An Analysis of Cardiovascular Risk Factors in 995 Chronic Dialysis Patients: A-CARD study ----- the Role of Gender

九百九十五位慢性血液透析病人心臟血管疾病及其危險因子之分析：性別的影響

陳良根(L. K. Chen) ； 劉宏祥(H. H. Liou) ； 劉美琴(M. C. Liu) ； A-CARD研究小組(A-CARD Study Group)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 298-298

並列摘要

In general, men have a higher risk for coronary artery disease (CHD)than do premenopausal women of the same age. Although CHD risk in women lags behind that of men by about 10 year, risk increases progressively after menopause. However, this issue needed to be confirmed in chronic uremic patients. Therefore, we conducted a multicenter, cross-sectional survey to exam the impact of gender on the cardiovascular risk factors in chronic HD patients. Of the data from 1027 HD patients recruited from 12 HD centers, 995 patients, 498 male & 497 female, who received HD for at least 3 months and whose age was 20 years of age an older were used. The mean age of these patients was 56.4±14.3years. The mean serum cholesterol, LDL, AopB, HDL, & ApoA1 levels in male/female were 169.4±42.0/189.4±44.7,75.5±32.2/88.4±37.2,84.1±24.4/91.9±26.8,38.2±11.5/43.7±14.3,and 111.2±20.3/123.6±25.8 mg/dL, respectively. The percentage of HD patients (M/F) who had their serum cholesterol≥240 mg/dL were 5/13, 200-239 mg/dL were 18/26, &＜200 mg/dL were 77/61; serum TG≥500 mg/dL were 5/5, 200-499 mg/dL were 19/21, 150-199mg/dL were 16/16, & ＜150 mg/dL were 60/58; serum HDL-C≥60 mg/dL were 5/14, & ＜40 mg/dL were 59/43. The prevalence rate of CHD in HD patients (M/F)were 27/21, cerebrovascular disease (CVD) were 8/5, & peripheral vascular disease (PVD) were 6/5, respectively. Among the CHD patients, male had higher DBP, serum Cr, Hct & lower cholesterol, LDL-C, HDL-C, Apo A1, Apo B levels. Among the CVD patients, male had higher DBP, BUN, serum Cr & lower LDL-C, HDL-C Lp (a) levels. Among the PVD patients, male had higher DBP, serum Cr, Hct & lower ApoA1 levels. The cigarette smoking rate is higher in male patients with CHD, CVD, or PVD, The CHD patients with both genders had an older age. Among the male, CHD patients had higher EPOrequirement, CTR & lower BUN, serum Cr, Alb, ApoA1. Among the female, CHD patients were had higher EPO requirement, CTR & lower serum Cr, cholesterol, HDL-C, ApoA1 level. All the lipid & lipoprotein levels were higher in female HD patients than in male. However, a higher percentage of male HD patients had CHD & CVD. Therefore, lipids & lipoproteins did not prove helpful in identifying HD patients with CHD, CVD, or PAD in both gender, except lower HDL-C &/or ApoA1.