大连高新区部分居民几种慢性病患病情况调查

目的了解大连高新区15~74岁居民主要慢性病患病基本特征,为制定和评价大连高新区卫生政策和干预措施提供基础数据。方法在大连高新区采用分层整群随机抽样方法,随机抽取15~74岁常住居民的976人为调查对象进行调查。结果高血压患病率为33.61%,糖尿病患病率为11.07%,冠心病患病率为6.76%,血脂异常患病率为50.41%,城乡间患病率无差异;高血压、糖尿病、冠心病和血脂异常患病率均随着年龄的增加呈逐渐上升趋势,丧偶人群患病率最高(P0.05);高血压、糖尿病、血脂异常患病率,男性高于女性,文化程度低者高于文化程度高者,且随着体重指数的增高而增高(P0.05);高血压、糖尿病、血脂异常患者中,有超过半数为本次检查新发现病例。结论大连高新区居民慢性非传染性疾病患病率处于较高水平,防控策略和措施亟待加强。     

农村地区慢性病流行现状及控制管理对策分析

慢性病严重危害人群健康,已成为疾病负担的主要原因.本文通过三间分布(人群分布、地区分布、时间分布)发现,我国农村地区慢性病患病率随年龄增加而增高;发病年龄提前;年龄越小,增幅越大;不同的慢性病在性别间呈现不同的发病趋势;农村居民现代医学知识缺乏,健康意识淡薄,对慢性病的知晓率、治疗率和控制率低;农村地区经济收入低,医疗保障差,慢性病会对其经济上造成沉重的负担;农村的慢性病患病率增长已经快于城市,且在死因顺位中上升.针对目前我国农村地区慢性病的这些流行现状,进一步分析了农村地区慢性病防治存在的主要问题,并提出了控制对策及管理方法.     

兰州地区人群的牙周健康状况和牙龈卟啉单胞菌感染情况分析

目的了解兰州地区人群的牙周健康状况,检测牙周健康者及牙周疾病患者口腔唾液中牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)的阳性率,为兰州地区人群防治牙周疾病提供科学依据。方法收集942例唾液标本,采用常规厌氧培养法,挑取产黑色素菌落进行革兰染色与生化鉴定。结果兰州地区人群牙周疾病患病率为78.45%,男女性别间差异无统计学意义(P=0.655);农村人群(53.45%)高于城市人群(46.55%),差异有统计学意义(P=0.029);各年龄段差异有显著的统计学意义(P=0.001),随年龄增长患病率呈增长趋势。兰州地区人群唾液中Pg总阳性率为71.23%,牙周疾病组(82.22%)显著高于牙周健康组(27.57%),差异有显著的统计学意义(P=0.000)。结论兰州地区人群牙周健康状况与生活环境、年龄、性别有关;在不同的牙周健康状况人群中牙龈卟啉单胞菌的分布不同。     

农村地区慢性病流行现状及控制管理对策分析

慢性病严重危害人群健康,已成为疾病负担的主要原因。本文通过三间分布（人群分布、地区分布、时间分布）发现,我国农村地区慢性病患病率随年龄增加而增高;发病年龄提前;年龄越小,增幅越大;不同的慢性病在性别间呈现不同的发病趋势;农村居民现代医学知识缺乏,健康意识淡薄,对慢性病的知晓率、治疗率和控制卒低;农村地区经济收入低,医疗保障差,慢性病会对其经济上造成沉重的负担;农村的慢性病患病率增长已经快于城市,且在死因顺位中上升。针对目前我国农村地区慢性痛的这些流行现状,进一步分析了农村地区慢性病防治存在的主要问题,并提出了控制对策及管理方法。     

广东丰顺地区老年高血压患者的危险因素及合并症的特征

目的:分析广东省丰顺地区老年高血压患者的临床特点,为临床治疗该地区老年高血压病提供参考。方法:选取广东省丰顺县人民医院等共3所医院2015年1月至2016年1月收治的老年高血压患者827例,并对所收集的临床资料进行整理,回顾性分析该地区老年人高血压病心脑血管危险因素的分布特征以及其合并症的发生情况。结果:本次纳入研究的827例老年高血压患者中,男性409人,占49.5%,女性418人,占50.5%,平均年龄(75.32±8.74)岁。其中,34.23%存在血脂异常,15.60%有吸烟史,4.47%有高血压家族史,肥胖占2.06%,23.10%合并糖尿病,29.02%合并冠心病,5.20%合并心力衰竭,28.78%合并脑血管疾病,25.83%合并肾功能不全。不同高血压级别合并脑血管病、冠心病、心力衰竭、肾功能不全的发生率存在显著差异(P=0.047,P0.001,P=0.026,P=0.041),而吸烟、血脂异常、肥胖、糖尿病的占比差异无统计学意义(P0.05)。结论:广东省丰顺地区老年高血压患者在心脑血管病危险因素中所占比重最大的是血脂异常,合并冠心病及脑血管疾病比例最大,这可能与血脂异常有着密切的关系。     

