Porkka K V, Viikari J S, Taimela S, Dahl M, Akerblom H K
Third Department of Medicine, University of Helsinki, Finland.
Am J Epidemiol. 1994 Dec 15;140(12):1096-110. doi: 10.1093/oxfordjournals.aje.a117210.
The authors analyzed tracking and predictiveness of serum lipid and lipoprotein measurements in Finnish children and young adults over a 12-year follow-up period. A representative sample of 3,596 healthy subjects aged 3-18 years was examined in 1980. The follow-up studies were done in 1983, 1986, 1989, and 1992. Data were available on serum lipids and lipoproteins, anthropometric measurements, dietary and smoking habits, and use of oral contraceptives. Complete data on serum lipids in 1980 and 1992 were available for 883 subjects (47% males), and they comprised the study cohort for this analysis. Significant tracking was found in each of the serum lipid variables studied. The range of 12-year correlations was 0.48-0.58, 0.53-0.58, 0.53-0.58, 0.57-0.59, and 0.33-0.37 for serum total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, the LDL:HDL cholesterol ratio, and triglycerides, respectively. Males showed more tracking than females; there was no clear age trend. Tracking of HDL2 cholesterol was better than that of HDL3 cholesterol (0.64 vs. 0.43, respectively; 3-year tracking). Apolipoproteins A-I and B showed similar amounts of tracking compared with HDL and LDL cholesterol, respectively. Approximately 50% of subjects who initially fell into the extreme quintiles of total cholesterol, LDL cholesterol, and HDL cholesterol were in the same quintiles after 12 years. In multiple regression analyses, childhood obesity, exercise, diet, and smoking habits did not markedly aid the prediction of adult serum lipid values. However, the use of two childhood measurements increased the amount of adult serum lipid variability explained. Although universal screening cannot be endorsed, these findings emphasize the importance of serum lipid measurements in the early detection of familial lipoprotein disorders and in the initial evaluation of coronary heart disease risk in childhood.
作者分析了芬兰儿童和年轻人在12年随访期内血清脂质和脂蛋白测量的追踪情况及预测性。1980年对3596名3至18岁的健康受试者进行了代表性抽样检查。随访研究分别在1983年、1986年、1989年和1992年进行。可获得血清脂质和脂蛋白、人体测量、饮食和吸烟习惯以及口服避孕药使用情况的数据。1980年和1992年有883名受试者（47%为男性）的血清脂质完整数据，他们构成了本次分析的研究队列。在所研究的每个血清脂质变量中均发现了显著的追踪情况。血清总胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇、LDL:HDL胆固醇比值和甘油三酯的12年相关性范围分别为0.48 - 0.58、0.53 - 0.58、0.53 - 0.58、0.57 - 0.59和0.33 - 0.37。男性的追踪情况比女性更明显；没有明显的年龄趋势。HDL2胆固醇的追踪情况优于HDL3胆固醇（分别为0.64对0.43；3年追踪）。载脂蛋白A - I和B的追踪情况分别与HDL和LDL胆固醇相似。最初处于总胆固醇、LDL胆固醇和HDL胆固醇极端五分位数的受试者中，约50%在12年后仍处于相同的五分位数。在多元回归分析中，儿童肥胖、运动、饮食和吸烟习惯对预测成人血清脂质值没有显著帮助。然而，使用两项儿童测量指标增加了解释的成人血清脂质变异性。尽管不能支持普遍筛查，但这些发现强调了血清脂质测量在早期发现家族性脂蛋白疾病以及儿童冠心病风险初始评估中的重要性。
