RESUMEN
BACKGROUND: There is limited information regarding the associations of lifestyle factors and sex with HDL subclasses containing apolipoprotein (apo) A-I (Lp A-I) and both apo A-I and apo A-II (Lp A-I:A-II). OBJECTIVE: We sought to examine the relations between 2 major HDL subclasses and sex, menopausal status, nutrient intakes, and adiposity. DESIGN: We conducted interviews and measured blood variables in 409 government employees aged 40-59 y in Taiwan. RESULTS: Women (n = 203) had significantly higher concentrations of HDL cholesterol, Lp A-I, and Lp A-I:A-II than did men (n = 206). Postmenopausal women (n = 72) had higher concentrations of HDL cholesterol, Lp A-I, and Lp A-I:A-II than did premenopausal women (n = 131). Body mass index and waist-to-hip ratio were strong predictors of and exerted an independent additive effect on Lp A-I concentrations in both men and women. However, body adiposity was associated with Lp A-I:A-II concentrations only in men. Waist-to-hip ratio was an independent determinant of Lp A-I but not of Lp A-I:A-II in men and postmenopausal women after adjustment for age, body mass index, smoking, and diet. Although there were relatively weak associations between dietary factors and both HDL subclasses (r = 0.01-0.26) in men and women according to bivariate analyses, multiple regression models showed that total fat, saturated fat, and cholesterol intakes were significantly correlated with HDL cholesterol and both Lp A-I and Lp A-I:A-II in men, but not in women. CONCLUSION: Our data suggest that body adiposity and dietary fat consumption affect 2 major HDL subclasses differently depending on subject sex and menopausal status.
Asunto(s)
Apolipoproteína A-II/sangre , Apolipoproteína A-I/sangre , Constitución Corporal , Lipoproteínas HDL/sangre , Menopausia/sangre , Tejido Adiposo/anatomía & histología , Adulto , Biomarcadores/sangre , Índice de Masa Corporal , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/etiología , Femenino , Humanos , Entrevistas como Asunto , Estilo de Vida , Masculino , Persona de Mediana Edad , Factores Sexuales , TaiwánRESUMEN
This cross-sectional study explored the relation between mammographic densities (a predictor of breast cancer risk), ethnicity, and dietary factors among women in Hawaii. Thirty-nine postmenopausal women with Japanese, Chinese, Caucasian, and Native Hawaiian ancestry who had received a screening mammogram completed a medical, reproductive, and dietary history. Using a computerized method, we determined the total and the dense area of the breast and calculated the ratio between the two. Blood lipids were measured using standard methods. For statistical analysis, we applied analysis of variance and multiple linear regression. Whereas the mean dense area of the breast was one third smaller in Asian than in Caucasian and Native Hawaiian women, the percent of the breast occupied by dense tissue in the Asian women was slightly higher than in the Caucasian/Hawaiian group, possibly a result of the Asian women's smaller breast size. The exploratory analysis indicated inverse relations of body mass index, high-density lipoprotein cholesterol (HDLC), age at menarche, and soy intake with mammographic densities, as well as direct relations of estrogen use and family history with mammographic densities. The results of this study suggest that variations in these factors may be responsible for ethnic differences in mammographic densities and in breast cancer risk.
