficacy of sphingomyelin/cholesterol liposomal vincristine for therapeutic treatment of cancer Webb, M. S., P. Logan, et al. (1998), Cancer Chemother Pharmacol 42(6): 461-70. Abstract: PURPOSE: To establish the pharmacodynamic relationships between drug biodistribution and drug toxicity/efficacy, a comprehensive preclinical evaluation of sphingomyelin/cholesterol (SM/chol) liposomal vincristine and unencapsulated vincristine in mice was undertaken. METHODS: Pharmaceutically acceptable formulations of unencapsulated vincristine and liposomal vincristine at drug/lipid ratios of 0.05 or 0.10 (wt/wt) were evaluated for toxicity, antitumor activity and pharmacokinetics following intravenous administration. RESULTS: Mice given liposomal vincristine at 2 mg/kg vincristine had concentrations of vincristine in blood and plasma at least two orders of magnitude greater then those achieved after an identical dose of unencapsulated drug. One day after administration of the liposomal vincristine, there were at least tenfold greater drug quantities, relative to unencapsulated vincristine, in the axillary lymph nodes, heart, inguinal lymph nodes, kidney, liver, skin, small intestines and spleen. Increased plasma and tissue exposure to vincristine as a result of encapsulation in SM/chol liposomes was not associated with increased drug toxicities. Treatment of the murine P388 ascitic tumor with a single intravenous dose of unencapsulated drug at 2, 3 and 4 mg/kg, initiated 1 day after tumor cell inoculation, resulted in a 33 to 38% increase in lifespan. In contrast, long-term survival rates of 50% or more were achieved in all groups treated with the SM/chol liposomal vincristine formulations at doses of 2, 3 and 4 mg/kg. At the 4 mg/kg dose, eight of ten and nine of ten animals survived past day 60 when treated with SM/chol liposomal vincristine prepared at the 0.05 and 0.1 drug/lipid ratios, respectively. CONCLUSIONS: Overall, increased and prolonged plasma concentrations of vincristine achieved by liposomal encapsulation were correlated with dramatically increased antitumor activity in comparison with the unencapsulated drug, but no correlations could be established between pharmacokinetic parameters and toxicity. |
| Precursors for cholesterol synthesis (7-dehydrocholesterol, 7-dehydrodesmosterol, and desmosterol): cholesterol/7-dehydrocholesterol ratio as an index of development and aging in PNS but not in CNS Bourre, J. M., M. Clement, et al. (1990), J Neurochem 54(4): 1196-9. Abstract: In rat sciatic nerve, the 7-dehydrocholesterol content decreased dramatically during the postnatal period and slowly during adulthood and aging. In contrast, the 7-dehydrodesmosterol content peaked at 14 days and was nearly undetectable after 60 days. The desmosterol content peaked at 21 days and was nearly undetectable after 1 year. The cholesterol content increased up to 21 days and remained nearly constant thereafter. In brain (in contrast to sciatic nerve), 7-dehydrodesmosterol and desmosterol contents decreased dramatically during development and slightly during adulthood and aging; the 7-dehydrocholesterol content peaked at 21 days and remained constant during aging. Only 7-dehydrocholesterol was dramatically more concentrated in PNS than in CNS. In brain, the cholesterol/7-dehydrocholesterol ratio increased during development and remained stable after 6 months. In contrast, in sciatic nerve, this ratio continuously increased during development and aging (950-fold between 5 days and 18 months). Thus, the cholesterol/7-dehydrocholesterol ratio is a useful biochemical index of development and aging in the PNS. |
| Precursors of essential hypertension: pulmonary function, heart rate, uric acid, serum cholesterol, and other serum chemistries Selby, J. V., G. D. Friedman, et al. (1990), Am J Epidemiol 131(6): 1017-27. Abstract: Exploratory analyses were conducted in a nested case-control study of 1,031 incident cases of essential hypertension and 1,031 persistently normotensive controls from the Kaiser Permanente Multiphasic Health Checkup cohort in Northern California. Previous analyses have confirmed hypotheses that baseline weight, subsequent weight gain, alcohol consumption, parental history of hypertension, excessive use of salt, and centralized body fat distribution are predictive of developing hypertension. In the present study, pulmonary function tests, several serum chemistries, and heart rate were strongly predictive in univariate analyses. Adjusting for the