Ginsberg H N, Karmally W, Siddiqui M, Holleran S, Tall A R, Blaner W S, Ramakrishnan R
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Arterioscler Thromb Vasc Biol. 1995 Feb;15(2):169-78. doi: 10.1161/01.atv.15.2.169.
We studied the effects of dietary cholesterol intake on lipid and lipoprotein levels in healthy young women (n = 13) who were otherwise eating an American Heart Association (AHA) diet. The study used a randomized, three-way crossover design to determine the effects of 0, 1, or 3 eggs added per day (dietary cholesterol range, 108 to 667 mg/d). Each of the three diets was eaten for 8 weeks, with a washout period between diets. Three fasting blood samples were obtained during the last 3 weeks of each diet period to observe changes in fasting plasma lipid levels associated with the menstrual cycle. We also obtained blood just before and 4 and 8 hours after the subjects ingested a standard high-fat formula. During the menstrual cycle, total cholesterol and LDL cholesterol levels fell by 0.051 mmol/L (1.99 mg/dL) and 0.064 mmol/L (2.48 mg/dL) per week, respectively. HDL cholesterol concentrations increased by 0.060 mmol/L (2.3 mg/dL) per week during the first half of the cycle and then fell by 0.050 mmol/L (1.94 mg/dL) per week during the second half. Therefore, all statistical analyses were performed on values adjusted to midcycle. Total fasting cholesterol concentrations increased by 0.073 mmol/L (2.81 mg/dL) per 100 mg dietary cholesterol added to the diet per day (P = .001). LDL cholesterol increased by 0.054 mmol/L (2.08 mg/dL) per 100 mg/d dietary cholesterol (P = .003); this accounted for about 75% of the rise in total cholesterol. HDL cholesterol concentrations increased by 0.015 mmol/L (0.57 mg/dL) per 100 mg/d dietary cholesterol (P < .04). There was a wide range of responses among the women. Plasma apoB levels increased significantly, 0.93 mg/dL per 100 mg/d dietary cholesterol (P = .025), whereas apoA-I levels tended to rise (1.35 mg/dL per 100 mg/d, P = .056). Increases in dietary cholesterol did not produce any observable effects on fasting plasma cholesteryl ester transfer protein levels and had no effect on the response to a standard high-fat formula. Although menstrual-cycle changes in plasma total, LDL, and HDL cholesterol levels were observed, the effects of the diets were similar in the follicular and luteal phases of the menstrual cycle. Additionally, despite changes associated with the menstrual cycle, within-subject variation in plasma total cholesterol was actually smaller in this study than in our study of young men.
我们研究了膳食胆固醇摄入量对健康年轻女性(n = 13)血脂和脂蛋白水平的影响,这些女性原本遵循美国心脏协会(AHA)饮食。该研究采用随机、三因素交叉设计,以确定每天添加0、1或3个鸡蛋(膳食胆固醇范围为108至667 mg/d)的效果。三种饮食方案各持续8周,不同饮食方案之间设有洗脱期。在每个饮食阶段的最后3周采集三份空腹血样,以观察与月经周期相关的空腹血浆脂质水平变化。我们还在受试者摄入标准高脂配方食品之前、之后4小时和8小时采集血液。在月经周期中,总胆固醇和低密度脂蛋白胆固醇水平每周分别下降0.051 mmol/L(1.99 mg/dL)和0.064 mmol/L(2.48 mg/dL)。高密度脂蛋白胆固醇浓度在周期前半段每周增加0.060 mmol/L(2.3 mg/dL),然后在后半段每周下降0.050 mmol/L(1.94 mg/dL)。因此,所有统计分析均基于调整至月经周期中期的值进行。每天饮食中每添加100 mg膳食胆固醇,空腹总胆固醇浓度增加0.073 mmol/L(2.81 mg/dL)(P = 0.001)。每100 mg/d膳食胆固醇,低密度脂蛋白胆固醇增加0.054 mmol/L(2.08 mg/dL)(P = 0.003);这约占总胆固醇升高的75%。每100 mg/d膳食胆固醇,高密度脂蛋白胆固醇浓度增加0.015 mmol/L(0.57 mg/dL)(P < 0.04)。女性之间的反应存在很大差异。血浆载脂蛋白B水平显著升高,每100 mg/d膳食胆固醇升高0.93 mg/dL(P = 0.025),而载脂蛋白A-I水平有升高趋势(每100 mg/d升高1.35 mg/dL,P = 0.056)。膳食胆固醇增加对空腹血浆胆固醇酯转运蛋白水平未产生任何可观察到的影响,对标准高脂配方食品的反应也无影响。尽管观察到血浆总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇水平在月经周期中的变化,但饮食在月经周期的卵泡期和黄体期的影响相似。此外,尽管存在与月经周期相关的变化,但在本研究中,血浆总胆固醇的个体内变异实际上比我们对年轻男性的研究更小。