Bakx J C, van den Hoogen H J, Deurenberg P, van Doremalen J, van den Bosch W J
Department of General Practice, University of Nijmegen, Nijmegen, The Netherlands.
Prev Med. 2000 Feb;30(2):138-45. doi: 10.1006/pmed.1999.0608.
This study aimed to investigate to what extent cholesterol levels change in individuals in different age groups over an 18-year period. Factors that contribute to the changes, with respect to prevention of cardiovascular disease, were taken into account.
In 1977 serum cholesterol, systolic and diastolic blood pressures, body mass index, and smoking habits were measured in a cohort of 7,092 patients (men and women from 20 to 50 years of age) from six general practices in The Netherlands. In 1995, a sample of 2,600 of these same patients were invited to take part in a similar screening program; 2,335 patients, consisting of 1,171 men and 1,164 women, agreed to participate. Patients were derived from both high-risk and low- to normal-risk category in 1977. The differences in cholesterol between 1977 and 1995 were calculated and cholesterol levels were tracked over the study period by determining Pearson correlation coefficients. A multiple linear regression analysis was performed to investigate the determinants influencing the changes in cholesterol level.
The mean cholesterol levels rose during the study period in all age groups. The highest mean increase in men was 1.23 mmol/L, or 20%, in the youngest age group (20-24 years), and in women the maximum mean increase was 1.12 mmol/L, or 17%, in the age group 40-44 years. Correlation coefficients between the 1977 and 1995 readings varied from 0.63 in the youngest age group to 0.41 in the oldest. Body weight change during the study period, more than initial body weight, was found to have influenced the rise in serum cholesterol. At basic screening, 19.2% of the men and 12.4% of the women had cholesterol levels of 6. 5 mmol/L or higher, as against 35.8 and 36.8%, respectively, in 1995.
Over an 18-year period cholesterol level increased in most subjects, at a younger age in men than in women. The highest increase in women took place during the menopausal period. Weight gain, more than baseline weight, had a positive influence on the increase in cholesterol.
本研究旨在调查不同年龄组个体的胆固醇水平在18年期间的变化程度。研究还考虑了与心血管疾病预防相关的促成这些变化的因素。
1977年，对来自荷兰六个全科医疗中心的7092名患者（年龄在20至50岁之间的男性和女性）进行了血清胆固醇、收缩压和舒张压、体重指数及吸烟习惯的测量。1995年，邀请了这些患者中的2600人参加类似的筛查项目；2335名患者（包括1171名男性和1164名女性）同意参与。这些患者在1977年时既有高危人群，也有低至正常风险人群。计算了1977年和1995年胆固醇水平的差异，并通过确定皮尔逊相关系数在研究期间追踪胆固醇水平。进行了多元线性回归分析以研究影响胆固醇水平变化的决定因素。
在研究期间，所有年龄组的平均胆固醇水平均有所上升。男性中，最年轻年龄组（20 - 24岁）的平均增幅最高，为1.23 mmol/L，即20%；女性中，40 - 44岁年龄组的平均增幅最大，为1.12 mmol/L，即17%。1977年和1995年测量值之间的相关系数从最年轻年龄组的0.63到最年长年龄组的0.41不等。研究期间体重的变化比初始体重对血清胆固醇的升高影响更大。在基础筛查时，19.2%的男性和12.4%的女性胆固醇水平达到或高于6.5 mmol/L，而在1995年，这一比例分别为35.8%和36.8%。
在18年期间，大多数受试者的胆固醇水平升高，男性升高的年龄比女性小。女性胆固醇水平升高幅度最大的时期是绝经期。体重增加而非基线体重对胆固醇升高有积极影响。
