scholarly journals Alcohol Intake and Incident Myocardial Infarction: The Role of High-density Lipoprotein Cholesterol (P18-020-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Shue Huang ◽  
Zhe Huang ◽  
Gregory Shearer ◽  
Shanshan Li ◽  
Shuohua Chen ◽  
...  

Abstract Objectives The aim of this study is to test the hypothesis that the lower risk of myocardial infarction (MI) associated with alcohol intake is through its effect on raising high-density lipoprotein (HDL) cholesterol. Methods This study included 81,827 Chinese men and women (mean age: 51 ± 12 yr.) from the Kailuan Study who were free of cardiovascular disease in 2006 (at baseline) and were followed up to Dec. 2016. At baseline, alcohol consumption was assessed via a questionnaire and the concentration of HDL cholesterol was measured. Incident MI at follow up was a first MI event, confirmed by medical record review. Multivariable Cox regression was used to model the association between habitual alcohol intake and risks of MI, adjusting for potential covariates including age, sex, education, monthly income, occupation, smoking status, physical activity, body mass index, waist circumferences, hypertension, diabetes and total cholesterol. Mediated effect through HDL cholesterol was assessed using a causal mediating analysis (SAS macro). Results During an average of 9.6 years of follow-up, we documented 1095 incident cases. The adjusted hazard ratio (HR) for MI was 0.64 (95% confidence interval (CI), 0.54–0.76) for current alcohol drinkers compared with never or former. The ratio changed very slightly, to 0.65 (95% CI, 0.55–0.76) after further adjustment of HDL cholesterol concentration. Mediation analysis showed that HDL cholesterol concentrations mediated a small, non-significant proportion (1.8%) of the effect of alcohol on MI. Conclusions Alcohol consumption was associated with a lower risk for MI incidence in a large Chinese cohort. Our results suggest that the benefits associated with moderate alcohol consumption is not related to the effects of alcohol on HDL cholesterol. Funding Sources Start-up grant from Penn State College of Health and Human Development, and Penn State CyberScience Seed Grant Program.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Shue Huang ◽  
Xiang Gao ◽  
Shanshan Li ◽  
Gregory Shearer

Abstract Objectives The aim of this study was to investigate whether and to what extent the association between alcohol intake and incident myocardial infarction (MI) is mediated through high density lipoprotein cholesterol (HDL-C), and HDL particles (HDL-P). Methods A total of 6,704 participants from the Multi-Ethnic Study of Atherosclerosis were included in the analysis. Alcohol consumption information was assessed via a questionnaire at baseline (exam 1). HDL-C concentrations and HDL-P were both measured at exam 1. Cox regression was used to model the association of habitual alcohol intake and risk for MI before and after adjusting HDL-C and HDL-P, in addition to adjustment of all potential covariates. Mediated effects through HDL-C, and HDL-P were estimated using the causal mediation analysis. Results After a median of 8 years follow-up, 171 incident MI cases were documented. Alcohol intake was associated with a lower risk for incident MI (adjusted Hazard Ratio (HR) = 0.69, 95% Confidence Interval (CI): 0.50-0.95), relative to non-drinkers. The relation between alcohol intake and MI became nonsignificant after further adjusting HDL-P. The HRs of the indirect effect of alcohol through HDL-C and HDL-P were 0.97 (95% CI: 0.93, 1.01) (P = 0.16) and 0.94 (95% CI: 0.90, 0.99) (P = 0.02), indicating that on average, alcohol intake reduced the risk of MI by 6% through its effect on HDL-P and not through HDL-C. The proportion of the effect of alcohol on MI mediated by HDL-P was 14.6%. Conclusions This study indicates that the lower risk of MI related to alcohol intake appears to partially work through increasing HDL-P, however, the mechanism for much of alcohol's effect to reduce MI risk remains unexplained. This suggests that HDL-P can be a target for MI prevention, however the mediating effect of HDL-P is very moderate. Funding Sources N/A.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Catherine Rahilly-Tierney ◽  
Howard D Sesso ◽  
J. Michael Gaziano ◽  
Luc Djousse