Asunto(s)
Asiático , Neoplasias de la Mama/etnología , Mamografía , Población Blanca , Índice de Masa Corporal , Neoplasias de la Mama/sangre , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/fisiopatología , HDL-Colesterol/análisis , Estudios Transversales , Femenino , Hawaii , Humanos , Persona de Mediana EdadRESUMEN
It has been suggested that, for a substantial proportion of "sporadic" colorectal cancers (CRCs), inheritance determines individual susceptibility and that lifestyle determines which susceptible individuals express cancer. Because the genetic basis of this inherited susceptibility remains undefined, we used family history of the disease as a proxy for a genetic predisposition to examine its interactions with a variety of lifestyle factors in a large population-based case-control study of CRC. The subjects were 698 male and 494 female Japanese, Caucasian, Filipino, Hawaiian, and Chinese patients diagnosed with CRC in Hawaii during 1987-1991 and 1192 population controls matched to cases on age, sex, and ethnicity. Fourteen percent of the cases and 6% of the controls reported a family history of CRC among parents or siblings. After adjusting for other covariates, significant interactions with family history were found for beef and ethanol intakes in males (P = 0.03). Relative to men without a family history and whose intake fell in the lower third, odds ratios (ORs) for CRC for men with a family history and in the upper tertile of intake were 10.8 [95% confidence interval (CI), 4.2-27.6] and 7.5 (CI, 3.1-18.2) for beef and ethanol, respectively. The corresponding ORs for men without a family history and in the upper tertile were 1.5 (CI, 1.0-2.3) and 1.4 (CI, 1.0-1.9), respectively. No interactions were detected in women. Using a summary measure of lifestyle, we found that family history was not associated with CRC among men who were at the lower-risk tertile for all of the lifestyle risk factors. In contrast, the OR for men with a family history and at the higher-risk tertile for all of the lifestyle variables was 11.7 (CI, 5.8-23.9). In the absence of a family history, this OR was 4.8 (CI, 3.2-7.2). These data suggest that family history increases the risk of sporadic CRC in men mainly through its interaction with lifestyle exposures, primarily a high beef and ethanol intake, and are consistent with recent reports of effect modifications of dietary associations by metabolic genes. Computation of population attributable risks also suggested that a comprehensive reduction in exposure to lifestyle risk factors--and more specifically to ethanol and beef for individuals with a familial predisposition for the disease--may have a large beneficial effect on CRC incidence.
Asunto(s)
Neoplasias del Colon/etiología , Predisposición Genética a la Enfermedad , Estilo de Vida , Neoplasias del Recto/etiología , Factores de Edad , Anciano , Consumo de Bebidas Alcohólicas , Animales , Pueblo Asiatico/genética , Estudios de Casos y Controles , Bovinos , Neoplasias del Colon/genética , Neoplasias del Colon/prevención & control , Intervalos de Confianza , Etnicidad/genética , Conducta Alimentaria , Femenino , Regulación Neoplásica de la Expresión Génica , Hawaii , Humanos , Incidencia , Modelos Logísticos , Masculino , Carne , Persona de Mediana Edad , Oportunidad Relativa , Neoplasias del Recto/genética , Neoplasias del Recto/prevención & control , Factores de Riesgo , Factores Sexuales , Población Blanca/genéticaRESUMEN
OBJECTIVE: To develop and test a quantitative food frequency method for administration by telephone. DESIGN: A comparison study of telephone and face-to-face interviews was conducted among a representative sample of the five major ethnic groups in Oahu, Hawaii. Two interviews were administered 4 to 6 months apart by trained interviewers using identical questionnaires and color photographs of food items showing three different portion sizes. The order of the interviewing methods was randomly assigned. The questionnaire included 115 food items selected to estimate 80% or more of usual dietary intakes. Frequencies and quantities of each item consumed during the past year were obtained. SUBJECTS/SETTING: Subjects were recruited from the Health Surveillance Program of the Hawaii State Department of Health and consisted of 167 men and 158 women, aged 45 to 74 years, who provided a telephone number. Eighty percent of the face-to-face interviews were conducted in the subjects' homes and 20% were conducted at the workplace or the University of Hawaii Cancer Research Center, if requested. STATISTICAL ANALYSES: The paired t test was used to compare the mean daily intakes obtained by the telephone and face-to-face methods. Agreement was measured by the intraclass correlation coefficient (ICC), Pearson correlation coefficient and weighted kappa statistic. RESULTS: The means of energy and each nutrient were slightly higher in the first interview than the second, regardless of the interviewing method. Because of close correspondence among all 3 statistical measures of agreement, only the ICCs are reported. The ICCs ranged from .61 for protein and vitamin A to .69 for dietary cholesterol among men, and from .61 for vitamin C to .74 for saturated fat among women. Agreement was not significantly affected by age, gender, ethnicity, order of interview, or educational level. APPLICATIONS: Telephone interviews to obtain quantitative food frequencies are cost-efficient methods for estimating usual dietary intakes among persons in widely scattered geographic areas. Photographs of the foods in 3 portion sizes mailed in advance help the respondents estimate amounts eaten.