risk factors mentioned above, forced vital capacity (p less than 0.001), serum uric acid (p = 0.003), serum cholesterol (p = 0.012), and heart rate (p = 0.014) remained independently predictive. Further adjustment for baseline blood pressure completely explained the association of heart rate with hypertension, and reduced the association with serum cholesterol to borderline significance. Forced vital capacity remained a strong, inverse predictor (odds ratio, fifth vs. first quintile = 0.22, 95% confidence interval (Cl) 0.11-0.46). Uric acid remained positively related to risk (odds ratio, fifth vs. first quintile = 2.19, 95% Cl 1.20-3.98). Although neither association is presently understood, both forced vital capacity and serum uric acid are closely linked to development of hypertension and may be markers of susceptibility or intermediate steps in pathways leading to hypertension. |
| Predicting cholesterol, progesterone, and days to ovulation using postpartum metabolic and endocrine measures Francisco, C. C., L. J. Spicer, et al. (2003), J Dairy Sci 86(9): 2852-63. Abstract: The objective of this study was to examine relationships among metabolic and endocrine factors that may influence ovarian activity during early lactation. Holstein cows (n = 19) were bled twice each week to determine plasma concentrations of insulin (INS), glucose, cholesterol, insulin-like growth factor-1 (IGF-I), and progesterone (P4). Feed intake and milk production were recorded daily while body weights and milk composition were recorded weekly. Relationships among plasma cholesterol and P4, and days to first and second postpartum ovulation were modeled with energy balance (EB), dry matter intake, milk yield and composition, plasma metabolites, and hormones using the backward elimination technique of multivariate regression analysis. Variables that contributed the most to predicting plasma cholesterol concentrations were dry matter intake x SNF using model 1 (production variables) and the square of glucose (i.e., glucose2) using model 3 (plasma hormones and metabolites). For plasma P4 concentrations, EB (model 2, production variables) and IGF-I (model 3, plasma hormones and metabolites) were the major predictors. The production variables EB and percentage of milk lactose were the greatest contributors to the models predicting days to first and second postpartum ovulations, respectively. Of the plasma hormones and metabolites evaluated, IGF-I2 was the most significant predictor of days to first postpartum ovulation, whereas glucose2 and INS were the significant predictors of days to second postpartum ovulation. Plasma IGF-I, glucose, and INS have been implicated in ovarian functions and their significant contributions to these models are consistent with possible important roles in postpartum return to ovarian competence. |
| Predicting coronary risk in the general population--is it necessary to measure high-density lipoprotein cholesterol? Wilson, S., A. Johnston, et al. (2003), J Cardiovasc Risk 10(2): 137-41. Abstract: BACKGROUND: The Joint British Societies Coronary Risk Prediction Charts recommend the use of a high-density lipoprotein cholesterol value of 1 mmol/l where actual values have not been measured. It is important to quantify the impact of this advice if risk assessments are to be sufficiently accurate to guide treatment decisions. DESIGN: The risks of 5005 individuals from the Health Survey for England 1998 were calculated using the Joint British Societies charts. Each individual's risk was recalculated assuming a high-density lipoprotein cholesterol value of 1 mmol/l. These risk estimates were compared with those derived from the Framingham equation. METHODS: Using the Framingham equation as the gold standard, the positive and negative predictive values, sensitivity and specificity with 95% confidence intervals of the Joint British charts with actual and estimated high-density lipoprotein cholesterol values were calculated. RESULTS: At the 30% 10-year coronary heart disease risk threshold using measured high-density lipoprotein cholesterol values, the charts had a sensitivity of 83% and specificity of 99%. Using an estimated high-density lipoprotein cholesterol value of 1 mmol/l reduced the sensitivity to 58% with a specificity of 98%. CONCLUSIONS: In the presence of measured high-density lipoprotein cholesterol values there was good agreement between the Framingham equation and the Joint British Societies charts. The use of a fixed high-density lipoprotein cholesterol value of 1 mmol/l introduced important and significant errors into the risk assessment. This study reinforces the need to measure both total and high-density lipoprotein cholesterol when assessing coronary risk. |
