Zoratti R
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, National Heart & Lung Institute, Imperial College, UK.
Eur J Epidemiol. 1998 Jan;14(1):9-21. doi: 10.1023/a:1007492202045.
Black people in the UK, in the Caribbean, and to a lesser extent in the USA, experience coronary heart disease events at different rates than white people. Despite having higher prevalence of hypertension, cigarette smoking and diabetes, black males have significantly lower coronary heart disease rates than white males, whereas no significant differences have been detected in females. The only known risk factor differences that could account for the difference in CHD rates are higher HDL cholesterol and lower triglycerides that are seen in blacks compared with whites. Obesity and, in particular abdominal obesity, seems to determine TG and HDL cholesterol levels: black males are less centrally obese than whites, while total adiposity and central distribution of fat is more predominant in black females compared with white females. We propose that the less degree of abdominal adiposity observed in black males is related with an increased anti-lipolytic effect of insulin, which could account for low triglycerides and high HDL cholesterol levels, and consequently explain the higher protection from coronary heart disease experienced by black males compared with whites and black females.
在英国、加勒比地区以及在美国程度稍轻一些，黑人患冠心病的几率与白人不同。尽管黑人高血压、吸烟和糖尿病的患病率较高，但黑人男性的冠心病发病率显著低于白人男性，而女性中未发现显著差异。唯一已知的、能解释冠心病发病率差异的风险因素差异是，与白人相比，黑人的高密度脂蛋白胆固醇水平较高，甘油三酯水平较低。肥胖，尤其是腹部肥胖，似乎决定了甘油三酯和高密度脂蛋白胆固醇的水平：黑人男性的腹部肥胖程度低于白人，而与白人女性相比，黑人女性的总体肥胖程度和脂肪的中心分布更为明显。我们认为，黑人男性腹部肥胖程度较低与胰岛素抗脂解作用增强有关，这可能是甘油三酯水平低和高密度脂蛋白胆固醇水平高的原因，从而解释了与白人和黑人女性相比，黑人男性对冠心病的更高防护能力。