Asunto(s)
Encuestas sobre Dietas , Dieta , Entrevistas como Asunto/métodos , Anciano , Etnicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , TeléfonoRESUMEN
Endometrial cancer is associated with increased weight and body size, diabetes, and other conditions that may result from an excess in calories or lack of physical activity. Although a few studies have explored the effect of dietary constituents on the risk of endometrial cancer, the nature of the joint association of these constituents and obesity, energy intake, or energy expenditure with risk is unknown. A population-based case-control study was conducted in Hawaii to examine the association of diet, body size, and physical activity with the risk of endometrial cancer. Subjects included 332 histologically confirmed, primary endometrial cancer cases and 511 controls identified between 1985 and 1993. Cases and controls were residents of Oahu, Hawaii who were between 18 and 84 years of age and were from one of the following ethnic groups: Japanese, Caucasian, Native Hawaiian, Filipino, and Chinese. Cases were identified through the Hawaii Tumor Registry and matched to the controls on age (+/-2.5 years) and ethnicity. In-person interviews, conducted in the subjects' homes, included dietary, reproductive, menstrual, and medical histories and use of exogenous hormones, physical activity, and other lifestyle variables. Weight, girth, and skinfold measurements were taken at the time of the interview. We found a strong dose-response relation of increased body size to the development of endometrial cancer after adjustment for energy intake. The odds ratio (OR) for endometrial cancer among women in the highest quartile of body mass index (BMI; kg/m2) was more than four times that among women in the lowest quartile. Waist, hip, midarm, and wrist girths were positively associated with the estimated risk of endometrial cancer after adjustment for total calories and other nondietary risk factors, although the trends in the ORs were attenuated after adjustment for BMI. Physically active women had a modest reduction in their risk of disease compared with inactive women. Cases consumed a greater percentage of their calories from fat and a lower percentage of their calories from carbohydrates than did controls. Adjustment for BMI reduced the ORs for the highest compared with the lowest quartile of fat calorie intake from 2.0 (95% confidence interval, 1.3-3.2) to 1.6 (95% confidence interval, 1.0-2.6), suggesting that part of the association is explained by obesity. There was a differential effect of fat on endometrial cancer according to BMI. For all components of fat, the associations with endometrial cancer were either minimal or absent among leaner women (i.e., those with BMI below the median), whereas, among more obese women, two-fold differences in risk were observed between women above and below the median of fat intake. Foods that are high in fat and cholesterol, such as red meat, margarine, and eggs, were positively associated with endometrial cancer, whereas cereals, legumes, vegetables, and fruits, particularly those high in lutein, were inversely associated. These findings suggest that women who avoid being overweight and who consume a diet low in plant and animal fats and high in complex carbohydrates are at a reduced risk of endometrial cancer.
