Campos H, Bailey S M, Gussak L S, Siles X, Ordovas J M, Schaefer E J
Lipid Metabolism Laboratory, US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111.
Arterioscler Thromb. 1991 Jul-Aug;11(4):1077-88. doi: 10.1161/01.atv.11.4.1077.
Increased general and abdominal obesity has been independently associated with diabetes, increased risk of stroke, and coronary artery disease (CAD). It is more prevalent in developed countries and in urban areas of nonindustrialized nations than in less developed and rural areas. To evaluate the associations between general and abdominal obesity (as determined by total body fat, waist to hip ratio, umbilical to triceps ratio, and umbilical to subscapular ratio) with glucose, plasma lipoproteins, apolipoprotein (apo) A-I and B concentrations, and low density lipoprotein (LDL) particle size (LDL 1-7), we randomly selected 222 men and 243 women from rural and urban areas of Puriscal, Costa Rica. Abdominal obesity, as assessed by the waist to hip ratio, was independently and significantly associated with higher triglyceride levels (p less than 0.01) and with lower high density lipoprotein cholesterol levels (p less than 0.05) in men and women and with higher glucose levels (p less than 0.05) and smaller LDL particle size (p less than 0.01) in women. Abdominal obesity, as assessed by the umbilical to subscapular ratio, was independently and significantly associated with higher total cholesterol (p less than 0.005) and apo B (p less than 0.01) levels. Umbilical to triceps ratio was positively associated with blood pressure in men. Urban men had increased general and abdominal obesity (p less than 0.0001), number of cigarettes smoked per day (p less than 0.0001), and diastolic blood pressure (p less than 0.05) and had a decreased fitness level (p less than 0.0001) as well as higher (p less than 0.05) plasma glucose, triglyceride, and total cholesterol concentrations and lower (p less than 0.05) apo A-I and HDL cholesterol levels compared with rural men. The differences between rural and urban women were not as striking. Urban women had increased general and abdominal obesity, glucose, and apo B levels (p less than 0.05) and a decreased fitness level (p less than 0.0001). Our data indicate that general and abdominal obesity, increased cigarette smoking, diastolic blood pressure, and decreased fitness level are more prevalent in an urban than in a rural area in Costa Rica, particularly in men. The higher prevalence of such risk factors in the urban area is associated with a more atherogenic plasma lipoprotein profile.
全身肥胖及腹型肥胖程度增加已分别与糖尿病、中风风险增加及冠状动脉疾病（CAD）相关联。在发达国家以及非工业化国家的城市地区，其比欠发达地区和农村地区更为普遍。为评估全身肥胖及腹型肥胖（通过体脂总量、腰臀比、脐三头肌比值及脐肩胛下比值来确定）与血糖、血浆脂蛋白、载脂蛋白（apo）A-I和B浓度以及低密度脂蛋白（LDL）颗粒大小（LDL 1-7）之间的关联，我们从哥斯达黎加普里西卡尔的农村和城市地区随机选取了222名男性和243名女性。通过腰臀比评估的腹型肥胖，在男性和女性中均与较高的甘油三酯水平（p<0.01）及较低的高密度脂蛋白胆固醇水平（p<0.05）独立且显著相关，在女性中还与较高的血糖水平（p<0.05）及较小的LDL颗粒大小（p<0.01）相关。通过脐肩胛下比值评估的腹型肥胖，与较高的总胆固醇（p<0.005）及apo B（p<0.01）水平独立且显著相关。脐三头肌比值在男性中与血压呈正相关。与农村男性相比，城市男性的全身肥胖及腹型肥胖程度增加（p<0.0001）、每日吸烟量增加（p<0.0001）、舒张压升高（p<0.05）、身体适应能力下降（p<0.0001），且血浆葡萄糖、甘油三酯和总胆固醇浓度较高（p<0.05），apo A-I和高密度脂蛋白胆固醇水平较低（p<0.05）。农村和城市女性之间的差异没有那么显著。城市女性的全身肥胖及腹型肥胖、血糖和apo B水平升高（p<0.05），身体适应能力下降（p<0.0001）。我们的数据表明，在哥斯达黎加，全身肥胖及腹型肥胖、吸烟量增加、舒张压升高和身体适应能力下降在城市比农村更为普遍，尤其是在男性中。城市地区这些危险因素的较高患病率与更具动脉粥样硬化性的血浆脂蛋白谱相关。
