Mann J I, Lewis B, Shepherd J, Winder A F, Fenster S, Rose L, Morgan B
Department of Community Medicine, University of Oxford.
Br Med J (Clin Res Ed). 1988 Jun 18;296(6638):1702-6. doi: 10.1136/bmj.296.6638.1702.
To establish the distribution of blood lipid concentrations and the prevalences of other risk factors for cardiovascular disease in Britain 12,092 men and women aged 25-59 in Glasgow, Leicester, London, and Oxford were studied. Subjects were selected by opportunistic case finding, in which patients consulting their general practitioner for any reason were offered a health check by appointment, or random selection from age-sex registers, in which an invitation for a health check was posted. The overall rate of response was 73%, being 91-94% by opportunistic case finding and 36-63% by random selection. At the health check subjects answered a brief questionnaire about risk factors for cardiovascular disease, and their height, weight, and blood pressure were recorded; a blood sample was taken for measuring plasma concentrations of cholesterol, triglyceride, high density lipoprotein cholesterol, and glucose. The mean cholesterol concentrations were 5.9 (SD 1.2) and 5.8 (1.2) mmol/l in men and women, respectively. In London the mean value was 5.5 (1.2) mmol/l for both men and women and was significantly lower than mean values in the three other centres, among which there were no significant differences. In men and women aged 25-29 concentrations were similar but they increased in men until the age of 45-49, after which they showed no further increase; in women concentrations did not increase until the age of 40-44 and by the age of 50-59 values were higher than in men. Mean triglyceride concentrations were significantly higher in men than in women (1.8 (1.4) v 1.3 (0.9) mmol/l, respectively), and trends with age were similar to those for cholesterol concentrations, except that at no age were values higher in women than in men. Mean triglyceride values overall were higher in Glasgow and London than in Oxford and Leicester. Body mass index was higher in Glasgow and London than in the other two centres and correlated with systolic and diastolic blood pressures and triglyceride concentration. In addition, subjects in Glasgow smoked significantly more than those in the other centres. These observations could contribute to the higher rate of coronary heart disease in Glasgow. Plasma lipid concentrations and the prevalences of other risk factors for cardiovascular disease were similar in subjects selected by opportunistic case finding and by random selection. In Britain cholesterol values have changed little during the past 12 years despite dietary recommendations and health education.(ABSTRACT TRUNCATED AT 400 WORDS)
为了确定英国血脂浓度的分布情况以及心血管疾病其他危险因素的流行率,对格拉斯哥、莱斯特、伦敦和牛津的12092名年龄在25至59岁之间的男性和女性进行了研究。研究对象通过机会性病例发现法选取,即任何原因咨询全科医生的患者可预约进行健康检查,或者从年龄 - 性别登记册中随机选取,即向其发送健康检查邀请。总体应答率为73%,通过机会性病例发现法的应答率为91% - 94%,通过随机选取的应答率为36% - 63%。在健康检查时,研究对象回答了一份关于心血管疾病危险因素的简短问卷,并记录了他们的身高、体重和血压;采集血样以测量血浆中胆固醇、甘油三酯、高密度脂蛋白胆固醇和葡萄糖的浓度。男性和女性的平均胆固醇浓度分别为5.9(标准差1.2)和5.8(1.2)mmol/L。在伦敦,男性和女性的平均值均为5.5(1.2)mmol/L,显著低于其他三个中心的平均值,而其他三个中心之间无显著差异。25至29岁的男性和女性胆固醇浓度相似,但男性的浓度在45至49岁之前持续上升,之后不再升高;女性的浓度直到40至44岁才开始上升,到50至59岁时高于男性。男性的平均甘油三酯浓度显著高于女性(分别为1.8(1.4)和1.3(0.9)mmol/L),年龄趋势与胆固醇浓度相似,只是在任何年龄女性的值都不高于男性。格拉斯哥和伦敦的总体平均甘油三酯值高于牛津和莱斯特。格拉斯哥和伦敦的体重指数高于其他两个中心,且与收缩压、舒张压和甘油三酯浓度相关。此外,格拉斯哥的研究对象吸烟量显著多于其他中心。这些观察结果可能是格拉斯哥冠心病发病率较高的原因。通过机会性病例发现法和随机选取法选取的研究对象中,血浆脂质浓度和心血管疾病其他危险因素的流行率相似。在英国,尽管有饮食建议和健康教育,但在过去12年中胆固醇值变化不大。(摘要截选至400字)