Asunto(s)
Constitución Corporal , Índice de Masa Corporal , Grasas de la Dieta/efectos adversos , Neoplasias Endometriales/etiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Grasas de la Dieta/administración & dosificación , Ingestión de Energía , Conducta Alimentaria , Femenino , Humanos , Persona de Mediana Edad , Oportunidad RelativaRESUMEN
Variation in colorectal cancer rates between countries and within ethnic groups upon migration and/or Westernization suggests a role for some aspects of Western lifestyle in the etiology of this disease. We conducted a population-based case-control study in the multiethnic population of Hawaii to evaluate associations between colorectal cancer and a number of characteristics of the Western lifestyle (high caloric intake, physical inactivity, obesity, smoking, and drinking) and some of their associated diseases. We interviewed in person 698 male and 494 female United States-born or immigrant Japanese, Caucasian, Filipino, Hawaiian, and Chinese patients diagnosed in 1987-1991 with colorectal cancer and 1192 population controls matched on age, sex, and ethnicity. Conditional logistic regression was used to estimate odds ratios adjusting for dietary and nondietary risk factors. Place of birth and duration of residence in the United States were unrelated to colorectal cancer risk. Energy intake (independent of the calorie source) and body mass index were directly associated with risk, and lifetime recreational physical activity was inversely associated with risk. The associations with these factors were independent of each other, additive (on the logistic scale) and stronger in men. When individuals were cross-categorized in relation to the medians of these variables, those with the higher energy intake and body mass index and lower physical activity were at the highest risk (for males, OR, 3.0; 95% confidence interval, 1.8-5.0, and for females, OR, 1.7; 95% confidence interval, 1.0-3.2). Smoking in the distant, as well as recent, past and alcohol use were directly associated with colorectal cancer in both sexes. Individuals with a history of diabetes or frequent constipation were at increased risk for this cancer, whereas past diagnosis of hypercholesterolemia was inversely associated with risk. The findings were consistent between sexes, among ethnic groups, and across stages at diagnosis, making bias an unlikely explanation. These results confirm the data from immigrant studies that suggest that the increase in colorectal cancer risk experienced by Asian immigrants to the United States occurred in the first generation because we found no difference in risk between the immigrants themselves and subsequent generations. They also agree with recent findings that suggest that high energy intake, large body mass, and physical inactivity independently increase risk of this disease and that a nutritional imbalance, similar to the one involved in diabetes, may lead to colorectal cancer.
Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Neoplasias del Colon/etiología , Complicaciones de la Diabetes , Estilo de Vida , Obesidad/complicaciones , Neoplasias del Recto/etiología , Fumar/efectos adversos , Anciano , Anciano de 80 o más Años , Constitución Corporal , Estudios de Casos y Controles , Neoplasias del Colon/etnología , Ingestión de Energía , Ejercicio Físico , Femenino , Hawaii/epidemiología , Hawaii/etnología , Humanos , Hipercolesterolemia/complicaciones , Masculino , Oportunidad Relativa , Neoplasias del Recto/etnología , Factores Sexuales , Factores Socioeconómicos , Mundo OccidentalRESUMEN
We conducted a population-based case-control study among different ethnic groups in Hawaii to evaluate the role of various types and components of fiber, as well as micronutrients and foods of plant origin, on the risk of colorectal cancer. We administered personal interviews to 698 male and 494 female Japanese, Caucasian, Filipino, Hawaiian, and Chinese cases diagnosed during 1987-1991 with adenocarcinoma of the colon or rectum and to 1,192 population controls matched to cases by age, sex, and ethnicity. We used conditional logistic regression to estimate odds ratios, adjusted for caloric intake and other covariates. We found a strong, dose-dependent, inverse association in both sexes with fiber intake measured as crude fiber, dietary fiber, or nonstarch polysaccharides. We found inverse associations of similar magnitude for the soluble and insoluble fiber fractions and for cellulose and noncellulosic polysaccharides. This protective effect of fiber was limited to fiber from vegetable sources, with an odds ratio of 0.6 (95% confidence interval = 0.4-0.9) and 0.5 (95% confidence interval = 0.3-0.7) for the highest compared with the lowest quartile of intake for men and women, respectively. We found associations of the same magnitude for soluble and insoluble vegetable fiber, but no clear association with fiber from fruits or cereals. This pattern was consistent between sexes, across segments of the large bowel (right colon, left colon, and rectum), and among most ethnic groups. The effect of vegetable fiber may be independent of the effects of other phytochemicals, since the effect estimates remained unchanged after further adjustment for other nutrients. Intakes of carotenoids, light green vegetables, yellow-orange vegetables, broccoli, corn, carrots, bananas, garlic, and legumes (including soy products) were inversely associated with risk, even after adjustment for vegetable fiber. The data support a protective role of fiber from vegetables against colorectal cancer, which appears independent of its water solubility property and of the effects of other phytochemicals. The data also indicate that certain vegetables and fruits may be protective against this disease through mechanisms other than their fiber content.
