Differences in HDL cholesterol concentrations in Japanese, American, and Australian children

Lipid profile and dyslipidemia among school-age children in urban Ghana

Background

Dyslipidemia during childhood has been associated with higher risk of atherosclerosis later in life. Information on the lipid profile of Ghanaian children is scarce. The aim of this study was to assess the lipid profiles of school children between the ages of 9–15 years, living in urban Ghana.

Methods

A total of 802 randomly selected school-age children participated in the Ghana School Survey implemented in Kumasi and Accra, Ghana. A structured questionnaire was used to collect information on child and maternal socio-demographic characteristics (including age, education, and occupation), 7-day food frequency, home and school activity, as well as measurement of weight and standing height. Weight, height, and age data were converted into BMI-for-age indices to determine weight status. Finger-prick fasting blood samples were taken from the school-age children. Total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) cholesterol levels were determined using the CardioChek® PA Test System. Reference lipid levels based on the US National Cholesterol Education Program 2001 guidelines were used to determine the proportion of children with dyslipidemia.

Results

The mean TC, LDL-C, HDL-C, and TG levels were 149.0 ± 57.0 mg/dl, 80.1 ± 38.6 mg/dl, 53.5 ± 19.4 mg/dl, and 71.4 ± 54.7 mg/dl, respectively. Mean TC/HDL-C ratio was 3.0 ± 1.0. The proportion of children with abnormal values were 12.1% for TC, 4.5% for TG, 28.4% for HDL-C, 9.2% for LDL-C, and 6.6% for TC/HDL-C ratio. The levels of dyslipidemia (HDL, LDL, and TC/HDL-C ratio) were higher among overweight/obese compared to normal-weight children. More frequent fruit consumption was also linked with lower LDL-C (p = 0.020) while watching television (TV) in the mornings was linked with both higher TC (p = 0.011) and TG (p = 0.006).

Conclusions

Majority of urban-dwelling Ghanaian school children had normal lipid profiles. However, the higher levels of dyslipidemia observed among overweight and obese children suggest the need for population level physical activity and dietary interventions among children to reduce risk of cardiovascular diseases in adult life.

Total HDL cholesterol efflux capacity in healthy children - Associations with adiposity and dietary intakes of mother and child

BACKGROUND AND AIMS

High-density lipoprotein (HDL) cholesterol efflux capacity in adults may be a measure of the atheroprotective property of HDL. Little however, is known about HDL cholesterol efflux capacity in childhood. We aimed to investigate the relationship between HDL cholesterol efflux capacity and childhood anthropometrics in a longitudinal study.

METHODS AND RESULTS

Seventy-five children (mean age = 9.4 ± 0.4 years) were followed from birth until the age of 9 years. HDL cholesterol efflux capacity was determined at age 9 by incubating serum-derived HDL-supernatants with ³H-cholesterol labeled J774 macrophages and percentage efflux determined. Mothers provided dietary information by completing food frequency questionnaires in early pregnancy and then 5 years later on behalf of themselves and their children. Pearson's correlations and multiple regression analyses were conducted to confirm independent associations with HDL efflux. There was a negative correlation between HDL cholesterol efflux capacity and waist circumference at age 5 (r = -0.3, p = 0.01) and age 9 (r = -0.24, p = 0.04) and BMI at age 5 (r = -0.45, p = 0.01) and age 9 (r = -0.19, p = 0.1). Multiple regression analysis showed that BMI at age 5 remained significantly associated with reduced HDL cholesterol efflux capacity (r = -0.45, p < 0.001). HDL-C was negatively correlated with energy-adjusted fat intake (r = -0.24, p = 0.04) and positively correlated with energy-adjusted protein (r = 0.24, p = 0.04) and starch (r = 0.29, p = 0.01) intakes during pregnancy. HDL-C was not significantly correlated with children dietary intake at age 5. There were no significant correlations between maternal or children dietary intake and HDL cholesterol efflux capacity.

CONCLUSIONS

This novel analysis shows that efflux capacity is negatively associated with adiposity in early childhood independent of HDL-C.

