Garrison R J, Wilson P W, Castelli W P, Feinleib M, Kannel W B, McNamara P M
Metabolism. 1980 Oct;29(11):1053-60. doi: 10.1016/0026-0495(80)90216-4.
This study examines the relationship between obesity and low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and very-low-density lipoprotein (VLDL) cholesterol in 4260 young adult men and women. The strongest association between obesity and LDL cholesterol was found in 20-29 yr-old males, the weakest in 40-49-yr-old males. Conversely, in women the relationship between LDL cholesterol and obesity was modest except in the oldest (40-49 yr) age group. An inverse relationship between obesity and HDL cholesterol was of similar shape and strength in all sex and age-specific groups. When the ratio of total cholesterol (TCHOL) to HDL cholesterol was compared in lean and grossly obese 20-29-yr-old males, substantial differences were found. Since other data show this index of the lipoprotein profile to be the single best indicator of CHD risk, it would appear that the atherogenic potential of obesity is greater than would be suggested by the relatively weak association between obesity and TCHOL or any single lipoprotein cholesterol. These data also suggest that the impact of obesity as a risk factor for CHD may have been underestimated. The paucity of lean males 40-49-yr-old prevents firm conclusions about the CHD risk in such a group. Indirect evidence indicates that lean 40-49-yr-old men would have a markedly more favorable lipoprotein profile and consequently a much lower risk of CHD.
本研究调查了4260名年轻成年男性和女性中肥胖与低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇及极低密度脂蛋白（VLDL）胆固醇之间的关系。肥胖与LDL胆固醇之间的最强关联见于20 - 29岁男性，最弱关联见于40 - 49岁男性。相反，在女性中，LDL胆固醇与肥胖之间的关系除了在年龄最大的（40 - 49岁）年龄组外并不明显。肥胖与HDL胆固醇之间的负相关在所有性别和年龄特定组中具有相似的形态和强度。在体型瘦和严重肥胖的20 - 29岁男性中比较总胆固醇（TCHOL）与HDL胆固醇的比值时，发现了显著差异。由于其他数据表明这种脂蛋白谱指标是冠心病风险的单一最佳指标，肥胖的致动脉粥样硬化潜力似乎大于肥胖与TCHOL或任何单一脂蛋白胆固醇之间相对较弱关联所显示的情况。这些数据还表明，肥胖作为冠心病风险因素的影响可能被低估了。40 - 49岁瘦男性数量较少，妨碍了对该组冠心病风险得出确凿结论。间接证据表明，40 - 49岁瘦男性的脂蛋白谱会明显更有利，因此冠心病风险要低得多。