Asunto(s)
Adenocarcinoma/epidemiología , Neoplasias Colorrectales/epidemiología , Fibras de la Dieta/administración & dosificación , Conducta Alimentaria , Sustancias Protectoras/administración & dosificación , Adenocarcinoma/prevención & control , Neoplasias Colorrectales/prevención & control , Intervalos de Confianza , Bases de Datos Factuales , Conducta Alimentaria/etnología , Femenino , Hawaii/epidemiología , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Polisacáridos/administración & dosificación , Estudios Retrospectivos , Medición de Riesgo , Distribución por Sexo , Verduras/químicaRESUMEN
The authors conducted a case-control study among the multi-ethnic population of Hawaii to examine the role of dietary soy, fiber, and related foods and nutrients on the risk of endometrial cancer. Endometrial cancer cases (n = 332) diagnosed between 1985 and 1993 were identified from the five main ethnic groups in the state (Japanese, Caucasian, Native Hawaiian, Filipino, and Chinese) through the rapid-reporting system of the Hawaii Tumor Registry. Population controls (n = 511) were selected randomly from lists of female Oahu residents and matched to cases on age (+/-2.5 years) and ethnicity. All subjects were interviewed using a diet history questionnaire that included over 250 food items. Non-dietary risk factors for endometrial cancer included nulliparity, never using oral contraceptives, fertility drug use, use of unopposed estrogens, a history of diabetes mellitus or hypertension, and a high Quetelet's index (kg/cm2). Energy intake from fat, but not from other sources, was positively associated with the risk of endometrial cancer. The authors also found a positive, monotonic relation of fat intake with the odds ratios for endometrial cancer after adjustment for energy intake. The consumption of fiber, but not starch, was inversely related to risk after adjustment for energy intake and other confounders. Similar inverse gradients in the odds ratios were obtained for crude fiber, non-starch polysaccharide, and dietary fiber. Sources of fiber, including cereal and vegetable and fruit fiber, were associated with a 29-46% reduction in risk for women in the highest quartiles of consumption. Vitamin A and possibly vitamin C, but not vitamin E, were also inversely associated with endometrial cancer, although trends were not strong. High consumption of soy products and other legumes was associated with a decreased risk of endometrial cancer (p for trend = 0.01; odds ratio = 0.46, 95% confidence interval 0.26-0.83) for the highest compared with the lowest quartile of soy intake. Similar reductions in risk were found for increased consumption of other sources of phytoestrogens such as whole grains, vegetables, fruits, and seaweeds. Ethnic-specific analyses were generally consistent with these results. The observed dietary associations appeared to be largely independent of other risk factors, although the effects of soy and legumes on risk were limited to women who were never pregnant or who had never used unopposed estrogens. These data suggest that plant-based diets low in calories from fat, high in fiber, and rich in legumes (especially soybeans), whole grain foods, vegetables, and fruits reduce the risk of endometrial cancer. These dietary associations may explain in part the reduced rates of uterine cancer in Asian countries compared with those in the United States.
