Serum levels of thiobarbituric acid-reactive substances are associated with risk of coronary heart disease

Aim: evidence of relationships between lipid peroxidation and the incidence of coronary heart disease is limited. we therefore investigated this association in a japanese general population. methods: we prospectively studied 1945 individuals who were apparently healthy at the baseline. cox proportional-hazards models were used to investigate the relationship between serum levels of thiobarbituric acid-reactive substances (tbars) as a marker of lipid peroxidation and the incidence of coronary heart disease,adjusted for established risk factors including age,sex,current smoking,body mass index,systolic blood pressure,glycohemoglobin a1c,serum total cholesterol,and serum high-density lipoprotein cholesterol levels. results: during 20,226 person-years of follow-up (median follow-up,10.9 years),44 coronary events were documented. the risk of coronary heart disease increased in consecutive tertiles of the tbars level. on age-and sex-adjusted analysis,the level of tbars was significantly associated with the incidence of coronary heart disease. the hazard ratio in the highest tertile compared with the lowest tertile was 3.22 (95% confidence interval,1.38 to 7.53; p = 0.007). on multivariate analysis adjusted for age,sex,and other established risk factors,this association remained significant (hazard ratio,3.23; 95% confidence interval,1.28 to 8.16; p = 0.01). conclusions: serum levels of tbars are a strong and independent predictor of coronary heart disease. these findings support the hypothesis that lipid peroxidation is an important risk factor for coronary heart disease.