一级预防护理干预对特需病房冠心病高危患者的影响

目的:探讨特需病房冠心病高危患者一级预防的护理干预效果。方法:以2010年7月~2012年7月期间四川大学华西医院金卡医疗中心收住的104例冠心病高危患者为研究对象,随机分为对照组和干预组两组各52例,分别实施常规护理和冠心病一级预防护理干预并随访1年,观察两组效果。结果:干预组干预后血压、血脂、血糖以及体重指数的全部指标值及各项指标达标人数和干预前比较差异均有统计学意义(P0.05或0.001);除TG指标外,其他指标值以及各项指标达标人数和对照组比较差异也均有统计学意义(P0.05或0.001)。对照组患除血压及血压达标人数和入院时比较有明显差异(P0.05或0.001),其余各项指标及达标人数均出入不大(P0.05)。两组随访1年,干预组发生冠心病3例,其他心血管事6例,发生率均明显低于对照组(P0.05)。结论:对特需病房冠心病高危人群通过认知、行为、饮食、用药、心理等方面的护理干预进行冠心病的一级预防,患者血压、血脂、血糖及体重指数均得到了较好的控制。患者若能长期坚持执行预防措施,将大大降低冠心病的发病危险。     

阿托伐他汀与辛伐他汀治疗老年冠心病合并高脂血症的效果观察

目的探讨阿托伐他汀与辛伐他汀治疗老年冠心病合并高脂血症患者的临床疗效。方法将我院收治疗的老年冠心病合并高脂血症患者100例作为研究对象,按随机数字表法分为观察组和对照组各50例,对照组给予辛伐他汀治疗,观察组给予阿托伐他汀治疗,并对两组患者的临床效果,以及治疗前后TC、TG、HDL-C、CRP进行分析比较。结果观察组患者的治疗总有效率为96.00%,显著高于对照组的80.00%,两组比较差异有统计学意义(P0.05)。两组患者治疗前的TC、TG、HDL-C、CRP比较,差异无统计学意义(P0.05);治疗后,观察组患者的TC、TG、CRP显著低于对照组,差异有统计学意义(P0.05)。结论老年冠心病合并高脂血症患者应用阿托伐他汀治疗能显著提高临床效果,改善血脂水平,值得临床推广。     

猫嗅球外丛层和僧帽细胞层年龄相关形态学变化

分别用Nissl法及免疫组织化学ABC法标记青、老年猫嗅球中嗅觉二级神经元和外丛层胶质细胞,显微镜下观察其分布并计数,对嗅觉二级神经元胞体直径和外丛层厚度进行测量,比较其年龄相关性变化,研究神经元与胶质细胞之间的关系,探讨老年性嗅觉功能衰退的相关神经机理。结果显示,老年猫嗅觉二级神经元胞体直径和分布密度均有不同程度的显著性下降(P<0.05);外丛层厚度变化不明显(P>0.05);外丛层胶质细胞特别是星形胶质细胞显著性增生(P<0.05)。表明在衰老过程中嗅觉二级神经元有丢失,并呈现功能下降,可能是老年性嗅觉功能衰退的原因之一。同时外丛层胶质细胞增生以进一步保护神经元,延缓其衰老。     

