Kallio M J, Salmenperä L, Siimes M A, Perheentupa J, Gylling H, Miettinen T A
Children's Hospital, University of Helsinki, Finland.
Pediatr Res. 1998 Mar;43(3):381-5. doi: 10.1203/00006450-199803000-00012.
The extent to which an individual maintains his position relative to the rest of the population is called tracking. The objective of this study was to examine the effect of the apolipoprotein E (apoE) phenotype on the tracking of serum cholesterol and lipoproteins from birth to the age of 11 y. In a longitudinal follow-up study of healthy children, concentrations of total serum cholesterol and triglyceride were determined at birth (n = 193), and at the ages of 2 (n = 192), 4 (n = 192), 6 (n = 190), 9 (n = 188), and 12 mo (n = 196), and 5 (n = 162) and 11 y (n = 153). Concentrations of total HDL, HDL2, and HDL3, VLDL, and LDL cholesterol were determined at 2, 6, 9, and 12 mo (n = 36), and 5 (n = 162) and 11 y (n = 153). The apoE phenotype was determined in 151 children. The children had the following apoE phenotypes: 4 had type 4/4 and 40 type 3/4 (group apoE4), 94 had type 3/3 (group apoE3), and 11 had type 2/3 and 2 type 2/4 (group apoE2). The correlation coefficients for total cholesterol levels during childhood compared with the level at 11 y of age were: 0.03 at birth, 0.26 (p < 0.001) at 2 mo, 0.24 (p < 0.001) at 4 mo, 0.24 (p < 0.001) at 6 mo, 0.28 (p < 0.001) at 9 mo, 0.41 (p < 0.001) at 12 mo, and 0.60 (p < 0.001) at 5 y. When the children were divided into three groups according to their apoE phenotypes, these three groups had the following correlation coefficients at 4 mo, 12 mo, or 5 y of age compared with the level at the age of 11 y; group apoE2: r = 0.65 (p < 0.01), r = 0.59 (p < 0.01), and r = 0.72 (p < 0.01); group apoE3: r = 0.27 (p < 0.01), 0.43 (p < 0.001), and r = 0.64 (p < 0.001); and group apoE4: r = 0.14 (p = NS), r = 0.33 (p < 0.05), and 0.42 (p < 0.01). The apoE phenotype also strongly influenced the tracking of the LDL cholesterol levels; the correlation coefficients between 5 and 11 y of age were for group apoE2 r = 0.84 (p < 0.001), for group apoE3 r = 0.70 (p < 0.001), and for group apoE4 r = 0.37 (p < 0.05). Our results indicate that the apoE phenotype strongly influences the tracking of lipids. The children having apoE 2/3, 2/4, and 3/3 phenotypes maintained their relative cholesterol and lipoprotein levels better than the others throughout the first 11 y of age. Because the apoE phenotype strongly affects the tracking of serum cholesterol, the usefulness of cholesterol screening in predicting future cholesterol values should be analyzed, keeping the apoE phenotype in mind.
个体相对于其他人群维持其自身位置的程度被称为追踪。本研究的目的是检验载脂蛋白E（apoE）表型对从出生到11岁血清胆固醇和脂蛋白追踪的影响。在一项对健康儿童的纵向随访研究中，测定了出生时（n = 193）、2岁时（n = 192）、4岁时（n = 192）、6岁时（n = 190）、9岁时（n = 188）、12个月时（n = 196）、5岁时（n = 162）和11岁时（n = 153）的总血清胆固醇和甘油三酯浓度。在2、6、9和12个月时（n = 36）、5岁时（n = 162）和11岁时（n = 153）测定了总高密度脂蛋白（HDL）、HDL2、HDL3、极低密度脂蛋白（VLDL）和低密度脂蛋白（LDL）胆固醇的浓度。在151名儿童中测定了apoE表型。这些儿童具有以下apoE表型：4名具有4/4型，40名具有3/4型（apoE4组），94名具有3/3型（apoE3组），11名具有2/3型和2名具有2/4型（apoE2组）。儿童期总胆固醇水平与11岁时水平的相关系数分别为：出生时0.03，2个月时0.26（p < 0.00），4个月时0.24（p < 0.001），6个月时0.24（p < 0.001），9个月时0.28（p < 0.001），12个月时0.41（p < 0.001），5岁时0.60（p < 0.001）。当根据apoE表型将儿童分为三组时，这三组在4个月、12个月或5岁时与11岁时水平相比的相关系数如下：apoE2组：r = 0.65（p < 0.01），r = 0.59（p < 0.01），r = 0.72（p < 0.01）；apoE3组：r = 0.27（p < 0.01），0.43（p < 0.001），r = 0.64（p < 0.001）；apoE4组：r = 0.14（p = 无显著性差异），r = 0.33（p < 0.05），0.42（p < 0.01）。apoE表型也强烈影响LDL胆固醇水平的追踪；5岁至11岁之间的相关系数，apoE2组为r = 0.84（p < 0.001），apoE3组为r = 0.70（p < 0.001），apoE4组为r = 0.37（p < 0.05）。我们的结果表明，apoE表型强烈影响脂质的追踪。具有apoE 2/3、2/4和3/3表型的儿童在11岁之前比其他儿童更好地维持了他们相对的胆固醇和脂蛋白水平。由于apoE表型强烈影响血清胆固醇的追踪，在预测未来胆固醇值时应考虑apoE表型来分析胆固醇筛查的有用性。