Continuous decline in mortality from coronary heart disease in Japan despite a continuous and marked rise in total cholesterol: Japanese experience after the Seven Countries Study

BACKGROUND

The Seven Countries Study in the 1960s showed very low mortality from coronary heart disease (CHD) in Japan, which was attributed to very low levels of total cholesterol. Studies of migrant Japanese to the USA in the 1970s documented increase in CHD rates, thus CHD mortality in Japan was expected to increase as their lifestyle became Westernized, yet CHD mortality has continued to decline since 1970. This study describes trends in CHD mortality and its risk factors since 1980 in Japan, contrasting those in other selected developed countries.

METHODS

We selected Australia, Canada, France, Japan, Spain, Sweden, the UK and the USA. CHD mortality between 1980 and 2007 was obtained from WHO Statistical Information System. National data on traditional risk factors during the same period were obtained from literature and national surveys.

RESULTS

Age-adjusted CHD mortality continuously declined between 1980 and 2007 in all these countries. The decline was accompanied by a constant fall in total cholesterol except Japan where total cholesterol continuously rose. In the birth cohort of individuals currently aged 50-69 years, levels of total cholesterol have been higher in Japan than in the USA, yet CHD mortality in Japan remained the lowest: >67% lower in men and > 75% lower in women compared with the USA. The direction and magnitude of changes in other risk factors were generally similar between Japan and the other countries.

CONCLUSIONS

Decline in CHD mortality despite a continuous rise in total cholesterol is unique. The observation may suggest some protective factors unique to Japanese.

How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: A study in Polish primary care

Background

Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women.

Methods

A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual’s CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects’ self-care behavior was examined.

Results

We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most important.

Conclusions

Different predictors of acquisition of health behavior are encountered in men and women. Our results suggest that gender-adjusted motivation models influencing the recognition process need to be considered to optimize compliance in patients with CVR.

Reduced atherogenic indices in prepubertal girls with precocious adrenarche born appropriate for gestational age in relation to the conundrum of DHEAS

CONTEXT

An association between low birth weight, insulin resistance (IR), dyslipidemia, and atherogenesis has been shown in girls with precocious adrenarche (PA).

OBJECTIVE

To evaluate whether girls with PA born appropriate for gestational age (AGA) have increased risk for metabolic complications at initial evaluation.

DESIGN/METHODS

We conducted a cross-sectional study on 69 AGA born girls with PA (mean (±s.d.) age 7.1±1 years) and 45 body mass index (BMI)- and waist circumference (WC)-matched prepubertal peers born AGA (mean (±s.d.) 7.5±1.9 years). A standard 2-h oral glucose tolerance test with insulin sampling was performed. Fasting plasma lipids and high-sensitivity C-reactive protein were analyzed, and blood pressure was recorded. Insulin sensitivity (IS) index (ISIcomp), homeostasis model assessment of IR, and atherogenic index (AI) (triglycerides/high-density lipoprotein cholesterol) were calculated.

SETTING

The study was performed at University Hospital.

RESULTS

AI was significantly lower in girls with PA than in controls (P<0.001), and it was correlated with BMI SDS (r=0.44, P=0.001) and WC (r=0.39, P=0.001). The significant correlation of AI with ISIcomp (r=-0.38, P=0.001) disappeared after correcting for BMI (r=-0.185, P=0.16). Multivariate regression analysis revealed that DHEAS was the only significant parameter influencing AI in girls with born AGA (R (2)=0.475 β=-0.018, P=0.0001).

CONCLUSIONS

Metabolic screening in prepubertal AGA born girls with PA may yield favorable lipid profiles. AI in girls with PA is increased in relation to decreasing IS and increasing BMI and WC. DHEAS seems to have the most significant effect on AI.

