Dwyer T, Iwane H, Dean K, Odagiri Y, Shimomitsu T, Blizzard L, Srinivasan S, Nicklas T, Wattigney W, Riley M, Berenson G
Menzies Centre for Population Health Research, WHO Collaborating Centre for Population Based Cardiovascular Disease Prevention Programmes, University of Tasmania, Hobart, Australia.
Circulation. 1997 Nov 4;96(9):2830-6. doi: 10.1161/01.cir.96.9.2830.
Mortality from coronary heart disease is relatively low in Japan compared with other developed countries and has remained low despite an increasing standard of living and an apparent increase in mean plasma cholesterol concentration in adults over the past three decades. Important differences in childhood plasma lipoprotein profile might contribute to some of the difference in coronary heart disease mortality seen between Japan and both Australia and North America.
Plasma HDL cholesterol and total cholesterol were surveyed in representative populations of schoolchildren in Australia, Japan, and Bogalusa, La. The mean concentration of plasma HDL cholesterol (but not total cholesterol) was higher for Japanese schoolchildren than for Australian or US schoolchildren (P<.001). In addition, the difference in plasma HDL cholesterol between the ages of 8 to 10 years and 12 to 15 years was much greater for Australian (boys, 15.2%; girls, 2.6%) and US (boys, 9.1%; girls, 2.7%) children than for their Japanese counterparts (boys, 4.2%; girls, 1.9%). An examination of potential explanatory factors revealed little difference in body mass index between samples, higher physical activity levels for the Japanese compared with the Australians, and substantial differences in dietary intake between Japanese and Australian schoolchildren.
The relatively high ratio of plasma HDL cholesterol to total cholesterol in Japanese schoolchildren and the relatively small negative difference of plasma HDL cholesterol with age may help to explain why the coronary heart disease mortality rate in Japan is low compared with that in other developed countries.
与其他发达国家相比，日本冠心病死亡率相对较低，尽管过去三十年日本成年人生活水平提高且平均血浆胆固醇浓度明显上升，但冠心病死亡率仍保持在较低水平。儿童期血浆脂蛋白谱的重要差异可能是日本与澳大利亚和北美冠心病死亡率差异的部分原因。
对澳大利亚、日本和路易斯安那州博加卢萨市具有代表性的学龄儿童人群进行了血浆高密度脂蛋白胆固醇（HDL胆固醇）和总胆固醇的调查。日本学龄儿童的血浆HDL胆固醇平均浓度（而非总胆固醇）高于澳大利亚或美国学龄儿童（P<0.001）。此外，澳大利亚（男孩为15.2%；女孩为2.6%）和美国（男孩为9.1%；女孩为2.7%）8至10岁与12至15岁儿童血浆HDL胆固醇的差异远大于日本儿童（男孩为4.2%；女孩为1.9%）。对潜在解释因素的研究表明，样本间体重指数差异不大，日本人的身体活动水平高于澳大利亚人，日本和澳大利亚学龄儿童的饮食摄入量存在显著差异。
日本学龄儿童血浆HDL胆固醇与总胆固醇的比例相对较高，且血浆HDL胆固醇随年龄增长的负差异相对较小，这可能有助于解释为何日本的冠心病死亡率低于其他发达国家。
