高膽固醇可以預測兒童期肥胖症的發生


  2002年9月5日─儘管傳統觀點認為肥胖導致高膽固醇的發生,但是在9月份《American Journal of Clinical Nutrition》報導的一項研究結果顯示,至少就女孩而言,高膽固醇可以作為今後在兒童期會發生肥胖症的一個標誌。
  
  賓州費城兒童醫院的Andrew M. Tershakovec及其同事認為,為何高膽固醇與肥胖症傾向有關,目前還不清楚,似乎可能是高膽固醇可以作為代謝異常的一個指標,此種代謝異常導致過度肥胖。
  
  這項研究是由Bogalusa心臟研究分支出來,對58名高膽固醇的兒童(低密度脂蛋白〔LDL)濃度高於75個百分比),和215名膽固醇濃度正常的兒童(LDL低於60個百分比)進行比較。被研究者被募集研究時是5-6歲,且沒有人患有肥胖症。男孩與女孩的數量相同,而且41%的兒童是黑人。儘管非高膽固醇兒童的身高高於高膽固醇兒童,但是這兩組之間沒有顯著的統計學上的意義。
  
  在3-6年的隨訪中,高膽固醇的女孩身體質量數(BMI)高於非高膽固醇的女孩。當被研究者年齡到11-12歲時,45.2%的高膽固醇女孩超重或肥胖,而膽固醇值正常的女孩只有21.6%的人體重超重。這種現象在男孩中並未觀察到,並且這種現象與女孩的種族無關。
  
  BMI與心血管危險因數例如血壓、胰島素濃度和血脂的關聯隨著年齡的增長而增加,並且在高膽固醇的孩子和女孩中此種關聯更強。
  
  高膽固醇與女孩體重的相對增加有關。當體重相對增長,尤其是在年齡較小的時候,高膽固醇兒童的血脂和其他心血管危險因素的有害影響有關,儘管這種變化的強度是與性別有關的。
  
  
  

High Cholesterol Can Predict C

By Laurie Barclay, MD
Medscape Medical News

Sept. 25, 2002 — Although conventional wisdom is that obesity causes high cholesterol, results of a study in the September issue of the American Journal of Clinical Nutrition suggest that, at least for girls, high cholesterol can be a marker of obesity developing later in childhood.

"It is not clear how hypercholesterolemia is linked to high adiposity," write Andrew M. Tershakovec, from the Children's Hospital of Philadelphia, Pennsylvania, and colleagues. "It seems more likely that hypercholesterolemia acts as a marker of altered metabolism, which results in excessive adiposity."

This spinoff from the Bogalusa Heart study compared 58 hypercholesterolemic children (low-density lipoprotein [LDL] levels greater than 75th percentile) with 215 children who had normal cholesterol levels (LDL less than 60th percentile). Subjects were age 5 to 6 years at study enrollment, and none were obese. There were equal numbers of girls and boys, and 41% of the children were black. Although the nonhypercholesterolemic children were taller than the hypercholesterolemic children, there were no other significant differences between the two groups.

At three- and six-year follow-up, body mass index (BMI) in the hypercholesterolemic girls increased at a greater rate than in the normocholesterolemic girls. By age 11 to 12 years, 45.2% of the hypercholesterolemic girls were overweight or obese, as were 21.6% of the girls with normal cholesterol. This effect was not observed in boys, and it was independent of race in girls.

Associations between BMI and cardiovascular risk factors including blood pressure, insulin, and blood lipids were stronger with increasing age, and in some cases were stronger in hypercholesterolemic children and girls.

"Hypercholesterolemia is associated with increased relative weight in girls," the authors write. "The increased relative weight, even at an early age, is associated with a deleterious effect on blood lipids and other cardiovascular disease risk factors in hypercholesterolemic children, although the strength of these associations is sex dependent."

Am J Clin Nutr. 2002;76:730-735

Reviewed by Gary D. Vogin, MD

    
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