Safety, pharmacokinetics and pharmacodynamics of four-hour intravenous infusions of eritoran in healthy Japanese and Caucasian men

Eritoran, a synthetic analogue of lipid A, has been shown to bind to TLR4/MD-2 complex and thereby block the interaction of endotoxins with TLR4. We report here the results of a study conducted to assess the single-dose safety and tolerability, as well as the pharmacokinetics and pharmacodynamics, of eritoran infusion in Japanese and Caucasian healthy adult men. Sixty-four men (aged 20-45 years; body mass index 18-30 kg/m(2)) were randomized into four groups: 4-mg total dose (six Japanese and six Caucasian men); 12-mg total dose (12 Japanese and 12 Caucasian men); 28-mg total dose (six Japanese and six Caucasian men); and placebo (eight Japanese and eight Caucasian men). Eritoran in single doses up to 28 mg over 4 h was well tolerated, with no apparent ethnic differences noted. Plasma concentrations were slightly higher in Japanese versus Caucasian men; these differences were not significant after adjustment for differences in body mass (clearance: approximately 1.2 ml/h/kg; volume of distribution at steady state: approximately 0.07 l/kg). The ex vivo endotoxin inhibitory activity of eritoran was similar in Japanese and Caucasian men. The data do not indicate any need for clinical dose adjustment for possible ethnic-based differences in drug distribution or metabolism.

Socioeconomic position and the tracking of physical activity and cardiorespiratory fitness from childhood to adulthood

This study examined the influence of childhood socioeconomic position (SEP) and social mobility on activity and fitness tracking from childhood into adulthood. In a prospective cohort of 2,185 Australian adults (aged 26-36 years), first examined in 1985 (at ages 7-15 years), self-reported physical activity and cardiorespiratory fitness (subsample only) were measured. SEP measures included retrospectively reported parental education (baseline) and own education (follow-up). There was little evidence of a relation between childhood SEP and activity tracking, but high childhood SEP (maternal education) was associated with a 59% increased likelihood of persistent fitness, and medium childhood SEP (paternal and parental education) was associated with a 33%-36% decreased likelihood of persistent fitness. Upward social mobility was associated with a greater likelihood of increasing activity (38%-49%) and fitness (90%), and persistently high SEP was associated with a greater likelihood of increasing activity (males: 58%) and fitness (males and females combined: 89%). In conclusion, persistently high SEP and upward social mobility were associated with increases in activity and fitness from childhood to adulthood. Findings highlight socioeconomic differentials in activity and fitness patterns and suggest that improvements in education may represent a pathway through which physical activity levels can be increased and health benefits achieved.

Obesity and cholesterol in Japanese, French, and U.S. children

The number of children at risk for overweight/obesity has increased dramatically in the last decade worldwide. This study compares measures of obesity (body mass index [BMI] and body fat percentage) and total cholesterol in 4,013 fourth-grade students from three countries, France, Japan, and the United States. Data were analyzed using t test, chi-square, and analysis of variance to determine differences between groups and by multiple linear regression. All variables differed significantly by group. BMI was highest in U.S. children. Body fat percentage was also highest in U.S. children and lowest in French children. Total cholesterol was highest in French children and lowest in U.S. White children. There were modest but significant associations between BMI and cholesterol in all groups except French children; associations varied by gender. Results indicate there was great variation in measures of obesity and cholesterol by country. The association between obesity and cholesterol may vary by culture, ethnicity, and gender.

The lack of effect of isoflavones on high-density lipoprotein cholesterol concentrations in adolescent boys: a 6-week randomised trial

Background

A substantial fall in high-density lipoprotein cholesterol (HDL-C) during puberty in boys, but not girls, has been reported in Western populations. The fall in boys is believed to be due to hormonal changes – androgens have been shown to be associated with lower HDL-C, whereas oestrogens are associated with higher HDL-C. The fall in HDL-C during puberty was not observed, however, in a study of Moslem boys in Israel, nor in a group of Japanese boys. A diet high in phyto-oestrogens may account for the lack of a fall in HDL-C in these populations.

Objective

To examine the effect of dietary supplementation with phyto-oestrogens on the HDL-C concentration of adolescent boys from a Western population. We hypothesised that dietary supplementation of 50 mg of the isoflavones daidzein and genistein would produce a 12% higher HDL-C concentration than in controls at the end of a 6-week intervention period.

Design

A randomised controlled trial.

Setting

Hellyer College in Burnie (Tasmania, Australia).

Subjects

Adolescent boys (aged 16–18 years) were recruited through a letter sent to parents. A total of 132 eligible participants enrolled and five subjects withdrew from the trial.

Results

No significant increase in HDL-C was observed in the treatment group (–0.02 mmol l–1, standard error (SE)=0.03, P = 0.53) or the placebo group (0.05 mmol l–1, SE = 0.03, P = 0.11).

