Mahley R W, Palaoğlu K E, Atak Z, Dawson-Pepin J, Langlois A M, Cheung V, Onat H, Fulks P, Mahley L L, Vakar F
Gladstone Institute of Cardiovascular Disease, Department of Pathology, University of California, San Francisco 94141-9100, USA.
J Lipid Res. 1995 Apr;36(4):839-59.
We examined the plasma lipids, lipoproteins, and selected apolipoproteins in approximately 9,000 men and women from six different regions of Turkey with markedly different diets, ranging from an Aegean coast diet high in olive oil (plasma cholesteryl ester fatty acids enriched in monounsaturated fatty acids) to an inland Anatolian diet high in meat and dairy products (plasma cholesteryl esters enriched in saturated fatty acids). The rural population consuming an olive oil-rich diet had the lowest plasma cholesterol levels (men, 149 mg/dl; women, 150 mg/dl). The urban populations of Istanbul and Adana had higher plasma cholesterol levels (men, 202 and 184 mg/dl, respectively; women, 181 and 190 mg/dl, respectively). Affluent men had the highest cholesterol levels (207 mg/dl). The low density lipoprotein (LDL) cholesterol levels tended to parallel the total cholesterol levels (highest for Istanbul men at 136 mg/dl and lowest for Aegean coast men and women at approximately 100 mg/dl). Strikingly, the Turkish people were found to have very low levels of high density lipoprotein (HDL) cholesterol (HDL-C) (mean values for all six regions: men, 34-38 mg/dl; women, 37-45 mg/dl) and total cholesterol/HDL-C ratios that were high (mean values for all six regions: men, 4.5-5.5; women, 3.9-5.0). The low HDL-C levels appear to be caused, at least in part, by a genetic factor. Triglyceride levels also tended to be high in Turkish men (approximately 120-150 mg/dl) and women (approximately 90-110 mg/dl). Thus, even though the total plasma cholesterol levels are not excessively elevated in comparison to those in other populations, the presence of low HDL-C or low HDL-C coupled with mildly elevated triglyceride levels may represent a significant risk factor for heart disease in the Turkish population. Affluence and higher education were associated with higher cholesterol levels. Lack of physical activity, smoking, and alcohol consumption also tended to be associated with a detrimental lipid profile. Lipoprotein[a] levels were identical among the regions surveyed (mean: 11-15 mg/dl) and displayed the typical distribution with an increased number of individuals with low levels. The 90th percentile value for lipoprotein[a] was about 30 mg/dl for both men and women. Smoking, a major risk factor for heart disease, was very prevalent in the Turkish population, especially in men (50-70% smokers) and women in urban areas (30-40% smokers). Hypertension, defined as a systolic pressure > 140 or a diastolic pressure of > 90 occurred in approximately 17% and 26% of the men and women surveyed, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
我们检测了来自土耳其六个不同地区、饮食差异显著的约9000名男性和女性的血浆脂质、脂蛋白及特定载脂蛋白。饮食差异范围从富含橄榄油的爱琴海沿岸饮食（血浆胆固醇酯脂肪酸富含单不饱和脂肪酸）到富含肉类和奶制品的安纳托利亚内陆饮食（血浆胆固醇酯富含饱和脂肪酸）。食用富含橄榄油饮食的农村人口血浆胆固醇水平最低（男性为149毫克/分升；女性为150毫克/分升）。伊斯坦布尔和阿达纳的城市人口血浆胆固醇水平较高（男性分别为202毫克/分升和184毫克/分升；女性分别为181毫克/分升和190毫克/分升）。富裕男性的胆固醇水平最高（207毫克/分升）。低密度脂蛋白（LDL）胆固醇水平往往与总胆固醇水平平行（伊斯坦布尔男性最高，为136毫克/分升，爱琴海沿岸男性和女性最低，约为100毫克/分升）。引人注目的是，发现土耳其人高密度脂蛋白（HDL）胆固醇（HDL-C）水平极低（所有六个地区的平均值：男性为34 - 38毫克/分升；女性为37 - 45毫克/分升），且总胆固醇/HDL-C比值很高（所有六个地区的平均值：男性为4.5 - 5.5；女性为3.9 - 5.0）。低HDL-C水平似乎至少部分是由遗传因素导致的。土耳其男性（约120 - 150毫克/分升）和女性（约90 - 110毫克/分升）的甘油三酯水平也往往较高。因此，尽管与其他人群相比，血浆总胆固醇水平没有过度升高，但低HDL-C或低HDL-C加上轻度升高的甘油三酯水平可能是土耳其人群患心脏病的重要危险因素。富裕和高学历与较高的胆固醇水平相关。缺乏体育活动、吸烟和饮酒也往往与不良的血脂状况有关。在所调查的地区中，脂蛋白[a]水平相同（平均值：11 - 15毫克/分升），呈现出典型的分布，低水平个体数量增加。男性和女性脂蛋白[a]的第90百分位数约为30毫克/分升。吸烟是心脏病的主要危险因素，在土耳其人群中非常普遍，尤其是男性（50 - 70%吸烟）和城市地区的女性（30 - 40%吸烟）。高血压定义为收缩压>140或舒张压>90，在所调查的男性和女性中分别约有17%和26%出现。（摘要截取自400字）