Asunto(s)
Fibras de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Neoplasias Endometriales/prevención & control , Isoflavonas , Proteínas de Soja/administración & dosificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Factores de Confusión Epidemiológicos , Grasas de la Dieta/administración & dosificación , Grasas de la Dieta/efectos adversos , Neoplasias Endometriales/etnología , Neoplasias Endometriales/etiología , Ingestión de Energía , Estrógenos no Esteroides/administración & dosificación , Etnicidad , Femenino , Hawaii , Humanos , Persona de Mediana Edad , Oportunidad Relativa , Fitoestrógenos , Preparaciones de Plantas , Plantas Comestibles , Factores de RiesgoRESUMEN
Temporal trend and migrant studies have indicated that the etiology of colorectal cancer is predominantly environmental and, hence, modifiable. Animal fat intake has been frequently, but inconsistently, associated with the risk of this disease. We conducted a population-based case-control study in Hawaii (United States) among ethnic groups at different risks of the disease to evaluate the role of dietary lipids and foods of animal origin on the risk of colorectal cancer. We interviewed 698 male and 494 female Japanese, Caucasian (White), Filipino, Hawaiian, and Chinese patients diagnosed during 1987-91 with pathologically confirmed adenocarcinoma of the colon or rectum, and 1,192 population controls matched to cases on age, gender and ethnicity. Odds ratios (OR), adjusted for caloric intake and other dietary and non-dietary risk factors, were estimated using conditional logistic regression. Intakes of total fat, saturated fat (S) and polyunsaturated fat (P) were not related to the risk of colorectal cancer. However, an inverse association was found for the P/S ratio, with ORs of 0.6 in both genders (95 percent confidence interval [CI] = 0.4-1.0 for males; CI = 0.3-0.9 for females) for the highest compared with the lowest quartile (P < 0.05 for trend). Intakes of red meat and processed meat were associated with the risk of cancer in the right colon and rectum, respectively, in men only. Fat-trimmed red meat and fish intakes were not related to risk. Chicken eaten without skin was associated inversely with risk in both genders. The strongest association was found for eggs, with an OR of 2.7 (CI = 1.7-4.0) and 2.3 (CI = 1.4-3.7) for the highest compared with the lowest quartile of intake in men and women, respectively (P < 0.001 for trend). This association was dose-dependent, not explained by known confounders or other dietary variables, and was very consistent between genders, among ethnic groups, and across all segments of the large bowel. These data suggest that the ratio of polyunsaturated to saturated fat may be a better indicator of colorectal cancer risk than the absolute amount of specific fats in the diet. They also suggest that eggs and, possibly, untrimmed red meat and processed meat increase, and chicken eaten without skin decreases, colorectal cancer risk.
Asunto(s)
Adenocarcinoma/etnología , Adenocarcinoma/etiología , Neoplasias Colorrectales/etnología , Neoplasias Colorrectales/etiología , Diversidad Cultural , Grasas de la Dieta/efectos adversos , Carne/efectos adversos , Adulto , Estudios de Casos y Controles , China/etnología , Femenino , Hawaii , Humanos , Japón/etnología , Modelos Logísticos , Masculino , Oportunidad Relativa , Filipinas/etnología , Factores de Riesgo , Población BlancaRESUMEN
To determine whether the lower rates of heart disease in Taiwan than in the United States could be related to associations between plasma lipoproteins and dietary intake, we assessed these indexes in 423 adults in Taipei matched with 420 adults in Framingham, MA. Concentrations of LDL cholesterol were 14% lower, HDL cholesterol 9% higher, and LDL cholesterol: HDL cholesterol 27% lower in Taipei than in Framingham. Dietary intakes of total fat (34%), saturated fatty acids, and cholesterol (338 mg) were, respectively, 16%, 41%, and 19% lower in Taipei men, whereas polyunsaturated fatty acid intake was 89% higher than in Framingham men. Similar differences were seen for women except for total fat and cholesterol intakes, which were similar. From stepwise analyses of all subjects, we observed significant associations of lower LDL cholesterol: HDL cholesterol with higher polyunsaturated fatty acid intakes and lower body mass indexes in both men and women. Our data indicate that the more favorable lipoprotein profiles observed in Taipei subjects may be partly due to differences in type of dietary fat consumption as well as in body mass index.
Asunto(s)
Grasas de la Dieta/administración & dosificación , Lipoproteínas/sangre , Adulto , Apolipoproteínas/sangre , Cultura , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Taiwán , Estados UnidosRESUMEN
The relationships between six body girths (shoulder, midarm, waist, hip, thigh, and calf) and cardiovascular risk factors (systolic and diastolic blood pressures and glucose, triglyceride, lipoprotein cholesterol, and apolipoprotein levels) were examined in 407 healthy Chinese urban workers in Taipei, Taiwan who were between 40 to 59 years old. Canonical correlation analysis revealed significant associations of upper body adiposity (shoulder, midarm, and waist girths) with cardiovascular risk factors in all subgroups assessed: men, premenopausal women, and postmenopausal women. Waist girth and hip girth were consistent and important variables, and weighted in the opposite direction. Waist-hip ratio (WHR) was the best descriptor of centralized adiposity. Centralized fat distribution was positively associated with blood pressure and glucose, triglyceride, and apolipoprotein (apo) B levels, and negatively associated with high-density-lipoprotein (HDL) cholesterol and apo A-I levels in this population. Body fat distribution had an effect independent of body mass index and accounted for some of the differences in triglyceride, HDL cholesterol, apo A-I, and apo B concentrations among men, premenopausal women, and postmenopausal women. Our findings in a Chinese population are similar to data from other studies in Western populations, and are consistent with the hypothesis that centralized adiposity is related to cardiovascular risk factors independent of general obesity.
