Srinivasan S R, Wattigney W, Webber L S, Berenson G S
Department of Medicine, Louisiana State University Medical Center, New Orleans 70112.
Prev Med. 1991 Nov;20(6):671-84. doi: 10.1016/0091-7435(91)90063-a.
Serum lipoprotein profiles in 4,231 individuals, ages 5-26 years, were studied cross-sectionally in a biracial community to describe the race- and gender-specific changes from adolescence into young adulthood.
White children and adolescents of both genders showed significantly higher covariates--adjusted triglycerides (9-11 mg/dl) and very-low-density lipoprotein cholesterol (1-2 mg/dl)--and lower total cholesterol (3-14 mg/dl) and high-density lipoprotein cholesterol (6-10 mg/dl) levels than their black counterparts. These black-white differences persisted among young adults of both genders with the exception of total cholesterol levels (higher triglycerides: 23-32 mg/dl; higher very-low-density lipoprotein cholesterol: 5-7 mg/dl; lower high-density lipoprotein cholesterol: 9-11 mg/dl); in addition, white young adult males began to show higher levels of low-density lipoprotein cholesterol (14 mg/dl) than black young adult males. A consistent gender-related pattern emerged only among white young adults with males showing higher triglyceride levels (22 mg/dl), very-low-density lipoprotein cholesterol (5 mg/dl), and low-density lipoprotein cholesterol (10 mg/dl) and lower high-density lipoprotein cholesterol (10 mg/dl) than females. Lipoprotein changes from adolescence into young adulthood were more pronounced among white males than other race-gender groups, resulting in higher triglyceride, very-low-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, a higher total cholesterol/high-density lipoprotein cholesterol ratio, and a lower high-density lipoprotein cholesterol in their young adulthood. According to the National Cholesterol Education Program criteria, a relatively higher proportion of young adult white males was classified as borderline-high (22.6%) or high (9.1%) for low-density lipoprotein cholesterol. Adiposity was the major contributor to the adverse lipoprotein pattern, especially among white males. Sexual maturation and age influenced the lipoprotein levels to a greater extent among white males. Cigarette smoking, alcohol intake, and oral contraceptive use began to emerge as minor but significant factors contributing to the lipoprotein levels in adolescents and young adults.
These results underscore the desirability of early targeting for primary prevention.
在一个双种族社区对4231名年龄在5至26岁的个体进行血清脂蛋白谱的横断面研究，以描述从青春期到青年期种族和性别特异性的变化。
与黑人儿童和青少年相比，白种儿童和青少年无论男女，经协变量调整后的甘油三酯（高9 - 11毫克/分升）和极低密度脂蛋白胆固醇（高1 - 2毫克/分升）显著更高，而总胆固醇（低3 - 14毫克/分升）和高密度脂蛋白胆固醇（低6 - 10毫克/分升）水平更低。这些黑白差异在青年男女中持续存在，但总胆固醇水平除外（甘油三酯更高：23 - 32毫克/分升；极低密度脂蛋白胆固醇更高：5 - 7毫克/分升；高密度脂蛋白胆固醇更低：9 - 11毫克/分升）；此外，白人青年男性开始显示出比黑人青年男性更高的低密度脂蛋白胆固醇水平（高14毫克/分升）。仅在白人青年中出现了一种一致的性别相关模式，男性的甘油三酯水平（22毫克/分升）、极低密度脂蛋白胆固醇（5毫克/分升）和低密度脂蛋白胆固醇（10毫克/分升）更高，而高密度脂蛋白胆固醇（10毫克/分升）比女性更低。从青春期到青年期，白人男性的脂蛋白变化比其他种族 - 性别组更为明显，导致其青年期甘油三酯、极低密度脂蛋白胆固醇和低密度脂蛋白胆固醇更高，总胆固醇/高密度脂蛋白胆固醇比值更高，高密度脂蛋白胆固醇更低。根据美国国家胆固醇教育计划标准，相对较高比例的白人青年男性被归类为低密度脂蛋白胆固醇边缘升高（22.6%）或升高（9.1%）。肥胖是不良脂蛋白模式的主要促成因素，尤其是在白人男性中。性成熟和年龄在白人男性中对脂蛋白水平的影响更大。吸烟、饮酒和口服避孕药的使用开始成为影响青少年和青年脂蛋白水平的次要但显著的因素。
这些结果强调了早期进行一级预防的必要性。
