有些人认为，青年人胆固醇水平异常无关紧要，将来再治也不迟。但美国科研人员的新研究显示，如果青年人胆固醇水平异常，他们在40多岁后患心脏病的风险会提高，因此控制胆固醇水平宜趁早。
加州大学旧金山分校的研究人员在美国学术刊物《内科学文献》上报告说，他们从1985年开始，对来自美国4个城市的约3200名不超过30岁的青年，进行了为期20年的跟踪调查。调查期间，研究人员时常测量并记录被调查者的低密度脂蛋白胆固醇（坏胆固醇）和高密度脂蛋白胆固醇（好胆固醇）水平。
20年后，研究人员用X射线断层摄影技术观察被调查者的冠状动脉钙沉积程度。冠状动脉钙沉积状况是判断患心脏病风险的一个重要指标。
研究发现，如果被调查者在20多岁时低密度脂蛋白胆固醇水平超标，那么他们在45岁以后出现冠状动脉钙化的比例为44％。与之相比，如果20多岁时的低密度脂蛋白胆固醇水平正常，那么被调查者到45岁以后出现冠状动脉钙化的比例仅为8％。此外，如果青年时的高密度脂蛋白胆固醇水平较低，中年后出现冠状动脉钙化的几率也会提高。
研究人员指出，上述发现说明，胆固醇水平异常的青年人在步入中年后更容易发生冠状动脉钙化，从而提高患心脏病的风险。因此，如果在青年时代发现胆固醇水平异常，就应及早采取干预措施，以降低今后患心脏病的风险。在各种干预措施中，服药不是调整胆固醇水平的最佳途径，健康饮食和加强锻炼才是更加经济、有效和持久的方法。
推荐原文出处：
Arch Intern Med. 2010;170(12):1032-1036. doi：
Cholesterol Lowering, Cardiovascular Diseases, and the Rosuvastatin-JUPITER Controversy
Michel de Lorgeril, MD; Patricia Salen, BSc; John Abramson, MD; Sylvie Dodin, MD; Tomohito Hamazaki, PhD; Willy Kostucki, MD; Harumi Okuyama, PhD; Bruno Pavy, MD; Mikael Rabaeus, MD
Background Among the recently reported cholesterol-lowering drug trials, the JUPITER (Justification for the Use of Statins in Primary Prevention) trial is unique: it reports a substantial decrease in the risk of cardiovascular diseases among patients without coronary heart disease and with normal or low cholesterol levels.
Methods Careful review of both results and methods used in the trial and comparison with expected data.
Results The trial was flawed. It was discontinued (according to prespecified rules) after fewer than 2 years of follow-up, with no differences between the 2 groups on the most objective criteria. Clinical data showed a major discrepancy between significant reduction of nonfatal stroke and myocardial infarction but no effect on mortality from stroke and myocardial infarction. Cardiovascular mortality was surprisingly low compared with total mortality―between 5% and 18%―whereas the expected rate would have been close to 40%. Finally, there was a very low case-fatality rate of myocardial infarction, far from the expected number of close to 50%. The possibility that bias entered the trial is particularly concerning because of the strong commercial interest in the study.
Conclusion The results of the trial do not support the use of statin treatment for primary prevention of cardiovascular diseases and raise troubling questions concerning the role of commercial sponsors.