Conclusions

Factors other than isolated dietary isoflavones may be responsible for the lack of fall in HDL-C during puberty in Japanese and Moslem boys.

Lipid and lipoprotein profiles and prevalence of dyslipidemia in Mexican adolescents

The objective of the study was to determine the prevalence of different forms of dyslipidemia in an urban population of Mexican adolescents. A cross-sectional study was conducted in 1846 students from 8 randomly selected public junior high schools in Mexico City. Anthropometry, blood pressure, and 12-hour fasting lipids and lipoproteins were measured. We studied 770 male and 1076 female adolescents (13.2 +/- 1 years). The most prevalent dyslipidemia was low high-density lipoprotein cholesterol (HDL-C) (<35 mg/dL) either combined with other abnormalities (17.5% for male and 12.9% for female subjects, P < .001) or isolated (13.5% and 9.6% for male and female subjects, respectively, P < .001). Obese subjects showed the highest prevalence of low HDL-C (47.2% for male and 34.4% for female subjects) and of high total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) (19.4%, 27.8%, and 36.1%, respectively, for male subjects; 9.8%, 13.1%, and 24.6%, respectively, for female subjects). Multiple regression analysis showed that waist circumference was negatively associated with HDL-C and positively associated with LDL-C and TG levels, whereas Tanner stages were negatively associated but sex was positively associated with total cholesterol, LDL-C, and TG concentrations. As in Mexican adults, low HDL-C and high TG levels were the most prevalent dyslipidemias. Increased blood lipids over long periods suggest that, as adults, these adolescents will be facing a higher risk for atherosclerosis.

Body mass index and lipid levels in children from Ankara, Turkey versus Bogalusa, Louisiana

BACKGROUND

Turkish Heart Study demonstrated that low high density lipoprotein cholesterol levels are prevalent among Turkish adults.

METHODS

We compared body mass index and lipid levels of Turkish children (n = 1525, ages 10-17) with the bi-racial community of Bogalusa Heart Study.

RESULTS

Turkish children have lower body mass index than American children (19.0 +/- 3 kg/m(2) for Turkish girls, 20.2 +/- 4 for White American girls, 20.9 +/- 5 for African American girls; and 18.9 +/- 3 kg/m(2) for Turkish boys, 20.2 +/- 4 for White American boys, 20.0 +/- 4 for African American boys, P < 0.01). Turkish children have higher triglyceride and lower high density lipoprotein cholesterol levels despite their lower body mass index. High density lipoprotein cholesterol levels (mmol/L) are 1.3 +/- 0.3 for Turkish girls and boys versus 1.4 +/- 0.5 for White American girls and boys, versus 1.6 +/- 0.5 and 1.7 +/- 0.5 for African American girls and boys, respectively (P < 0.01). Triglyceride levels (mmol/L) are 1.0 +/- 0.6 and 1.0 +/- 0.5 for Turkish girls and boys versus 0.9 +/- 0.5 and 0.8 +/- 0.5 for White American; and 0.7 +/- 0.3 for African American girls and boys, respectively (P < 0.01).

CONCLUSIONS

Our observation of a lower HDL-C and a higher TG level in Turkish children (despite their lower BMI) is of interest and may indicate that unique characteristics in lipoprotein levels of Turkish adults start early in life.

Increased risk for coronary vascular disease in children with developmental coordination disorder

PURPOSE

Physical activity (PA) is compromised in children and adolescents with Developmental Coordination Disorder (DCD). The purpose of this study was to test a theoretical model linking DCD with 2 factors associated with increased risk for coronary vascular disease: (1) cardio-respiratory fitness (CF), and (2) relative body fat (BF), through physical activity.

METHODS

A cross-sectional design was implemented using 571 elementary school students (313 males, 258 females). Evaluation of body fat using bioelectric impedance, cardio-respiratory fitness using Léger 20-meter Shuttle Run, and physical activity level was determined using the Participation Questionnaire. The short-form version Bruininks-Oseretsky Test of Motor Proficiency was used to verify DCD. We tested to see how much of the association between DCD and factors associated with increased risk for coronary vascular disease (percentage body fat and cardio-respiratory fitness) using multivariate ordinary least squares regression analysis.

