Hobbs Michael S, Knuiman Matthew W, Briffa Tom, Ngo Hanh, Jamrozik Konrad
School of Population Health, University of Western Australia, Nedlands WA, Australia.
Eur J Cardiovasc Prev Rehabil. 2008 Jun;15(3):319-24. doi: 10.1097/HJR.0b013e3282f3c76b.
The rising prevalence of obesity and its putative impact on coronary risk factors threatens the sustained decline in the incidence of coronary heart disease. An understanding of the temporal relationship between obesity and other risk factors is required.
Independent cross-sectional surveys.
We analysed standardized data from five population surveys of risk factors involving Perth men (n=2767) and women (n=2833) aged 35-64 years from 1980 to 1999. Trends in plasma cholesterol, BMI and waist-hip ratio were assessed.
Striking annual increases were noted in BMI (and waist-hip ratio) of 0.075 kg/m in men and 0.083 kg/m in women (each P<0.0001), approximating an 0.8% annual rise in the prevalence of overweight. In contrast, annual mean total cholesterol fell by 0.024 mmol/l in men and 0.030 mmol/l in women (both P<0.0001), adjusted for confounders. Similarly, the prevalence of cholesterol>or=6.5 mmol/l declined an average of 0.6% per annum in men [odds ratio (OR)=0.970, 95% confidence interval (CI) 0.954-0.985, P=0.0002)] and by 0.9% in women (OR=0.955, 95% CI 0.938-0.971, P<0.0001). Decreases in cholesterol were associated with a downward population shift and increasing awareness and treatment of high cholesterol among the elderly.
Despite rapid increases in adult obesity, plasma mean cholesterol levels have fallen, due possibly to both dietary changes and greater awareness and treatment of high cholesterol in some individuals. This finding fails to confirm a positive association between trends in obesity and plasma cholesterol in the general population.
肥胖患病率的上升及其对冠心病危险因素的假定影响，威胁着冠心病发病率的持续下降。需要了解肥胖与其他危险因素之间的时间关系。
独立横断面调查。
我们分析了1980年至1999年对珀斯35至64岁男性（n = 2767）和女性（n = 2833）进行的五项危险因素人群调查的标准化数据。评估了血浆胆固醇、体重指数（BMI）和腰臀比的趋势。
男性BMI（和腰臀比）每年显著增加0.075kg/m²，女性为0.083kg/m²（均P<0.0001），超重患病率每年约上升0.8%。相比之下，在对混杂因素进行校正后，男性的年平均总胆固醇下降了0.024mmol/L，女性下降了0.030mmol/L（均P<0.0001）。同样，胆固醇≥6.5mmol/L的患病率男性每年平均下降0.6%[比值比（OR）=0.970，95%置信区间（CI）0.954 - 0.985，P = 0.0002]，女性下降0.9%（OR = 0.955，95%CI 0.938 - 0.971，P<0.0001）。胆固醇的降低与人群分布的下移以及老年人对高胆固醇认识和治疗的增加有关。
尽管成年肥胖迅速增加，但血浆平均胆固醇水平却有所下降，这可能是由于饮食变化以及部分人群对高胆固醇的认识和治疗增加所致。这一发现未能证实普通人群中肥胖趋势与血浆胆固醇之间存在正相关。