| Prediction of serum apolipoprotein B levels from total cholesterol and triacylglycerols, or from total heparin-precipitable lipoprotein Payne, R. H., K. Madhavankutty, et al. (1991), Biochem Soc Trans 19(2): 211S. |
| Prediction of total cholesterol: high-density-lipoprotein-cholesterol ratio in young adults Chen, W. H., Y. Y. Chang, et al. (1997), Southeast Asian J Trop Med Public Health 28(2): 410-6. Abstract: Abnormal cholesterol fraction is an essential risk factor for atherosclerosis of large cerebral arteries in young Asians. In order to reduce the medical cost and social resource for cholesterol electrophoresis, especially in undeveloped and developing Asian countries, we evaluated the validity of Nanji's GUT score for predicting TC: HDLC ratio in this population. Results showed that GUT score only predicted 71% of them. We also tested the predictive power of CUT index, and predicting rate was 81%. Therefore, Nanji's GUT score is not an ideal surrogate for cholesterol electrophoresis. We recommend CUT index to screen for high-risk subjects till a new method can satisfy the economic pattern in Asian countries. |
| Predictive value for coronary heart disease of baseline high-density and low-density lipoprotein cholesterol among Fredrickson type IIa subjects in the Helsinki Heart Study Manninen, V., P. Koskinen, et al. (1990), Am J Cardiol 66(6): 24A-27A. Abstract: In the Helsinki Heart Study 2,590 subjects (63.5% of total) had a type IIa hyperlipoproteinemia at screening. Baseline low-density lipoprotein (LDL) cholesterol (mean 193 mg/dl; 5 mmol/liter) and high-density lipoprotein (HDL) cholesterol (mean 50.2 mg/dl; 1.3 mmol/liter) showed no statistical correlation (r = 0.046). Both the placebo (1,293 patients) and gemfibrozil groups (1,297 patients) were divided into tertiles by baseline HDL and LDL cholesterol to determine the relative predictive risk of developing coronary artery disease. In a population with elevated LDL cholesterol, it is significant that the lipoprotein fraction with the greatest predictive value was HDL cholesterol. The severity of LDL cholesterol elevation did not provide any differential predictive value for coronary artery disease. |
| Predictive value of nutritional markers (albumin, creatinine, cholesterol, and hematocrit) for patients on dialysis for up to 30 years Avram, M. M., L. V. Bonomini, et al. (1996), Am J Kidney Dis 28(6): 910-7. Abstract: Mortality among end-stage renal disease patients in the United States remains unacceptably high despite progress in the management of renal replacement therapy. Consequently, there are few reports of long-term survivors on dialysis. We have analyzed characteristics of long-term (10 to 15 years, N = 40) and very long-term (15 to 30 years, N = 18) survivors on hemodialysis and long-term survivors (more than 10 years, N = 28) on peritoneal dialysis and compared them with "average survivors" (< 5 years, N = 65 for hemodialysis and N = 101 for peritoneal dialysis). Among hemodialysis patients, long- and very long-term survival was associated with younger age, nondiabetic status, black race, and male gender (P < 0.05 for all variables). Enrollment creatinine was higher among long- and very long-term survivors, whereas albumin and hematocrit increased significantly during the period of observation among long- and very long-term survivors compared with average survivors. Enrollment age, nondiabetic status, and albumin level predicted prolonged survival even after adjustments for confounding variables. Among peritoneal dialysis patients, younger age and nondiabetic status predicted prolonged survival. Black race was associated with improved survival, but the association was not statistically significant. Enrollment levels of albumin and creatinine were significantly higher among long-term survivors and the cholesterol increased during the period of observation in long-term survivors. Thus, demographic and biochemical indices reflecting nutritional status can predict prolonged survival in hemodialysis and peritoneal dialysis. Patient survival for periods of up to 30 years is possible on renal replacement therapy. Analyses of these outlier patients may offer clues to prolonged survival. |