RESULTS

Regression modeling demonstrated that DCD was associated with increased body fat and low cardio-respiratory fitness. Physical activity was a significant mediator in the DCD-CF relationship. Physical activity was also a mediating factor in the DCD-BF relationship, albeit to a lesser extent.

CONCLUSIONS

Developmental coordination disorder is related with factors associated with increased risk for coronary vascular disease, including decreased cardio-respiratory fitness and increased body fat through the mediating influence of physical activity in children.

Serum lipid levels and factors affecting atherogenic index in Japanese children

An evaluation was made of the serum lipid levels and factors relating to atherogenicity in schoolchildren in Akita, Japan, in order to determine actual conditions and promote awareness of health. The subjects were 2878 boys and 2729 girls aged 9, 12 and 15 years, who lived in cities, towns and villages in the Akita prefecture. Physical and lifestyle data including serum lipids were collected from the subjects in their schools under the direction of the prefectural board of education. Total cholesterol levels were found to be nearly equal to those currently representative for Japanese children, ethnically situated between blacks and whites in the United States of America. Atherogenic indices (AIs) were lower than those in all other countries owing to the elevated high-density lipoprotein (HDL) cholesterol levels observed in this study. According to data obtained from the questionnaires that were part of the study, regularly taking breakfast and exercising in sports clubs seems connected to maintaining lower atherogenicity in childhood.

Consistently high plasma high-density lipoprotein-cholesterol levels in children in Spain, a country with low cardiovascular mortality

Coronary heart disease (CHD) mortality is relatively low in Spain compared with other developed countries and has remained low despite an apparent increase in mean plasma cholesterol concentration in adults over the last several years. It is accepted that pathologic processes related to arteriosclerosis development begin in childhood and seem to be related to the presence of cardiovascular risk factors at this age. High-density lipoprotein-cholesterol (HDL-C) levels in children have been inversely correlated with the incidence of coronary heart disease in the different countries studied. Childhood plasma lipoprotein profile might contribute to the low coronary heart disease mortality in Spain. Thus, we analyzed data on lipid levels over time in schoolchildren in Spain in the last decade. Plasma lipid levels were analyzed in prepuberal children (6 to 8 years) in 3 school-based surveys performed by our group in Madrid in 1987, 1993, and 1999. A significant increase in plasma total cholesterol (P < .05) and low-density lipoprotein-cholesterol (LDL-C) (P < .01) levels in prepuberal children was observed over the last decade. However, the mean concentration of plasma HDL-C remained stable and very high. These high levels of plasma HDL-C in Spanish school children may help to explain why the coronary heart disease mortality rate in Spain is low compared with that in other developed countries.

Ethnic differences in hepatic lipase and HDL in Japanese, black, and white Americans

Hepatic lipase activity (HLA) is a determinant of HDL levels, and a polymorphism in the hepatic lipase gene (LIPC) promoter (C-514T) has been hypothesized to account for higher HDL in blacks and Japanese compared with whites. To determine whether the polymorphism contributes to ethnic differences in HDL, we compared LIPC allele frequencies and HLA in Japanese American (JA; n = 84), black American (BA; n = 94), and white American (WA; n = 110) men and women. The LIPC polymorphism was associated with HLA in all cohorts (BA, P = 0.012; JA, P = 0.008; WA, P = 0.009). WA men had 49% and 58% higher HLA than BA and JA men, respectively (both P < 0.05), yet no differences in HLA were found between the women. The higher HLA in the WA men remained after adjustment for the LIPC polymorphism's effect on HLA (P = 0.037) but was erased after adjustment for waist-to-hip-ratio (P = 0.46). Although the WA men had lower HDL and HDL(3) than the JA and BA men (all P < 0.05), there were no differences in HDL(2), implying that variance in HLA may not underlie the ethnic differences in HDL levels. These results suggest that 1) the LIPC promoter polymorphism contributes to variation in HLA and HDL(2) in the three ethnic groups; 2) WA men had higher HLA than BA and JA men, related to ethnic differences in central adiposity but not LIPC allele frequency; and 3) the higher HLA in WA men did not contribute to the ethnic differences in HDL, as the differences in HDL were made up entirely of differences in HDL(3) and not HDL(2).