北方汉族人群白细胞介素-6基因-572C/G单核苷酸多态性与冠心病的相关性研究

目的:探讨中国北方汉族人群中白细胞介素-6(IL-6)基因启动子区-572C/G单核苷酸多态性与冠心病的关系。方法:采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法,检测434例冠心病(冠心病组)患者和417名非冠心病人(对照组)的IL-6基因型,探讨-572C/G单核苷酸多态与冠心病的关系。结果:IL-6基因-572C/G多态位点的CC、CG和GG基因型在冠心病组中分别为59.68%、37.09%、3.23%,等位基因频率C和G分别为78.23%、21.77%;在健康成年者中基因型分别为67.87%、30.22%、1.92%,等位基因频率C和G分别为82.97%、17.03%。IL-6基因-572C/G位点多态性在两组人群中的分布差异存在显著性(P<0.05);经Logsitic回归校正性别、年龄、体重指数、高血压病、糖尿病、高胆固醇血症及吸烟等冠心病易患因素后,IL-6基因-572C/G单核苷酸多态是冠心病发病的独立的危险因素(P<0.05);等位基因频率的相对风险分析发现,G等位基因携带者患冠心病的风险是C等位基因的1.356倍〔OR=1.356,95%CI=1.0648～1.7279〕。...     

大剂量瑞舒伐他汀钙治疗老年冠心病合并高脂血症的疗效观察

目的:研究大剂量瑞舒伐他汀钙治疗老年冠心病合并高脂血症的临床疗效。方法:选取2013年10月到2014年10月我院收治的老年冠心病合并高脂血症患者110例,按照随机数字表法将患者分为研究组和对照组,每组55例。两组患者均给予常规治疗方法进行治疗,对照组增加5 mg瑞舒伐他汀钙进行治疗,研究组增加20 mg瑞舒伐他汀钙进行治疗,均每天1次,晚餐后应用,治疗时间为4个月。比较治疗前后两组血脂水平(胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C))及高密度脂蛋白(HDL-C)及其达标率以及不良反应。结果:治疗后两组TC、TG以及LDL-C均显著降低,HDL-C显著升高,且研究组优于对照组,比较差异具有统计学意义(P0.05);研究组治疗后TC和LDL-C达标率显著高于对照组,两组比较差异具有统计学意义(P0.05);两组不良反应发生率比较差异无统计学意义(P0.05)。结论:大剂量瑞舒伐他汀钙治疗老年冠心病合并高脂血症具有较好的临床疗效,能显著降低患者的血脂水平。     

Effects of particulate air pollution on cardiovascular health: a population health risk assessment

Particulate matter (PM) air pollution is increasingly recognized as an important and modifiable risk factor for adverse health outcomes including cardiovascular disease (CVD). However, there are still gaps regarding large population risk assessment. Results from the nationwide Behavioral Risk Factor Surveillance System (BRFSS) were used along with air quality monitoring measurements to implement a systematic evaluation of PM-related CVD risks at the national and regional scales. CVD status and individual-level risk factors were collected from more than 500,000 BRFSS respondents across 2,231 contiguous U.S. counties for 2007 and 2009. Chronic exposures to PM pollutants were estimated with spatial modeling from measurement data. CVD outcomes attributable to PM pollutants were assessed by mixed-effects logistic regression and latent class regression (LCR), with adjustment for multicausality. There were positive associations between CVD and PM after accounting for competing risk factors: the multivariable-adjusted odds for the multiplicity of CVD outcomes increased by 1.32 (95% confidence interval: 1.23-1.43) and 1.15 (1.07-1.22) times per 10 μg/m(3) increase in PM(2.5) and PM(10) respectively in the LCR analyses. After controlling for spatial confounding, there were moderate estimated effects of PM exposure on multiple cardiovascular manifestations. These results suggest that chronic exposures to ambient particulates are important environmental risk factors for cardiovascular morbidity.     

健康教育对心脑血管疾病终点事件发生的干预效应

通过健康教育干预探讨对心脑血管疾病发生之影响,为心脑血管疾病的防治工作提供理论依据。方法：从2000年到我院集中体检的大于50岁以上的在职和离退休干部4000人中,抽出资料完整并符合本次研究纳入标准者2000人,随机分为健康干预组和一般治疗对照组各1000人。其中干预组1000人中,高血压480人,高脂血症413人,高血压合并高脂血症107人;对照组1000人中,高血压478人,高脂血症423人．高血压合并高脂血症100人。两组均以高血压、高脂血症作为最主要的危险因素进行健康教育干预。健康教育干预组患者分别建立健康档案,制定系统的健康教育干预措施并组织实施,定期随访：一般治疗对照组患者将体检结果通知本人后,由其在门诊接受健康教育和治疗,对健康教育和治疗方法不作强制性规定。连续观察五年,比较两组五年间心脑血管疾病的发生情况（即以发生AMI／心绞痛、脑出血、脑血栓形成等心脑血管疾病的终点事件为评价标准）。结果：健康教育干预组病情控制良好,发生上述心脑血管疾病终点事件比危险因素对照组明显减少（急性心肌梗塞发生率为2．0％比3．4％,脑血栓发生率为4．3％比7．5％,TIA为2．1％比2．9％）,P〈0．01。结论：对存在心脑血管疾病危险因素者积极开展健康教育干预,可起到控制疾病进一步发展,减少心脑血管疾病终点事件的发生。     