| Predictive value of remnant-like particle cholesterol as an indicator of coronary artery stenosis in patients with normal serum triglyceride levels Masuoka, H., S. Kamei, et al. (2000), Intern Med 39(7): 540-6. Abstract: OBJECTIVE: We designed the present study to evaluate the association of various lipid and fibrinolytic components with coronary artery stenosis with respect to the triglyceride (TG) level. METHODS: Levels of TG, remnant-like particle cholesterol (RLP-C), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein-(a), uric acid, blood glucose, tissue plasminogen activator (t-PA), t-PA inhibitor type 1, antithrombin III, and protein C were measured in 208 patients who underwent diagnostic coronary angiograms. PATIENTS: Of these 208 patients, 59 were hypertriglyceridemic (150 mg/dl or higher) and 149 were normotriglyceridemic. RESULTS: Both LDL-C and HDL-C showed significant differences between patients with and those without coronary artery stenosis in both hypertriglyceridemic and normotriglyceridemic patient subgroups. However, RLP-C showed a significant difference in the normotriglyceridemic patient subgroup (p=0.012) but not in the hypertriglyceridemic patient subgroup (p=0.736). CONCLUSION: Our current retrospective study disclosed that RLP-C levels are closely associated with coronary artery stenosis in patients with normal TG levels. |
| Predictive value of remnant-like particles cholesterol/high-density lipoprotein cholesterol ratio as a new indicator of coronary artery disease Masuoka, H., K. Ishikura, et al. (1998), Am Heart J 136(2): 226-30. Abstract: BACKGROUND: There is as yet no definite consensus on the predictive value of the various lipid profiles and fibrinolytic parameters that became available in clinical use recently for coronary artery disease. METHODS: Levels of lipoprotein(a), high-density lipoprotein cholesterol (HDL-C), remnant-like particles cholesterol (RLP-C), tissue plasminogen activator (TPA), TPA inhibitor, antithrombin III, and protein C were measured in 124 patients who underwent diagnostic coronary angiograms. RESULTS: Of these patients, 37 had no significant stenoses (group N) and 87 had significant stenoses (group S). There were no significant differences in patient characteristics between the two groups. HDL-C was significantly lower (p = 0.0071) and RLP-C was significantly higher (p = 0.0022) in group S. When a product and a ratio of each of two factors were calculated, RLP-C/HDL-C was demonstrated to be a highly significant predictor for coronary artery stenoses (p < 0.0001). There were also significant increases in RLP-C/HDL-C levels with increasing number of vessels involved (r = 0.359, p < 0.0001). CONCLUSION: Our present study disclosed the predictive value of RLP-C/HDL-C ratio as a new indicator of coronary artery disease. |
| Predictive value of urinary micro-cholesterol (mCHO) levels in patients with progressive glomerular disease Hotta, O., H. Sugai, et al. (2004), Kidney Int 66(6): 2374-81. Abstract: BACKGROUND: Trace amounts of lipids are present in the urine of patients with glomerular disease, raising the possibility that the excess lipids reabsorbed by tubule cells may be toxic to these cells. In the present study, we assessed the prognostic value of micro-cholesterol (mCHO) levels in patients with chronic glomerular disease. METHODS: The urinary mCHO levels of healthy subjects and patients with chronic kidney disease were measured by the enzymatic cholesterol cycling (ECC) method with a minimum detection level of 0.10 x 10(-3) mmol/L. First, the urinary mCHO levels of healthy subjects and 320 patients with various glomerular diseases with proteinuria >1000 mg/gCr were measured. Second, correlations of urinary mCHO levels with those of various other molecules, including albumin, IgG, IgM, transferrin, phospholipid, alpha1-microglobulin (alpha1MG), Apo A1, Apo A2, and Apo B, and urinary fatty body counts, were determined. Third, urinary mCHO, total protein (TP), albumin, and N-acetyl-beta-D-glucosaminidase (NAG) levels were measured longitudinally over 12 months (20.5 +/- 5.8 months) in 68 nondiabetic patients with impaired renal function serum creatinine (Cr) > or = 1.5 mg/dL. Correlations of the concentrations of urinary parameters in the initial 3-month period with the slopes of the reciprocal of creatinine versus time for the entire follow-up period were assessed by the ROC method and multiple regression analysis. RESULTS: Urinary mCHO levels of the healthy subjects were 0.06 to 0.72 mg/gCr for males and 0.16 to 