Law M R, Wald N J
Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Medical College of St Bartholomew's Hospital, London, UK.
Eur J Clin Nutr. 1994 May;48(5):305-25.
(i) To carry out a quantitative analysis of the average serum cholesterol levels in different countries in relationship to the ischaemic heart disease (IHD) mortality in these countries. (ii) To examine changes in serum cholesterol levels over time in different countries.
Analysis of published surveys measuring average serum cholesterol in specified communities in different countries.
The original cholesterol surveys were mainly in occupational and residential settings.
Survey data allowed estimation of average serum cholesterol levels during specified time periods for 17 countries; estimates in men aged 40-59 years varied from 3.8 mmol/l (rural China) to 7.0 mmol/l (Finland). Variation in serum cholesterol accounted for 80% of the tenfold range in risk of IHD across countries. A difference in total (or LDL) cholesterol of 0.6 mmol/l between countries was associated with an average difference in IHD mortality of 37% at age 55-64 years. Repeat surveys showed that serum cholesterol reductions of the order of 0.6 mmol/l have occurred in some communities over about 5-10 years.
Variation in serum cholesterol explains four-fifths of the geographical variation in IHD mortality. Reductions in cholesterol of about 0.6 mmol/l (10%) have been achieved in some Western communities or countries over periods of a few years, a change that is associated with a decrease in IHD mortality of over one-third.
（i）对不同国家的平均血清胆固醇水平与这些国家的缺血性心脏病（IHD）死亡率之间的关系进行定量分析。（ii）研究不同国家血清胆固醇水平随时间的变化。
对在不同国家特定社区测量平均血清胆固醇的已发表调查进行分析。
最初的胆固醇调查主要在职业和居住环境中进行。
调查数据使得能够估计17个国家在特定时间段内的平均血清胆固醇水平；40 - 59岁男性的估计值从3.8 mmol/l（中国农村）到7.0 mmol/l（芬兰）不等。血清胆固醇的差异占各国IHD风险十倍范围的80%。各国之间总胆固醇（或低密度脂蛋白胆固醇）相差0.6 mmol/l，与55 - 64岁年龄段IHD死亡率平均相差37%相关。重复调查显示，在大约5 - 10年的时间里，一些社区的血清胆固醇水平降低了约0.6 mmol/l。
血清胆固醇的差异解释了IHD死亡率地域差异的五分之四。在一些西方社区或国家，几年内实现了胆固醇降低约0.6 mmol/l（10%），这一变化与IHD死亡率降低超过三分之一相关。