Severity of Depression,Anxious Distress and the Risk of Cardiovascular Disease in a Swedish Population-Based Cohort

Background

Depression is known to be associated with cardiovascular diseases (CVD). This population-based cohort study aimed to determine the association between depression of varying severity and risk for CVD and to study the effect of concomitant anxious distress on this association.

Methods

We utilized data from a longitudinal cohort study of mental health, work and relations among adults (20–64 years), with a total of 10,443 individuals. Depression and anxious distress were assessed using psychiatric rating scales and defined according to DSM-5. Outcomes were register-based and self-reported cardiovascular diseases.

Findings

Overall increased odds ratios of 1.5 to 2.6 were seen for the different severity levels of depression, with the highest adjusted OR for moderate depression (OR 2.1 (95% CI 1.3, 3.5). Similar odds ratios were seen for sub-groups of CVD: ischemic/hypertensive heart disease and stroke, 2.4 (95% CI 1.4, 3.9) and OR 2.1 (95%CI 1.2, 3.8) respectively. Depression with anxious distress as a specifier of severity showed OR of 2.1 (95% CI 1.5, 2.9) for CVD.

Conclusion

This study found that severity level of depression seems to be of significance for increased risk of CVD among depressed persons, although not in a dose-response manner which might be obscured due to treatment of depression. Further, we found a higher risk of CVD among depressed individuals with symptoms of anxious distress.     

Prevalence,incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large‐scale meta‐analysis of 3,211,768 patients and 113,383,368 controls

People with severe mental illness (SMI) – schizophrenia, bipolar disorder and major depressive disorder – appear at risk for cardiovascular disease (CVD), but a comprehensive meta‐analysis is lacking. We conducted a large‐scale meta‐analysis assessing the prevalence and incidence of CVD; coronary heart disease; stroke, transient ischemic attack or cerebrovascular disease; congestive heart failure; peripheral vascular disease; and CVD‐related death in SMI patients (N=3,211,768) versus controls (N=113,383,368) (92 studies). The pooled CVD prevalence in SMI patients (mean age 50 years) was 9.9% (95% CI: 7.4‐13.3). Adjusting for a median of seven confounders, patients had significantly higher odds of CVD versus controls in cross‐sectional studies (odds ratio, OR=1.53, 95% CI: 1.27‐1.83; 11 studies), and higher odds of coronary heart disease (OR=1.51, 95% CI: 1.47‐1.55) and cerebrovascular disease (OR=1.42, 95% CI: 1.21‐1.66). People with major depressive disorder were at increased risk for coronary heart disease, while those with schizophrenia were at increased risk for coronary heart disease, cerebrovascular disease and congestive heart failure. Cumulative CVD incidence in SMI patients was 3.6% (95% CI: 2.7‐5.3) during a median follow‐up of 8.4 years (range 1.8‐30.0). Adjusting for a median of six confounders, SMI patients had significantly higher CVD incidence than controls in longitudinal studies (hazard ratio, HR=1.78, 95% CI: 1.60‐1.98; 31 studies). The incidence was also higher for coronary heart disease (HR=1.54, 95% CI: 1.30‐1.82), cerebrovascular disease (HR=1.64, 95% CI: 1.26‐2.14), congestive heart failure (HR=2.10, 95% CI: 1.64‐2.70), and CVD‐related death (HR=1.85, 95% CI: 1.53‐2.24). People with major depressive disorder, bipolar disorder and schizophrenia were all at increased risk of CVD‐related death versus controls. CVD incidence increased with antipsychotic use (p=0.008), higher body mass index (p=0.008) and higher baseline CVD prevalence (p=0.03) in patients vs. controls. Moreover, CVD prevalence (p=0.007), but not CVD incidence (p=0.21), increased in more recently conducted studies. This large‐scale meta‐analysis confirms that SMI patients have significantly increased risk of CVD and CVD‐related mortality, and that elevated body mass index, antipsychotic use, and CVD screening and management require urgent clinical attention.     