Asunto(s)
Tejido Adiposo/anatomía & histología , Constitución Corporal/etnología , Enfermedades Cardiovasculares/etnología , Adulto , Análisis de Varianza , Presión Sanguínea , China/etnología , Femenino , Humanos , Lípidos/sangre , Masculino , Menopausia , Persona de Mediana Edad , Factores de Riesgo , TaiwánRESUMEN
Dietary intakes (24-hour recall), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein (apo) A-l and apo B were assessed in healthy middle-aged subjects in Taipei, and in sex-age-menopause matched subjects in the Framingham Heart Study. Taipei subjects consumed a diet consisting of 16%, 48%, 35% and 1% of calories from protein, carbohydrate, fat, and alcohol, vs 17%, 40%, 39%, and 4% in Framingham subjects, respectively. The saturated, monounsaturated, and polyunsaturated fatty acid content of the diet was estimated to be 9%, 13%, and 13% of total calories in Taipei subjects and 16%, 15%, and 8% in Framingham subjects, respectively. The differences between Taipei and Framingham subjects were quite substantial for lipid parameters but less so for apolipoprotein levels. Gender differences for TG, HDL C, apo A-l, and apo B were more profound than differences due to nationality. Taipei male and female subjects had significantly lower TC, LDL-C, and significantly higher HDL C concentrations than Framingham male and female subjects. After adjusting for body mass index (BMI), TC and LDL C levels remained significantly different for both sexes between populations, probably attributable to differences in saturated fat intake. This study documents that urban workers in Taipei consumed a diet with a relatively high polyunsaturated and low saturated content and had more favorable lipid profiles than Framingham Americans.
RESUMEN
We compared the plasma lipoprotein cholesterol, triglyceride, apolipoprotein (apo) A-I, apoB, and lipoprotein(a) [Lp(a)] concentrations in a low coronary heart disease (CHD) risk population (n = 440) in Taipei with a high CHD risk population (n = 428) in Framingham matched for age, sex, and menopausal status. Taipei men had significantly lower low-density lipoprotein cholesterol (LDL-C) (-20 mg/dL, -14%, P < .01) and apoB (-7 mg/dL, -6%, P < .05) levels and significantly higher high-density lipoprotein cholesterol (HDL-C) levels (6 mg/dL, 13%, P < .01) than Framingham men. Taipei women had significantly lower LDL-C (-18 mg/dL, -15%, P < .01) and higher HDL-C (4 mg/dL, 7%, P < .01) levels than Framingham women. Median concentrations and distributions of Lp(a) by sex were similar in Taipei and Framingham. After adjusting for body mass index and smoking status, only differences in total cholesterol and LDL-C levels remained significantly different for both sexes between the two populations (P < .01). Gender differences for lipids within populations were similar. After adjusting for age, body mass index, and smoking status, women in both Taipei and Framingham had significantly lower mean triglyceride, LDL-C, and apoB levels and significantly higher HDL-C and apoA-I levels than men. Postmenopausal women in Taipei had significantly higher mean total cholesterol, LDL-C, HDL-C, apoA-I, apoB, and Lp(a) levels than premenopausal women (P < .05), whereas in Framingham postmenopausal women had significantly higher total cholesterol, triglyceride, LDL-C, and apoB levels than premenopausal women (P < .05). Our data are consistent with the concept that plasma lipoprotein cholesterol levels (especially LDL-C) but not apolipoprotein values explain some of the twofold difference in age-adjusted CHD mortality between these two populations.