title: Changes in lipid measures and incident coronary heart disease: Tehran Lipid & Glucose Study.
abstract: BACKGROUND
  Data on the impact of changes in lipid measures on subsequent coronary heart disease (CHD) outcomes are not consistent.
  
  
  METHODS
  Study was conducted in 4459 adults, aged ≥30 years, free of cardiovascular disease at baseline who attended two consecutive examinations first in 1999-2001 and second in 2001-2003, and were followed up until March 31, 2010. Multivariate Cox proportional hazard regression adjusted for baseline lipid measures and other risk factors was calculated for a 1 standard deviation (SD) change in total cholesterol (TC), log-transformed triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) (calculated using modified Friedewald formula), non-HDL-C, TC/HDL-C and log-transformed TG/HDL-C. Effect of change in dyslipidemia (TC ≥6.21 mmol/L or TG ≥2.26 mmol/L or HDL-C <1.03 mmol/L or non-HDL-C ≥4.91 mmol/L) on incident CHD was examined, considering those with no dyslipidemia at baseline and follow-up as the reference group.
  
  
  RESULTS
  During a mean follow-up of 9.5 years, 303 cases of CHD occurred. A 1-SD increase in TC, TG, non-HDL-C, TC/HDL-C and TG/HDL-C was associated with 14, 20, 19, 16 and 14% increase in risk of CHD event, respectively (all p values <0.05); the corresponding risk for LDL-C was [1.12 (0.99-1.27), P=0.07]. Participants with maintained dyslipidemia during follow-up had a significant risk for incident CHD [HR: 1.67(1.21-2.49)] compared to those with no dyslipidemia at baseline or follow-up.
  
  
  CONCLUSIONS
  Changes in TC, TG, and non-HDL-C, TC/HDL-C, TG/HDL-C were independent predictors of CHD events. Furthermore, maintained dyslipidemia was a strong predictor for CHD events.
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Amirahmad
authors.initials: A
authors.lastname: Nejat
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Mohammadhassan
authors.initials: M
authors.lastname: Mirbolouk
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Mohebi
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Mitra
authors.initials: M
authors.lastname: Hasheminia
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Tohidi
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Navid
authors.initials: N
authors.lastname: Saadat
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran. Electronic address: fzhadaegh@endocrine.ac.ir.
authors.forename: Farzad
authors.initials: F
authors.lastname: Hadaegh
mesh_terms: D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007492:Iran; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; C034396:HDL-triglyceride; D008055:Lipids; D008075:Lipoproteins, HDL; D014280:Triglycerides; D002784:Cholesterol; D005947:Glucose
keywords: Coronary heart disease; Dyslipidemia; Lipid change