鳄蜥的两性异形

通过比较鳄蜥的体型与头部大小等特征的差异,研究了鳄蜥的两性异形情况.结果表明:性成熟鳄蜥个体体色差异显著,成年雄性头胸部腹面呈鲜红色或浅蓝色,而雌性为浅黄色或淡红色;成年雄性头部显著大于成年雌性(头长(HL),P＜0.001;头宽(HW),P＜0.001),成年雌性腹部长(AL)显著大干成年雄性(P=0.018);而成...     

Submitting articles to the BMJ

ObjectiveTo determine whether people whose marital partners have depression, diabetes, hypertension, ischaemic heart disease, stroke, hyperlipidaemia, peptic ulcer disease, or asthma or chronic obstructive pulmonary disease are at increased risk of the same disease.DesignCross sectional study.Setting10 practices from the Trent Focus Collaborative Research Practice Network.Participants8386 married couples (16 772 individuals) from a population of 29 014 participants aged 30-74 years.OutcomesRisk of disease in participants whose marital partner had that disease compared with those whose partner did not.ResultsAfter both partners'' age, smoking, and obesity and which general practice they attend were adjusted for, participants whose marital partner had asthma, depression, hypertension, hyperlipidaemia, and peptic ulcer disease were at increased risk of having the same disease. The adjusted odds ratios were 1.69 (95% confidence interval 1.43 to 2.98) for asthma, 2.08 (1.71 to 2.54) for depression, 1.32 (1.04 to 1.67) for hypertension, 1.44 (1.19 to 1.75) for hyperlipidaemia, and 2.01 (1.48 to 2.73) for peptic ulcer disease.ConclusionPartners of people with specific diseases are at increased risk of the disease themselves—at least 70% increased risk for asthma, depression, and peptic ulcer disease. This implicates shared environmental causes in some diseases in addition to any genetic or distant exposure or shared behaviours with respect to seeking health care.

What is already known on this topic

People whose spouses have hypertension are at increased risk of hypertensionLittle is known about the risks of disease for spouses of patients with diseases other than hypertension

What this study adds

People whose marital partner had asthma, depression, and peptic ulcer disease were at increased risk of having the same diseaseShared environmental factors contribute to the risk of diseasesThe costs and benefits of screening people for diseases of their spouses needs to be considered     

Anaemia, Haemoglobin Level and Cause-Specific Mortality in People with and without Diabetes

Background

Both anaemia and cardiovascular disease (CVD) are common in people with diabetes. While individually both characteristics are known to raise mortality risk, their combined influence has yet to be quantified. In this pooling project, we examined the combined impact of baseline haemoglobin levels and existing CVD on all-cause and CVD mortality in people with diabetes. We draw comparison of these effects with those apparent in diabetes-free individuals.

Methods/Principal Findings

A combined analyses of 7 UK population-based cohorts resulted in 26,480 study members. There were 946 participants with physician-diagnosed diabetes, 2227 with anaemia [haemoglobin<13 g/dl (men) or <12 (women)], 2592 with existing CVD (stroke, ischaemic heart disease), and 21,396 with none of the conditions. Across diabetes and anaemia subgroups, and using diabetes-free, non-anaemic participants as the referent group, the adjusted hazard ratios (HR) were 1.46 (95% CI: 1.30–1.63) for anaemia, 1.67 (1.45–1.92) for diabetes, and 2.10 (1.55–2.85) for diabetes and anaemia combined. Across combined diabetes, anaemia and CVD subgroups, and compared with non-anaemic, diabetes-free and CVD-free participants, HR (95% CI) for all-cause mortality were 1.49 (1.32–1.69) anaemia, 1.60 (1.46–1.76) for existing CVD, and 1.66 (1.39–1.97) for diabetes alone. Equivalents were 2.13 (1.48–3.07) for anaemia and diabetes, 2.68 (2.14–3.36) for diabetes and existing CVD, and 3.25 (1.88–5.62) for the three combined. Patterns were similar for CVD mortality.

Conclusions/Significance

Individually, anaemia and CVD confer similar mortality risks in people with diabetes, and are excessively fatal in combination. Screening for anaemia would identify vulnerable diabetic patients whose outcomes can potentially be improved.     

