Kallio M J, Salmenperä L, Siimes M A, Perheentupa J, Miettinen T A
Children's Hospital, University of Helsinki, Finland.
Pediatrics. 1993 May;91(5):949-54.
To examine the development of tracking of serum cholesterol concentration from birth to childhood.
In a longitudinal study of healthy children, concentrations of total serum cholesterol and triglyceride were determined at birth (n = 193); at 2 (n = 192), 4 (n = 192), 6 (n = 190), 7.5 (n = 118), 9 (n = 188), and 12 months (n = 196); and at 5 years of age (n = 162). Concentrations of cholesterol--very-low-density lipoprotein, low-density lipoprotein, high-density lipoprotein-2 (HDL2), and HDL3--were determined at 2, 6, 9, and 12 months (n = 36) and at 5 years (n = 162).
The correlation coefficients of total cholesterol levels during the first year of life with the level at 5 years of age were as follows: at birth .04, at 2 months .36 (P < .001), at 4 months .26 (P < .001), at 6 months .28 (P < .001), at 7.5 months .25 (P < .001), at 9 months .35 (P < .001), and at 12 months .48 (P < .001). The correlation for exclusively breast-fed children between 6 months and 5 years of age was r = .37, P < .001, while that for children receiving partially breast milk, formula, or solid foods was r = .12, P = not significant (NS), and between 9 months and 5 years r = .38, P < .01, and r = .28, P < .05, respectively. The correlation coefficients of the lipoprotein levels between ages 12 months and 5 years were as follows: low-density lipoprotein cholesterol .58 (P < .001), total HDL cholesterol .30 (P < .05), HDL2 cholesterol .34 (P < .05), HDL3 cholesterol .17 (P = NS), very-low-density lipoprotein cholesterol .24 (P = NS), total triglyceride .37 (P < .05), and triglyceride-very-low-density lipoprotein .37 (P < .05). Of the children whose total serum cholesterol level was above the 90th percentile at birth, or at 2, 4, 6, 7.5, 9, or 12 months, 6%, 35%, 29%, 30%, 31%, 33%, and 45%, respectively, were above the 90th percentile at 5 years of age. In retrospect, 45% of the children whose serum cholesterol level was above the 90th percentile at 5 years were above the 90th percentile at the age of 12 months and 80% were in the highest quartile.
The results indicate that tracking of serum cholesterol concentration during the first year of life is stronger when examining children who are receiving a relatively homogenous diet, such as exclusive breast-feeding, and weaker as children are weaned to formula and solid foods. After the weaning process is completed, children's relative serum cholesterol levels have become established and the tracking of serum cholesterol is of the same magnitude as for older children and adolescents.
研究从出生到儿童期血清胆固醇浓度的追踪情况。
在一项对健康儿童的纵向研究中，测定了193名儿童出生时、192名儿童2个月、192名儿童4个月、190名儿童6个月、118名儿童7.5个月、188名儿童9个月、196名儿童12个月以及162名儿童5岁时的总血清胆固醇和甘油三酯浓度。在36名儿童2、6、9和12个月以及162名儿童5岁时测定了胆固醇、极低密度脂蛋白、低密度脂蛋白、高密度脂蛋白2（HDL2）和高密度脂蛋白3（HDL3）的浓度。
出生后第一年总胆固醇水平与5岁时水平的相关系数如下：出生时为0.04，2个月时为0.36（P < 0.001），4个月时为0.26（P < 0.001），6个月时为0.28（P < 0.001），7.5个月时为0.25（P < 0.001），9个月时为0.35（P < 0.001），12个月时为0.48（P < 0.001）。6个月至5岁纯母乳喂养儿童的相关性为r = 0.37，P < 0.001，而接受部分母乳、配方奶或固体食物的儿童的相关性分别为r = 0.12，P = 无显著性差异（NS），9个月至5岁时分别为r = 0.38，P < 0.01和r = 0.28，P < 0.05。12个月至5岁脂蛋白水平的相关系数如下：低密度脂蛋白胆固醇为0.58（P < 0.001），总HDL胆固醇为0.30（P < 0.05），HDL2胆固醇为0.34（P < 0.05），HDL3胆固醇为0.17（P = NS），极低密度脂蛋白胆固醇为0.24（P = NS），总甘油三酯为0.37（P < 0.05），甘油三酯 - 极低密度脂蛋白为0.37（P < 0.05）。出生时、2、4、6、7.5、9或12个月时总血清胆固醇水平高于第90百分位数的儿童，5岁时分别有6%、35%、29%、30%、31%、33%和45%高于第90百分位数。回顾性分析显示，5岁时血清胆固醇水平高于第90百分位数的儿童中，45%在12个月时高于第90百分位数，80%处于最高四分位数。
结果表明，在研究接受相对同质饮食的儿童（如纯母乳喂养）时，出生后第一年血清胆固醇浓度的追踪更强，而随着儿童断奶改为配方奶和固体食物，追踪变弱。断奶过程完成后，儿童的相对血清胆固醇水平已确立，血清胆固醇的追踪与大龄儿童和青少年的程度相同。
