RESUMEN
BACKGROUND AND OBJECTIVES: In the Mexican Mestizo and Indian populations it is unknown the diagnostic criteria (DC) and associated risk of myocardial infarction (MI) for the HDL-cholesterol (HDL-c). We aimed to establish, in a Mexican adult population without cardiovascular risk factors, their HDL-c concentrations, the DC for hypoalphalipoproteinemia and prevalence base on the percentile-10 and the risk associated with MI, as well as the threshold (TH) associated with cardiovascular protection. SUBJECTS AND METHODS: In 826 adult Mestizos, 98 Indians and 155 Mestizos with MI for the first time the average HDL-c serum concentrations were determined. Then the percentile and statistical analysis were carried out. RESULTS: The average HDL-c (mg/dl) concentrations for Mestizos and Indians were 43.2 and 37.2 and the ones inferior to the percentile-10 were <30 and <26, respectively. In Mestizos, HDL-c concentrations of ≤ 35 mg/dl (odds ratio [OR] 1.91, 95% confidence interval [95%CI] 1.3-2.8, P=.001) were associated with MI and those >35 (OR 0.52, IC 95% 0.36-0.76, P=.001) were associated with a cardiovascular protection of 52%. The hypoalphalipoproteinemia prevalences in Mestizos and Indians were: for the percentile-10 DC 9 and 11% and for the TH associated with MI ≤ 35, 26 and 54%, respectively. CONCLUSIONS: The Indians average HDL-c concentration was significantly lower (P<.003) than for Mestizos. The established DC showed that the hypoalphalipoproteinemia prevalences in both populations were similar to those for other open populations. In Mestizos, HDL-c concentrations > 35 mg/dl are protective for MI, but it will be necessary to establish this TH for the Indian population. Each population should establish its own DC for hypoalphalipoproteinemia.
Asunto(s)
Hipoalfalipoproteinemias/diagnóstico , Indígenas Norteamericanos , Adulto , HDL-Colesterol/sangre , Estudios Transversales , Femenino , Humanos , Hipoalfalipoproteinemias/sangre , Hipoalfalipoproteinemias/epidemiología , Masculino , México , Infarto del Miocardio/sangre , Infarto del Miocardio/prevención & control , PrevalenciaRESUMEN
BACKGROUND: There is a need to assess whether human immunodeficiency virus (HIV)-infected patients are more likely than noninfected individuals to have any of the specific lipoprotein combination profiles identified as the best predictors of future cardiovascular disease in the general population. METHODS: One hundred five infected patients, randomly selected from a Mexican HIV clinic, and 105 age- and gender-matched noninfected community volunteers, were enrolled to study the prevalence of each of three highly atherogenic lipoprotein phenotypes [high apolipoprotein (Apo)B/ApoA-I ratio, hypertriglyceridemia with high ApoB and hypoalphalipoproteinemia with high ApoB], and the relationship between time of exposure to antiretroviral therapy (ART) drug class and lipid changes. RESULTS: The highly atherogenic lipoprotein phenotypes were similarly frequent in both groups. There was a nonsignificant increased risk of dyslipidemia with longer exposure to any of the ART drug classes, although this hazard seems to be greater in patients with central fat accumulation. CONCLUSIONS: No evidence of increased risk for certain highly atherogenic lipoprotein phenotypes in HIV-infected patients was found. More than one pathogenic mechanism for ART-associated dyslipidemia is postulated.