Trace element status in Saudi patients with established atherosclerosis

BACKGROUND: Traditional coronary risk factors do not fully explain variations in the incidence of cardiovascular disease (CVD). Epidemiological studies have implicated perturbations in selenium, copper, and zinc metabolism in the aetiology of CVD. However, these studies have been principally undertaken in Caucasian populations, in whom trace element intake is generally sufficient. METHOD: We have measured serum and urine selenium, copper, and zinc; and superoxide dismutase, glutathione peroxidase, and lipid peroxide concentrations in 130 Saudi male subjects with established CVD, and 130 age-matched controls. RESULTS: Diabetes mellitus, positive smoking habit (p<0.0001 for both), and hypertension (p<0.05) were more prevalent among CVD patients. Urinary copper (p<0.0001) and zinc (p<0.05) were higher among controls. Serum selenium concentrations were lower among CVD patients (p<0.001), and a high proportion (52%) had selenium levels below 79mug/L compared to controls (22%) (p<0.0001). Conditional logistic regression analysis, showed the characteristics differentiating CVD patients from controls were serum zinc (odds ratio (OR) 0.92, confidence interval (CI) 0.85-0.99, p<0.05), serum copper/zinc ratio (OR 0.31, CI 0.10-0.96), serum selenium (OR 0.07, CI 0.02-0.31, p<0.0001), and urine selenium (OR 3.34, CI 1.40-7.99, p<0.01). CONCLUSION: Measures of trace metals status appear to be associated with the risk of atherosclerosis in a Saudi male population.     

Association of Leisure-Time Physical Activity to Cardiovascular Disease Prevalence in Relation to Smoking among Adult Nevadans

It is well known that cigarette smoking and physical activity have significant impacts on cardiovascular disease (CVD) mortality and morbidity. Meanwhile, it is of interest to understand whether physical activity protects against CVD for smokers in a similar manner as it does for non-smokers. The present study examined how leisure-time physical activity (LTPA) is associated with the prevalence of CVD in relation to smoking status among adult Nevadans, using data from the 2010 Nevada Behavioral Risk Factor Surveillance System. Of the 3,913 survey respondents, 8.5% self-reported that they had ever been diagnosed with CVD. People with a history of CVD were significantly less likely to engage in LTPA than those with no history of CVD (p < 0.05). After adjusting for common sociodemographic variables, it was revealed that people with CVD were twice more likely to not engage in LTPA than their counterparts independent of smoking status. Without taking LTPA into account, the odds of having CVD for current and former smokers was 1.87–2.25 times higher than the odds for non-smokers. Interestingly, however, if LTPA was accounted for, there was no significant difference in the odds of having CVD between current and non-smokers. These results indicate that LTPA is inversely associated with the prevalence of CVD independent of smoking status, and that regular physical activity may protect against CVD for smokers as well as for non-smokers. Physical activity, along with smoking cessation, should be promoted to better prevent and control CVD among smokers.     

Low concentrations of medium-sized HDL particles predict incident CVD in chronic kidney disease patients

Patients with chronic kidney disease (CKD) are at high risk for CVD. However, traditional CVD risk factors cannot completely explain the increased risk. Altered HDL proteome is linked with incident CVD in CKD patients, but it is unclear whether other HDL metrics are associated with incident CVD in this population. In the current study, we analyzed samples from two independent prospective case-control cohorts of CKD patients, the Clinical Phenotyping and Resource Biobank Core (CPROBE) and the Chronic Renal Insufficiency Cohort (CRIC). We measured HDL particle sizes and concentrations (HDL-P) by calibrated ion mobility analysis and HDL cholesterol efflux capacity (CEC) by cAMP-stimulated J774 macrophages in 92 subjects from the CPROBE cohort (46 CVD and 46 controls) and in 91 subjects from the CRIC cohort (34 CVD and 57 controls). We tested associations of HDL metrics with incident CVD using logistic regression analysis. No significant associations were found for HDL-C or HDL-CEC in either cohort. Total HDL-P was only negatively associated with incident CVD in the CRIC cohort in unadjusted analysis. Among the six sized HDL subspecies, only medium-sized HDL-P was significantly and negatively associated with incident CVD in both cohorts after adjusting for clinical confounders and lipid risk factors with odds ratios (per 1-SD) of 0.45 (0.22–0.93, P = 0.032) and 0.42 (0.20–0.87, P = 0.019) for CPROBE and CRIC cohorts, respectively. Our observations indicate that medium-sized HDL-P—but not other-sized HDL-P or total HDL-P, HDL-C, or HDL-CEC—may be a prognostic cardiovascular risk marker in CKD.