BACKGROUND: Few studies have examined prospectively the relationship between baseline high-density lipoprotein (HDL) cholesterol and longevity. OBJECTIVES: We sought to examine whether higher HDL levels were associated with lower risk of all-cause, cardiovascular (CVD), and non-CVD mortality prior to age 90 in the Physicians’ Health Study (PHS). METHODS: We considered a baseline cohort of 1351 PHS participants who provided bloods between 1997 and 2001 and were old enough to reach age 90 by March 4, 2009. Included subjects had complete baseline data on HDL and total cholesterol; lifestyle factors including smoking, exercise, alcohol consumption, and BMI; and comorbidities including hypertension, diabetes mellitus, congestive heart failure, cancer, and stroke. We used Cox proportional hazards to determine the HRs and 95% CIs for all-cause, CVD, and non-CVD mortality prior to age 90, adjusting for baseline age, co-morbidities, and non-HDL cholesterol. RESULTS: At baseline, the cohort had a mean (SD) age of 81.9 (2.9) years and a mean (SD) HDL cholesterol of 44.8(16.5) mg/dL. After a mean follow-up of 6.8 years (maximum 12.3 years), 501 (37.1%) of men died prior to age 90. In multi-variable adjusted analyses, men in the highest HDL-C quartile (≥54.1 mg/dL) had a 28% lower risk (HR 0.72, 95% CI 0.55-0.95) of all-cause mortality prior to age 90 compared to men in the lowest HDL-C quartile (<32.8 mg/dL). From the lowest to highest HDL quartile, age-adjusted HR(95%CI) for CVD mortality prior to age 90 were 0.66 (0.44-0.99), 0.58 (0.38-0.90), and 0.53 (0.34-0.82) (p for trend 0.004). There was no significant association between baseline HDL cholesterol and non-CVD death. CONCLUSION: In a cohort of older male physicians with long-term follow-up, baseline HDL cholesterol was inversely associated with the risk of dying prior to age 90, largely explained by an inverse association between HDL and CVD mortality.


2019 ◽  
Vol 43 (1) ◽  
pp. 114 ◽  
Author(s):  
You-Cheol Hwang ◽  
Wilfred Y. Fujimoto ◽  
Steven E. Kahn ◽  
Donna L. Leonetti ◽  
Edward J. Boyko

Author(s):  
Yayie Dwina Putri ◽  
Tuty Prihandani ◽  
Lillah Lillah ◽  
Rismawati Yaswir

Acute Myocardial Infarction (AMI), one of the primary manifestation of coronary heart disease, is a significat cause of death worldwide. Hyperhomocysteinemia, a risk factor for cardiovascular disease, is caused by nutritional or genetic disturbances in homocysteine metabolism. The role of hyperhomocysteinemia in altered lipid metabolism presumed holds the key to an increased risk of cardiovascular disease. Hyperhomocysteinemia causes the reduction of serum High-Density Lipoprotein (HDL) cholesterol level by inhibiting hepatic synthesis of apo-A1 (significant apolipoprotein HDL). The aim of this study was to know the correlation between hyperhomocysteinemia and decreased HDL cholesterol levels for the management of cardiovascular disease risk factors. This research was an analytical study with cross-sectional design in 40 patients AMI who meet the inclusion and exclusion criteria and conduct blood test at the Central Laboratory of Hospital Dr. M. Djamil Padang and Biomedical Laboratory Faculty of Medicine Andalas University. The study was conducted in May 2016-Agustus 2017. Homocysteine level was measured by ELISA method. High-Density Lipoprotein level was performed by enzymatic colorimetric method. Data were analyzed by Spearman’s correlation test. Research subjects were 40 people with male gender 30 (75%) and female 10 (25%), mean age 61.08 (11.09) year. The mean level of HDL cholesterol in patients with AMI is 41.93 ± 13.12 mg/dL. The mean level of homocysteine in patients with AMI is 25.36 ± 22.2 µmol/L. Spearman’s correlation test showed a strong correlation between the levels of homocysteine and HDL cholesterol with r=-0.603 and p<0.01.


