Králíková E, Ceska R, Rames J
Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Cent Eur J Public Health. 1999 Feb;7(1):19-23.
This study analysed the diet (based on a 7-day-record), smoking habits and basic anthropometric parameters of patients with familial combined hyperlipidaemia (N = 154, 52% men, 48% women, mean age 55.73 +/- 12.95). These data were correlated with blood lipids and lipoproteins. In high-risk patients' diets we found not quantitative, but mostly qualitative shortcomings: the average energy intake was 104% of the recommended daily intake (RDI), but 34% of the energy was derived from fats. The daily fat intake represented 137% of RDI, and 60 g were of animal and 24 g of vegetable origine. The protein intake was 120% of RDI (155% animal, 75% vegetable protein), the carbohydrate intake was only 86% and the fibre intake 71% of RDI. A very high intake both of cholesterol--139% of RDI and NaCl 151% of RDI--was recorded, while the intake of antioxidant vitamins C and E was only 82% and 35% of RDI, respectively. Current smoking was recorded in 51% of patients. Smokers had also a poorer diet: higher animal fat and protein, as well as a higher cholesterol intake, lower vegetable fat, protein, fibre and vitamin E intake. Surprisingly smokers were found to ingest more vitamin C than non-smokers. As to blood lipids: smokers vs. non-smokers had the following values in mmol/l (SD): total cholesterol 7.8 (+/- 1.3) vs. 7.7 (+/- 1.82), triacylglycerols 3.27 (+/- 2.13) vs. 3.2 (+/- 3.11), HDL-cholesterol 1.25 (+/- 0.39) vs. 1.36 (+/- 0.43), LDL-cholesterol 5.11 (+/- 1.39) vs. 4.95 (+/- 1.51), and, in g/l, apolipoprotein A1 1.8 (+/- 0.30) vs. 1.66 (+/- 0.35), apolipoprotein B 1.66 (+/- 0.35) vs. 1.52 (+/- 0.44), lipoprotein (a) 0.36 (+/- 0.27) vs. 0.43 (+/- 0.50), all without statistical significance. For smokers vs. non-smokers anthropometric data were as follows (mean, SD): body mass index (BMI) 27.74 (+/- 3.77) vs. 27.02 (+/- 3.30), waist/hip ratio (WHR) 0.895 (+/- 0.086) vs. 0.911 (+/- 0.093), and % of body fat 29.6 (+/- 7.4) vs. 27.9 (+/- 7.9). Our conclusions suggest, that lifestyle choice are of great importance for patients with this serious genetic lipid metabolism disorder and that it is important to recognise the danger of risk factor cumulation in connection with cardiovascular diseases.
本研究分析了家族性混合性高脂血症患者（N = 154，男性占52%，女性占48%，平均年龄55.73±12.95岁）的饮食（基于7天记录）、吸烟习惯和基本人体测量参数。这些数据与血脂和脂蛋白相关。在高危患者的饮食中，我们发现存在的不是数量上而是质量上的缺陷：平均能量摄入量为推荐每日摄入量（RDI）的104%，但34%的能量来自脂肪。每日脂肪摄入量占RDI的137%，其中60克为动物脂肪，24克为植物脂肪。蛋白质摄入量为RDI的120%（动物蛋白占155%，植物蛋白占75%），碳水化合物摄入量仅为RDI的86%，纤维摄入量为RDI的71%。记录到胆固醇摄入量非常高，占RDI的139%，氯化钠摄入量占RDI的151%，而抗氧化维生素C和E的摄入量分别仅为RDI的82%和35%。51%的患者有当前吸烟记录。吸烟者的饮食也较差：动物脂肪和蛋白质摄入量较高，胆固醇摄入量也较高，而植物脂肪、蛋白质、纤维和维生素E摄入量较低。令人惊讶的是，发现吸烟者比不吸烟者摄入更多的维生素C。至于血脂：吸烟者与不吸烟者的血脂水平（单位：mmol/l，标准差）如下：总胆固醇7.8（±1.3）与7.7（±1.82），三酰甘油3.27（±2.13）与3.2（±3.11），高密度脂蛋白胆固醇1.25（±0.39）与1.36（±0.43），低密度脂蛋白胆固醇5.11（±1.39）与4.95（±1.51），以及载脂蛋白A1（单位：g/l）1.8（±0.30）与1.66（±0.35），载脂蛋白B 1.66（±0.35）与1.52（±0.44），脂蛋白（a）0.36（±0.27）与0.43（±0.50），所有这些均无统计学意义。吸烟者与不吸烟者的人体测量数据如下（均值，标准差）：体重指数（BMI）27.74（±3.77）与27.02（±3.30），腰臀比（WHR）0.895（±0.086）与0.911（±0.093），以及体脂百分比29.6（±7.4）与27.9（±7.9）。我们的结论表明，对于患有这种严重遗传性脂质代谢紊乱的患者，生活方式的选择非常重要，并且认识到与心血管疾病相关的危险因素累积的危险性很重要。
