Schooling C Mary, Lam Tai Hing, Thomas G Neil, Cowling Benjamin J, Heys Michelle, Janus Edward D, Leung Gabriel M
Department of Community Medicine and School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
PLoS One. 2007 Oct 24;2(10):e1070. doi: 10.1371/journal.pone.0001070.
Sex differences in lipids and body shape, but not diabetes, increase at puberty. Hong Kong Chinese are mainly first or second generation migrants from China, who have shared an economically developed environment for years, but grew up in very different environments in Hong Kong or contemporaneously undeveloped Guangdong, China. We assessed if environment during growth had sex-specific associations with lipids and body shape, but not diabetes.
We used multivariable regression in a population-based cross-sectional study, undertaken from 1994 to 1996, of 2537 Hong Kong Chinese residents aged 25 to 74 years with clinical measurements of ischaemic heart disease (IHD) risk, including HDL-cholesterol, ApoB, diabetes and obesity. Waist-hip ratio was higher (mean difference 0.01, 95% CI 0.001 to 0.02) in men, who had grown up in an economically developed rather than undeveloped environment, as was apolipoprotein B (0.05 g/L, 95% CI 0.001 to 0.10), adjusted for age, socio-economic status and lifestyle. In contrast, the same comparison was associated in women with lower waist-hip ratio (-0.01, 95% CI -0.001 to -0.02) and higher HDL-cholesterol (0.05 mmol/L, 95% CI 0.0004 to 0.10). The associations in men and women were significantly different (p-values<0.001). There were no such differences for diabetes.
Growth in a developed environment with improved nutrition may promote higher sex-steroids at puberty producing an atherogenic lipid profile and male fat pattern in men but the opposite in women, with tracking of increased male IHD risk into adult life.
青春期时,血脂和体型方面存在性别差异,但糖尿病方面不存在。香港华人主要是第一代或第二代从中国内地来的移民,他们多年来共享经济发达的环境,但在香港或当时尚未发展的中国广东的不同环境中长大。我们评估了成长过程中的环境是否对血脂和体型存在性别特异性关联,但对糖尿病不存在。
我们在一项基于人群的横断面研究中使用多变量回归分析,该研究于1994年至1996年进行,纳入了2537名年龄在25至74岁的香港华人居民,对其进行了缺血性心脏病(IHD)风险的临床测量,包括高密度脂蛋白胆固醇、载脂蛋白B、糖尿病和肥胖情况。在调整了年龄、社会经济地位和生活方式后,在经济发达而非不发达环境中长大的男性,其腰臀比更高(平均差异0.01,95%置信区间0.001至0.02),载脂蛋白B也是如此(0.05 g/L,95%置信区间0.001至0.10)。相比之下,同样的比较在女性中与较低的腰臀比(-0.01,95%置信区间-0.001至-0.02)和较高的高密度脂蛋白胆固醇(0.05 mmol/L,95%置信区间0.0004至0.10)相关。男性和女性的关联存在显著差异(p值<0.001)。糖尿病方面不存在此类差异。
在营养改善的发达环境中成长,可能会促使青春期时性类固醇水平升高,从而在男性中产生致动脉粥样硬化的血脂谱和男性脂肪分布模式,但在女性中则相反,男性患缺血性心脏病风险增加的情况会持续到成年期。