{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:37:57Z","timestamp":1769272677565,"version":"3.49.0"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,1,23]]},"abstract":"\n Background<\/jats:title>\n \n Available data are inconsistent regarding factors influencing plasma cholesterol homeostasis marker concentrations and their value in predicting subsequent cardiovascular disease (\n CVD<\/jats:styled-content>\n ) events.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n To address this issue, the relationship between markers of cholesterol absorption (campesterol, sitosterol, cholestanol) and synthesis (squalene, desmosterol, lathosterol) and 10\u2010year\n CVD<\/jats:styled-content>\n incidence was assessed in\n F<\/jats:styled-content>\n ramingham\n O<\/jats:styled-content>\n ffspring\n S<\/jats:styled-content>\n tudy participants (cycle 6) who were without\n CVD<\/jats:styled-content>\n at baseline and not taking lipid\u2010lowering medications (N=2616). The primary end point was \u201chard\u201d coronary heart disease (\n HCHD<\/jats:styled-content>\n ; coronary death and myocardial infarction), and the secondary end point was full\n CVD<\/jats:styled-content>\n (\n HCHD<\/jats:styled-content>\n plus stroke, coronary insufficiency, angina pectoris, peripheral artery disease, and congestive heart failure). In cross\u2010sectional analysis, significant differences by sex, age, body mass index, blood pressure, and smoking status were observed. In both women and men, lower cholesterol absorption was associated with higher triglyceride and lower high\u2010density lipoprotein (\n HDL<\/jats:styled-content>\n ) cholesterol concentrations, whereas lower cholesterol synthesis was associated with higher low\u2010density lipoprotein (\n LDL<\/jats:styled-content>\n ) cholesterol concentrations (\n P<\/jats:italic>\n for trend <0.05). In women only, lower cholesterol synthesis and absorption were associated with higher non\u2013\n HDL<\/jats:styled-content>\n cholesterol concentrations. Using\n C<\/jats:styled-content>\n ox proportional hazards model adjusting for standard\n CVD<\/jats:styled-content>\n risk factors, squalene concentrations were associated with lower\n HCHD<\/jats:styled-content>\n in women (hazard ratio=0.70 [0.5 to 0.9]). In contrast, squalene (hazard ratio=1.40 [1.1 to 1.8]) concentrations were associated with higher\n HCHD<\/jats:styled-content>\n in men (\n P<\/jats:italic>\n <0.0001 for interaction). The cholesterol absorption markers were not predictive of\n HCHD<\/jats:styled-content>\n or full\n CVD<\/jats:styled-content>\n in either women or men.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n These data suggest significant sex differences in the 10\u2010year prognostic value of cholesterol synthesis markers and\n HCHD<\/jats:styled-content>\n , specifically coronary death and incidence of myocardial infarction.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL:\n http:\/\/ClinicalTrials.gov<\/jats:ext-link>\n . Unique identifier: NCT00074464.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.112.005066","type":"journal-article","created":{"date-parts":[[2013,5,24]],"date-time":"2013-05-24T16:49:11Z","timestamp":1369414151000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Sex\u2010Specific Differences in the Predictive Value of Cholesterol Homeostasis Markers and 10\u2010Year Cardiovascular Disease Event Rate in Framingham Offspring Study Participants"],"prefix":"10.1161","volume":"2","author":[{"given":"Nirupa R.","family":"Matthan","sequence":"first","affiliation":[{"name":"Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Pencina","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph B.","family":"D'Agostino","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernst J.","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice H.","family":"Lichtenstein","sequence":"additional","affiliation":[{"name":"Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.106.25.3143"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9150(03)00248-X"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112813"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91846-M"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09328-5"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811053391902"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.20.1615"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/67.1.25"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199511163332001"},{"key":"e_1_3_4_11_2","first-page":"1383","article-title":"Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)","volume":"344","year":"1994","unstructured":"Anonymous. 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