Ehnholm C, Huttunen J K, Pietinen P, Leino U, Mutanen M, Kostiainen E, Pikkarainen J, Dougherty R, Iacono J, Puska P
N Engl J Med. 1982 Sep 30;307(14):850-5. doi: 10.1056/NEJM198209303071403.
The population of North Karelia, a county in Finland, has a high rate of coronary heart disease. It also has a high prevalence of hypercholesterolemia, but whether this reflects a diet rich in animal fats or is a result of genetic factors is unclear. We studied the effect on serum lipoproteins of a low-fat diet with a high ratio of polyunsaturated to saturated fatty acids in 54 middle-aged volunteers in North Karelia. Total serum cholesterol decreased, from 263 +/- 8 mg per deciliter (mean +/- S.E.) to 201 +/- 5 mg in men (P less than 0.0001) and from 239 +/- 8 to 188 +/- 8 mg in women (P less than 0.0001), along with low-density-lipoprotein cholesterol and apoprotein B. High-density lipoprotein decreased from 54 +/- 2 mg per deciliter to 44 +/- 2 in men (P less than 0.0001) and from 56 +/- 3 to 47 +/- 2 mg in women (P less than 0.0001). A small but significant reduction occurred in serum apoprotein A-I, whereas apoprotein A-II increased slightly. The individual changes in low-density-lipoprotein cholesterol correlated with those in high-density-lipoprotein cholesterol. The changes in serum lipids and apoproteins were reversed when the participants returned to their original diets. Our results suggest that the hypercholesterolemia characteristic of this population is due at least in part to dietary factors.
芬兰的北卡累利阿省居民的冠心病发病率很高。该地区高胆固醇血症的患病率也很高，但这是反映了富含动物脂肪的饮食，还是遗传因素的结果尚不清楚。我们对北卡累利阿省的54名中年志愿者进行了研究，观察了一种多不饱和脂肪酸与饱和脂肪酸比例高的低脂饮食对血清脂蛋白的影响。男性血清总胆固醇从每分升263±8毫克（均值±标准误）降至201±5毫克（P<0.0001），女性从239±8毫克降至188±8毫克（P<0.0001），同时低密度脂蛋白胆固醇和载脂蛋白B也下降。男性高密度脂蛋白从每分升54±2毫克降至44±2毫克（P<0.0001），女性从56±3毫克降至47±2毫克（P<0.0001）。血清载脂蛋白A-I有小幅但显著的降低，而载脂蛋白A-II略有升高。低密度脂蛋白胆固醇的个体变化与高密度脂蛋白胆固醇的变化相关。当参与者恢复原来的饮食时，血脂和载脂蛋白的变化逆转。我们的结果表明，该人群的高胆固醇血症特征至少部分归因于饮食因素。
