Kristenson M, Ziedén B, Kucinskienë Z, Elinder L S, Bergdahl B, Elwing B, Abaravicius A, Razinkovienë L, Calkauskas H, Olsson A G
Department of Health and Environment, Faculty of Health Science, inköping, Sweden.
BMJ. 1997 Mar 1;314(7081):629-33. doi: 10.1136/bmj.314.7081.629.
To investigate possible risk factors and mechanisms behind the four times higher and diverging mortality from coronary heart disease in Lithuanian compared with Swedish middle aged men.
Concomitant cross sectional comparison of randomly selected 50 year old men without serious acute or chronic disease. Methods and equipment were identical or highly standardised between the centres.
Linköping (Sweden) and Vilnius (Lithuania).
101 and 109 men aged 50 in Linköping and Vilnius respectively.
Anthropometric data, blood pressure, smoking, plasma lipid and lipoprotein concentrations, susceptibility of low density lipoprotein to oxidation, and plasma concentrations of fat soluble antioxidant vitamins.
Systolic blood pressure was higher (141 v 133 mm Hg, P < 0.01), smoking habits were similar, and plasma total cholesterol (5.10 v 5.49 mmol/l, P < 0.01) and low density lipoprotein cholesterol (3.30 v 3.68 mmol/l, P < 0.01) lower in men from Vilnius compared with those from Linköping. Triglyceride, high density lipoprotein cholesterol, and Lp(a) lipoprotein concentrations did not differ between the two groups. The resistance of low density lipoprotein to oxidation was lower in the men from Vilnius; lag phase was 67.6 v 79.5 minutes (P < 0.001). Also lower in the men from Vilnius were mean plasma concentrations of lipid soluble antioxidant vitamins (beta carotene 377 v 510 nmol/l, P < 0.01; lycopene 327 v 615 nmol/l, P < 0.001; and lipid adjusted gamma tocopherol 0.25 v 0.46 mumol/mmol, P < 0.001. alpha Tocopherol concentration did not differ). Regression analysis showed that the lag phase was still significantly shorter by 10 minutes in men from Vilnius when the influence of other known factors was taken into account.
The high mortality from coronary heart disease in Lithuania is not caused by traditional risk factors alone. Mechanisms related to antioxidant state may be important.
探究立陶宛中年男性冠心病死亡率比瑞典中年男性高四倍且存在差异的潜在风险因素及机制。
对随机选取的无严重急性或慢性疾病的50岁男性进行同步横断面比较。各中心的方法和设备相同或高度标准化。
林雪平（瑞典）和维尔纽斯（立陶宛）。
林雪平和维尔纽斯分别有101名和109名50岁男性。
人体测量数据、血压、吸烟情况、血浆脂质和脂蛋白浓度、低密度脂蛋白氧化易感性以及脂溶性抗氧化维生素的血浆浓度。
与林雪平的男性相比，维尔纽斯男性的收缩压更高（141对133毫米汞柱，P<0.01），吸烟习惯相似，血浆总胆固醇更低（5.10对5.49毫摩尔/升，P<0.01），低密度脂蛋白胆固醇也更低（3.30对3.68毫摩尔/升，P<0.01）。两组的甘油三酯、高密度脂蛋白胆固醇和脂蛋白(a)浓度无差异。维尔纽斯男性的低密度脂蛋白抗氧化能力更低；迟滞期为67.6对79.5分钟（P<0.001）。维尔纽斯男性的脂溶性抗氧化维生素平均血浆浓度也更低（β-胡萝卜素377对510纳摩尔/升，P<0.01；番茄红素327对615纳摩尔/升，P<0.001；脂质校正γ-生育酚0.25对0.46微摩尔/毫摩尔，P<0.001。α-生育酚浓度无差异）。回归分析显示，在考虑其他已知因素的影响后，维尔纽斯男性的迟滞期仍显著短10分钟。
立陶宛冠心病的高死亡率并非仅由传统风险因素导致。与抗氧化状态相关的机制可能很重要。