2.34 mg/gCr for females. Urinary mCHO levels in subjects with minimal change nephrotic syndrome were significantly lower than those in the patients with other glomerular diseases with massive proteinuria. Urinary mCHO levels correlated significantly with Apo A1 and Apo A2 levels, but not with urinary Apo B levels, in the latter subjects. The correlation coefficient of urinary fatty body counts (a marker of lipoprotein loading tubulopathy) with mCHO was higher than those with TP, albumin, IgG, IgM, and alpha1MG. The urinary mCHO elevation was significantly greater in patients who had a nonselective index of proteinuria than in those with a highly or moderately selective index. In nondiabetic patients with impaired renal function, the urinary mCHO level had a higher predictive value for rapid decline of renal function than TP, albumin, or NAG. CONCLUSION: The urinary cholesterol level corresponds to the magnitude of urinary HDL excretion, and correlates with the degree of lipoprotein loading tubulopathy. Measurement of urinary mCHO by the ECC method is a simple and useful tool for predicting progression of chronic glomerular disease. |
| Predictors of 14-year changes in the total cholesterol to high-density lipoprotein cholesterol ratio in men Scranton, R., H. D. Sesso, et al. (2004), Am Heart J 147(6): 1033-8. Abstract: BACKGROUND: Although the ratio of total to high-density lipoprotein cholesterol (TC/HDL) is a powerful predictor of cardiovascular disease (CVD), few studies have investigated which factors are associated with changes in this ratio over time. We examined predictors of a change in TC/HDL ratio over a period of 14 years among 4451 men free of CVD from the Physicians' Health Study. METHODS: Baseline and updated physician characteristics and CVD risk factors were included in multivariate linear and logistic regression models to determine factors associated with a change in the TC/HDL ratio or of having a ratio of > or =5 on follow-up. RESULTS: After a mean follow-up of 14 years, mean total cholesterol decreased by 7 mg/dL, HDL increased by 1 mg/dL, and the ratio decreased by 0.37. In multivariate logistic analyses, physicians were more likely to have a TC/HDL ratio of > or =5 at follow-up if they maintained a weight of > or =25 kg/m2 (OR, 1.69 1.35-2.12), gained weight (OR, 2.01 1.55-2.62), or became inactive (OR, 1.43 1.11-1.83). However, older physicians and those who consumed alcohol or received treatment for hyperlipidemia were more likely to have a ratio of <5. CONCLUSIONS: Although pharmacologic treatment for hyperlipidemia had the greatest favorable impact on the ratio over time, our data also show that maintaining an ideal weight and exercise have beneficial effects. We therefore advocate a renewed fervor for raising public awareness of the benefits of healthy lifestyle behaviors and pharmacologic treatments that are associated with long-term maintenance of favorable cholesterol levels. |
| Predictors of falling cholesterol levels in older adults: the Cardiovascular Health Study Manolio, T. A., M. Cushman, et al. (2004), Ann Epidemiol 14(5): 325-31. Abstract: PURPOSE: To estimate 4-year change in serum total cholesterol levels in a population-based sample of older adults and identify independent predictors of cholesterol decline. METHODS: Prospective study of 2837 adults aged 65 years and older with serum cholesterol measured in 1992-1993 and 1996-1997. RESULTS: Mean serum cholesterol levels declined 6.3 mg/dl between the two examinations. Declines were greater in white (-7.3 mg/dl) than black (-1.4 mg/dl) participants and in those in good/excellent health (-0.9 mg/dl) vs. fair/poor health (-3.1 mg/dl; both p < 0.01). Factors associated with greater decline on multivariate analysis included age, male gender, and higher white cell count, albumin, and baseline cholesterol. Cholesterol levels declined 2.0 mg/dl per 6 year increment in baseline age and 6.8 mg/dl more in men than women after adjustment for other factors. C-reactive protein levels were unrelated to cholesterol change. CONCLUSION: Declining cholesterol levels were associated with male gender, advanced age, weight loss, and white blood cell count but not with C-reactive protein levels. The role of declining cholesterol synthesis, due to as yet undefined age-related changes or to cytokine-mediated reductions related to illness, should be examined to help clarify the mechanisms of the sometimes marked declines in cholesterol levels observed at advanced ages. |