Wattigney W A, Harsha D W, Srinivasan S R, Webber L S, Berenson G S
Department of Medicine, Louisiana State University Medical Center, New Orleans 70112-2865.
Arch Intern Med. 1991 Oct;151(10):2017-22.
Obesity is an important determinant of serum lipids and lipoproteins in adults. Since obesity begins early in life, the impact of obesity of serum lipid and lipoprotein levels was examined in 3311 children and young adults (ages 5 to 26 years) from a totally biracial community. Study subjects were grouped according to race, sex, and age categories (5 to 10 years, 11 to 16 years, 17 to 22 years, and 23 to 26 years), excluding females using oral contraceptives or who were pregnant. Overall, associations increase with age, being most prominently noted in white males. The strong positive relation of ponderosity to low-density lipoprotein cholesterol was indicated in the older age groups with correlation coefficients ranging from r = -.09 in the youngest black males to r = .47 in white males aged 17 to 22 years. A negative association was noted between ponderosity and high-density lipoprotein cholesterol with correlation coefficients ranging from r = .08 in black females aged 17 to 22 years to r = -.39 in the oldest white males. Similar results were seen using subscapular skin-fold thickness as a measure of central obesity. Overweight was defined as exceeding 20% above the National Health Anthropometric and Nutritional Examination Survey II survey 50th percentiles. The prevalence of overweight individuals increased with age, being most prominent in black females. The percent(s) of hypercholesterolemic cases, based on the National Cholesterol Education Program criteria, likewise increased with age. A marked proportion of older white males were classified as borderline high and high for low-density lipoprotein cholesterol. A regression model using subscapular skinfold to predict serum lipids and lipoproteins within each age group indicated a consistent increase in the adverse nature of the lipid profile. Intervention and education programs aimed at reducing obesity at younger ages are recommended to reduce serum lipid and lipoprotein levels developing in young adulthood.
肥胖是成年人血清脂质和脂蛋白的重要决定因素。由于肥胖在生命早期就开始出现，因此在一个完全由两个种族组成的社区中，对3311名儿童和年轻人（5至26岁）进行了肥胖对血清脂质和脂蛋白水平影响的研究。研究对象根据种族、性别和年龄类别（5至10岁、11至16岁、17至22岁、23至26岁）进行分组，不包括使用口服避孕药或怀孕的女性。总体而言，相关性随年龄增加，在白人男性中最为显著。在年龄较大的组中，肥胖与低密度脂蛋白胆固醇呈强烈正相关，相关系数范围从最年轻的黑人男性的r = -0.09到17至22岁白人男性的r = 0.47。肥胖与高密度脂蛋白胆固醇之间存在负相关，相关系数范围从17至22岁黑人女性的r = 0.08到最年长白人男性的r = -0.39。使用肩胛下皮褶厚度作为中心性肥胖的指标也得到了类似的结果。超重定义为超过第二次全国健康人体测量和营养检查调查第50百分位数20%以上。超重个体的患病率随年龄增加，在黑人女性中最为突出。根据国家胆固醇教育计划标准，高胆固醇血症病例的百分比同样随年龄增加。相当比例的老年白人男性被归类为低密度脂蛋白胆固醇临界高和高。在每个年龄组中，使用肩胛下皮褶厚度预测血清脂质和脂蛋白的回归模型表明，脂质谱的不良性质持续增加。建议开展旨在降低年轻时肥胖率的干预和教育项目，以降低青年期出现的血清脂质和脂蛋白水平。
