Ghosh A
Palli Charcha Kendra, Visva Bharati University, Santiniketan, West Bengal, India.
Eur J Clin Nutr. 2007 Mar;61(3):412-9. doi: 10.1038/sj.ejcn.1602534. Epub 2006 Sep 27.
To compare obesity measures, metabolic profiles and dietary fatty acids in lean and obese dyslipideamic Asian Indian male subjects.
Cross-sectional.
Asian Indians living in the eastern part of India.
One hundred and thirty (Group I: lean control, n=50; Group II: lean dyslipidaemic, n=40 and Group III: obese dyslipidaemic, n=40) Asian Indian male subjects (> or =30 years) living in the eastern part of India.
Anthropometric measures namely height, weight, circumferences of waist (WC) and hip, lipids (total cholesterol (TC) and triglycerides (TG)), lipoproteins (high- (HDL) and low-density lipoproteins (LDL)), fasting plasma glucose (FPG) and dietary fatty acids were obtained from each participant. Obesity measures, that is, body mass index (BMI), waist-hip ratio (WHR) and conicity index (CI) were subsequently calculated from anthropometric measures. Obesity was defined as individuals having BMI> or =25 kg/m(2). SUBJECTS with one or more of the following conditions were considered as dyslipidaemic: TG> or =2.3 mmol/l, TC> or =6.2 mmol/l, or TC/HDL> or =4.4 mmol/l. Daily intake of nutrients as well as saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) were estimated by adding together all the foodstuffs consumed on weekly and monthly manner. Conversion of foodstuffs into nutrients was performed according to standard nutritive values of Indian foodstuffs.
Analysis of variance with Scheffe's post hoc test revealed that Group I had significantly lower mean compared to both Group II and Group III for age, WC, WHR, CI, TC, TG, LDL, FPG, total carbohydrates intake and intake of trans fatty acids. On the other hand, Group I had significantly lower mean than Group III only for BMI as well as intake of total proteins, total fats, total energy and erucic acids. Although, Group I had significantly greater mean compared to both Group II and Group III for HDL, UFA/SFA, MUFA/SFA and PUFA/SFA. Pearson's partial correlations (controlling for age and total energy) revealed that central obesity measures (WC, WHR and CI) had significant association with dietary fatty acids and their ratios. Furthermore, partial correlations (controlling for age) also showed that the ratios of unsaturated to SFA had significant negative association with lipids, lipoproteins (except HDL) and plasma glucose. Discriminant function analysis revealed that overall 78% of all entries were positively (correctly) classified in three groups using fatty acids and their ratios.
It seems rational to argue that while dealing with dyslipidaemic Asian Indians, clinicians should consider obesity measures, metabolic profiles and dietary fatty acids simultaneously to better comprehend the condition (s).
比较体型偏瘦和肥胖的血脂异常亚洲印度男性受试者的肥胖指标、代谢状况和膳食脂肪酸情况。
横断面研究。
生活在印度东部的亚洲印度人。
130名(第一组:体型偏瘦的对照组,n = 50;第二组:体型偏瘦的血脂异常者,n = 40;第三组:肥胖的血脂异常者,n = 40)年龄≥30岁、生活在印度东部的亚洲印度男性受试者。
测量每位受试者的人体测量学指标,即身高、体重、腰围(WC)和臀围,血脂(总胆固醇(TC)和甘油三酯(TG)),脂蛋白(高密度脂蛋白(HDL)和低密度脂蛋白(LDL)),空腹血糖(FPG)以及膳食脂肪酸。随后根据人体测量学指标计算肥胖指标,即体重指数(BMI)、腰臀比(WHR)和锥度指数(CI)。肥胖定义为BMI≥25kg/m²。具有以下一种或多种情况的受试者被视为血脂异常:TG≥2.3mmol/l、TC≥6.2mmol/l或TC/HDL≥4.4mmol/l。通过汇总每周和每月食用的所有食物来估算每日营养素以及饱和脂肪酸(SFA)、单不饱和脂肪酸(MUFA)和多不饱和脂肪酸(PUFA)的摄入量。根据印度食物的标准营养价值将食物转化为营养素。
采用谢费尔事后检验的方差分析显示,第一组在年龄、WC、WHR、CI、TC、TG、LDL、FPG、总碳水化合物摄入量和反式脂肪酸摄入量方面的均值显著低于第二组和第三组。另一方面,第一组仅在BMI以及总蛋白质、总脂肪、总能量和芥酸摄入量方面的均值显著低于第三组。尽管如此,第一组在HDL、不饱和脂肪酸/饱和脂肪酸(UFA/SFA)、单不饱和脂肪酸/饱和脂肪酸(MUFA/SFA)和多不饱和脂肪酸/饱和脂肪酸(PUFA/SFA)方面的均值显著高于第二组和第三组。皮尔逊偏相关分析(控制年龄和总能量)显示,中心性肥胖指标(WC、WHR和CI)与膳食脂肪酸及其比例显著相关。此外,偏相关分析(控制年龄)还表明,不饱和脂肪酸与饱和脂肪酸的比例与血脂、脂蛋白(HDL除外)和血糖呈显著负相关。判别函数分析显示,总体而言,使用脂肪酸及其比例可将所有受试者中的78%正确地分为三组。
有理由认为,在治疗血脂异常的亚洲印度人时,临床医生应同时考虑肥胖指标、代谢状况和膳食脂肪酸,以便更好地了解病情。