Campos H, Willett W C, Peterson R M, Siles X, Bailey S M, Wilson P W, Posner B M, Ordovas J M, Schaefer E J
Lipid Metabolism Laboratory, USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111.
Arterioscler Thromb. 1991 Jul-Aug;11(4):1089-99. doi: 10.1161/01.atv.11.4.1089.
To assess cross-cultural relations between dietary intake and plasma lipoproteins, we randomly selected 222 men and 243 women from the urban and rural areas of Puriscal, Costa Rica; related their dietary composition (assessed by a food-frequency questionnaire), fitness level, and body fat to plasma lipids, apolipoproteins, and low density lipoprotein (LDL) particle size; and compared these data with those from a subsample of 280 adults from the Framingham Offspring Study. Total cholesterol and LDL cholesterol levels were significantly (p less than 0.0001) higher in Framingham (207 and 137 mg/dl, respectively) than in Puriscal (184 and 114 mg/dl, respectively) residents. Elevated triglyceride and apolipoprotein (apo) B levels (25% and 16% higher), low HDL cholesterol and apo A-I levels (12% and 29% lower), and smaller LDL particles (17%) were more frequent in Puriscal than in Framingham residents. Urban Puriscal residents had a significantly lower fitness level; increased body fat, total cholesterol, and triglyceride levels; decreased HDL cholesterol in men; and higher apo B levels in women compared with rural Puriscal residents. Body fat, animal fat, and saturated fat intakes were significantly correlated with total cholesterol, LDL cholesterol, and apo B levels in both men and women in Puriscal. Intakes of protein and animal fat were higher among urban (10.7% and 14.1%, respectively) compared with rural (8.9% and 9.9%, respectively) Puriscal residents and in Framingham (16.0% and 20.8%, respectively) compared with Puriscal residents. No significant differences were found in dietary cholesterol. Saturated fat (largely from palm oil in Puriscal) intakes were significantly different among the three groups: rural Puriscal, 10.7% of calories; urban Puriscal, 11.6%; and Framingham residents, 12.9%. These data indicate that the more atherogenic plasma lipid profile among urban compared with Puriscal residents was largely explained by increased adiposity, decreased fitness level, and higher saturated fatty acid intake. Puriscal residents consumed less animal fat and more carbohydrate than did Framingham residents, and these differences were associated with a 21% lower LDL cholesterol level, a 12% lower HDL cholesterol level, a 29% lower apo A-I level, a 25% higher triglyceride level, a 16% higher apo B level, and a 17% smaller LDL particle size. Some of these cross-cultural differences may be due to differences in ethnic background and physical activity as well.
为评估饮食摄入与血浆脂蛋白之间的跨文化关系，我们从哥斯达黎加普里斯卡尔的城乡地区随机选取了222名男性和243名女性；将他们的饮食组成（通过食物频率问卷评估）、健康水平和体脂与血浆脂质、载脂蛋白和低密度脂蛋白（LDL）颗粒大小相关联；并将这些数据与弗雷明汉后代研究中280名成年人的子样本数据进行比较。弗雷明汉居民的总胆固醇和LDL胆固醇水平（分别为207和137mg/dl）显著高于普里斯卡尔居民（分别为184和114mg/dl）（p小于0.0001）。普里斯卡尔居民中甘油三酯和载脂蛋白（apo）B水平升高（分别高25%和16%）、HDL胆固醇和apo A-I水平降低（分别低12%和29%）以及LDL颗粒较小（小17%）的情况比弗雷明汉居民更常见。与普里斯卡尔农村居民相比，普里斯卡尔城市居民的健康水平显著较低；体脂、总胆固醇和甘油三酯水平升高；男性HDL胆固醇降低；女性apo B水平升高。在普里斯卡尔，男性和女性的体脂、动物脂肪和饱和脂肪摄入量与总胆固醇、LDL胆固醇和apo B水平显著相关。普里斯卡尔城市居民的蛋白质和动物脂肪摄入量（分别为10.7%和14.1%）高于农村居民（分别为8.9%和9.9%），且弗雷明汉居民（分别为16.0%和20.8%）高于普里斯卡尔居民。饮食胆固醇方面未发现显著差异。饱和脂肪（在普里斯卡尔主要来自棕榈油）摄入量在三组之间存在显著差异：普里斯卡尔农村居民，占卡路里的10.7%；普里斯卡尔城市居民，11.6%；弗雷明汉居民，12.9%。这些数据表明，与普里斯卡尔居民相比，城市居民中更具动脉粥样硬化性的血浆脂质谱在很大程度上可由肥胖增加、健康水平降低和饱和脂肪酸摄入量增加来解释。普里斯卡尔居民比弗雷明汉居民摄入的动物脂肪更少，碳水化合物更多，这些差异与LDL胆固醇水平低21%、HDL胆固醇水平低12%、apo A-I水平低29%、甘油三酯水平高25%、apo B水平高16%以及LDL颗粒大小小17%相关。其中一些跨文化差异可能也归因于种族背景和身体活动的差异。
