Okada T, Sato Y, Yamazaki H, Iwata F, Hara M, Misawa M, Kim H, Karasawa K, Noto N, Harada K, Ryo S
Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan.
Acta Paediatr Jpn. 1998 Feb;40(1):35-40. doi: 10.1111/j.1442-200x.1998.tb01399.x.
The influence of obesity and fat distribution on serum levels of lipoprotein and apolipoprotein was investigated in 294 Japanese junior high school children (12-13 years of age). Serum levels of low-density lipoprotein cholesterol (LDLC) (P = 0.013), triglycerides (TG) (P = 0.0006), and apolipoprotein B (apoB) (P = 0.003), and the apoB/A-I ratio (P = 0.005) were significantly higher and serum levels of high-density lipoprotein cholesterol (HDLC) (P = 0.00003) and apoA-1(P = 0.003) were significantly lower in obese boys than in non-obese boys. The serum levels of TG (P = 0.013) and the apoB/A-I ratio (P = 0.011) were significantly higher and the serum levels of HDLC (P = 0.004) was significantly lower in obese girls than in non-obese girls. The LDLC/apoB ratio was lower in obese girls than in non-obese girls (P = 0.03). Obesity (> or = 20% of ideal weight) was strongly correlated with the serum levels of lipids and apolipoproteins in boys; this relationship was less clear in girls. The degree of obesity and the body mass index (BMI) were more strongly correlated with serum levels of lipids and apolipoproteins in boys than in girls. In boys, atherogenic lipoproteins and apolipoproteins, such as LDLC and apoB, showed a stronger correlation with the thickness of the triceps skinfold, while in girls the anti-atherogenic lipoproteins and apolipoproteins, such as HDLC and apoA-I, showed a stronger correlation with both the triceps and the subscapular skinfold thicknesses. In girls the relationships between the BMI and the degree of obesity and the thickness of the subscapular skinfold (S) thickness were similar to the relationships between those parameters and the triceps skinfold (T) thickness. In boys, these parameters showed a stronger correlation with the subscapular skinfold thickness than with the triceps skinfold thickness. The correlation coefficients for the relationships between skinfold thickness and lipid and apolipoprotein levels were similar to the coefficients for the relationships between skinfold thicknesses and the severity of obesity and the BMI. The distribution of central-type fat accumulation, which is indicated by the thickness of the subscapular skinfold, the S/T ratio and S-T value, was inversely correlated with the HDLC level in both boys and girls. The degree of obesity was strongly correlated with the atherogenic lipoprotein profile in boys, in part because the subscapular skinfold thickness was strongly correlated with the degree of obesity and the BMI. In girls, the correlations between indices of central-type obesity and atherogenic lipid and apolipoprotein profiles were stronger than in boys. These data suggest that childhood obesity may be an early cardiovascular risk factor.
在294名日本初中儿童（12 - 13岁）中，研究了肥胖及脂肪分布对血清脂蛋白和载脂蛋白水平的影响。肥胖男孩的血清低密度脂蛋白胆固醇（LDLC）水平（P = 0.013）、甘油三酯（TG）水平（P = 0.0006）、载脂蛋白B（apoB）水平（P = 0.003）以及apoB/A - I比值（P = 0.005）显著高于非肥胖男孩，而血清高密度脂蛋白胆固醇（HDLC）水平（P = 0.00003）和载脂蛋白A - 1（apoA - 1）水平（P = 0.003）显著低于非肥胖男孩。肥胖女孩的血清TG水平（P = 0.013）和apoB/A - I比值（P = 0.011）显著高于非肥胖女孩，血清HDLC水平（P = 0.004）显著低于非肥胖女孩。肥胖女孩的LDLC/apoB比值低于非肥胖女孩（P = 0.03）。肥胖（≥理想体重的20%）与男孩的血脂和载脂蛋白水平密切相关；这种关系在女孩中不太明显。肥胖程度和体重指数（BMI）与男孩血脂和载脂蛋白水平的相关性比女孩更强。在男孩中，致动脉粥样硬化脂蛋白和载脂蛋白，如LDLC和apoB，与肱三头肌皮褶厚度的相关性更强，而在女孩中，抗动脉粥样硬化脂蛋白和载脂蛋白，如HDLC和apoA - I，与肱三头肌和肩胛下皮褶厚度的相关性更强。在女孩中，BMI、肥胖程度与肩胛下皮褶（S）厚度之间的关系与这些参数和肱三头肌皮褶（T）厚度之间的关系相似。在男孩中，这些参数与肩胛下皮褶厚度的相关性比与肱三头肌皮褶厚度的相关性更强。皮褶厚度与脂质和载脂蛋白水平之间关系的相关系数与皮褶厚度与肥胖严重程度和BMI之间关系的系数相似。以肩胛下皮褶厚度、S/T比值和S - T值表示的中心型脂肪堆积分布与男孩和女孩的HDLC水平呈负相关。肥胖程度与男孩的致动脉粥样硬化脂蛋白谱密切相关，部分原因是肩胛下皮褶厚度与肥胖程度和BMI密切相关。在女孩中，中心型肥胖指标与致动脉粥样硬化脂质和载脂蛋白谱之间的相关性比男孩更强。这些数据表明儿童肥胖可能是早期心血管危险因素。