Biomolecules ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 481
Author(s):  
Sara Sokooti ◽  
Tamas Szili-Torok ◽  
Jose L. Flores-Guerrero ◽  
Maryse C. J. Osté ◽  
António W. Gomes-Neto ◽  
...  

High concentrations of high-density lipoprotein (HDL) cholesterol are likely associated with a lower risk of posttransplantation diabetes mellitus (PTDM). However, HDL particles vary in size and density with yet unestablished associations with PTDM risk. The aim of our study was to determine the association between different HDL particles and development of PTDM in renal transplant recipients (RTRs). We included 351 stable outpatient adult RTRs without diabetes at baseline evaluation. HDL particle characteristics and size were measured by nuclear magnetic resonance (NMR) spectroscopy. During 5.2 (IQR, 4.1‒5.8) years of follow-up, 39 (11%) RTRs developed PTDM. In multivariable Cox regression analysis, levels of HDL cholesterol (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.40–0.94 per 1SD increase; p = 0.024) and of large HDL particles (HR 0.68, 95% CI 0.50–0.93 per log 1SD increase; p = 0.017), as well as larger HDL size (HR 0.58, 95% CI 0.36–0.93 per 1SD increase; p = 0.025) were inversely associated with PTDM development, independently of relevant covariates including, age, sex, body mass index, medication use, transplantation-specific parameters, blood pressure, triglycerides, and glucose. In conclusion, higher concentrations of HDL cholesterol and of large HDL particles and greater HDL size were associated with a lower risk of PTDM development in RTRs, independently of established risk factors for PTDM development.


1993 ◽  
Vol 329 (25) ◽  
pp. 1829-1834 ◽  
Author(s):  
J. Michael Gaziano ◽  
Julie E. Buring ◽  
Jan L. Breslow ◽  
Samuel Z. Goldhaber ◽  
Bernard Rosner ◽  
...  

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Susanna Calling ◽  
Sven-Erik Johansson ◽  
Moa Wolff ◽  
Jan Sundquist ◽  
Kristina Sundquist

Abstract Background Identifying variables predictive of acute myocardial infarction (AMI) in women is important. The use of the ratio of total cholesterol-to-high density lipoprotein cholesterol (TC/HDL-C) is often overlooked. The aim was to study TC/HDL-C in relation to later AMI, in a large sample of women, adjusted for age, educational status, smoking, waist-hip ratio, blood pressure, and neighbourhood socioeconomic status. The hypothesis was that increasing TC/HDL-C is associated with an increased risk of later AMI. Methods From December 1995 to February 2000, 6147 women aged 50–59 years from the Womens’ Health in Lund area (WHILA) study in southern Sweden underwent a physical examination, laboratory tests and filled in a questionnaire. The women were followed through national registers for incidence of AMI during a mean follow up of 17 years. Results An increasing TC/HDL-C showed a strong relationship with AMI, with the lowest hazard ratio (HR = 1) in women with a ratio of ≤3.5. The HR for AMI was 1.14 (95% CI: 0.73–1.78) for those with a ratio between 3.5 and 4.0; in those with a ratio between 4.0 and 5.0 the HR for AMI was 1.46 (95% CI: 1.00–2.13) and in those with a ratio > 5.0 the HR was 1.89 (95% CI 1.26–2.82), after adjusting for potential confounding factors. Conclusions TC/HDL-C ratio is a powerful predictor of AMI in middle-aged women. The results indicate that this variable should be used in clinical practice and is important for early identification of individuals at risk of AMI.


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