Atherogenic lipid profiles in Filipino adolescents with low body mass index and low dietary fat intake

This study reports mean lipid levels and their association with body composition, diet, and activity level in 300 male and 308 female adolescents (14-16 years) living in Cebu City, the Philippines. Participants were selected from the Cebu Longitudinal Health and Nutrition Survey (CLHNS), a 1-year birth cohort study begun in 1982-83. Lipid profiles suggest high cardiovascular disease (CVD) risk in this sample, despite low intake of dietary fat (22% for both sexes) and an absence of obesity (0.3% of sample). Mean lipid levels for males and females were, respectively, 153.2 mg/dl and 182.5 mg/dl for total cholesterol (TC), 91.9 mg/dl and 104.6 mg/dl for low-density lipoprotein cholesterol (LDL-C), 38.3 mg/dl and 41.3 mg/dl for high-density lipoprotein cholesterol (HDL-C, geometric mean), and 73.9 mg/dl and 79.6 mg/dl for triglycerides (TG, geometric mean). The atherogenic ratio of TC/HDL-C was high at 4.16 and 4.55 for males and females. Adjusting for maturational changes, the body mass index (BMI) and skinfold measures were positively associated with most lipids in males. Among females, BMI and skinfolds related positively to LDL-C and TG, and inversely to HDL-C. Although males had a higher waist hip ratio (WHR), WHR only predicted lipid profiles in females. Activity level had a beneficial association with lipid profiles in both sexes, while dietary fat intake was positively associated with LDL-C in males and with HDL-C in females. In sum, diet, adiposity, and physical activity predict variability in lipid profiles in this adolescent Filipino population. However, the low fat intake and near-absence of obesity raise questions about the causes of the high apparent risk for future CVD in this young population.

[Cardiovascular risk factors in children and teenagers aged 6-18 years old from Medellin (Colombia)]

OBJECTIVE

To evaluate exposure to the major risk factors for cardiovascular disease in children from Medellín according to age, sex, type of school, and socioeconomic status.

METHOD

We performed a descriptive study in 2611 children aged 6-18 years old from the city of Medellín in Colombia. Lipid profile, blood pressure, body mass index, diet, exercise, alcohol intake, and smoking were evaluated.

RESULTS

Forty-six percent of the children drank alcohol, 8.7 % smoked and 50 % were physically inactive. Fat and carbohydrate intake was high in 48 % and 47 %, respectively. A total of 9.3 % of the children were overweight and 4.6 % were obese. Systolic and diastolic blood pressure were high in 1.3 % and 3.9 %, respectively. Mean high-density lipoprotein cholesterol (HDL-C) values were lower than in other populations, while triglyceride values were higher. Differences in serum lipid concentrations were found according to age and sex. The prevalence of risk factors according to the National Cholesterol Education Program criteria were: 19.1 % for HDL-C, 17.1 % for triglycerides, 17.0 % for low-density lipoprotein cholesterol (LDL-C), 13.5 % for total cholesterol (TC) and 22.9 % for TC/HDL-C.

CONCLUSIONS

In children from the city of Medellín, the most prevalent cardiovascular risk factors were related to lifestyle. Mean plasma lipid concentrations varied according to age and sex. The prevalence of overweight was higher than in other populations in Colombia but was lower than that reported for other countries.

Lipid profiles in adolescent Filipinos: relation to birth weight and maternal energy status during pregnancy

BACKGROUND

The finding that persons with low birth weight have a higher cardiovascular disease (CVD) risk than do persons with higher birth weight remains poorly understood.

OBJECTIVE

We tested the hypothesis that maternal arm fat area (MAFA) in the third trimester of pregnancy and birth weight of offspring are inversely related to the offspring's risk of CVD.

DESIGN

In a 1-y birth cohort study (1983-1984), 296 male and 307 female offspring were followed up (1998-1999) to measure their lipid profiles. Participants came from randomly selected communities of Cebu, Philippines.

RESULTS

MAFA (log cm2) was positively associated (beta) with HDL cholesterol (0.12 log mg/dL; P < 0.01) and inversely associated with total cholesterol (-10.0 mg/dL; P < 0.10), LDL cholesterol (-13.1 mg/dL; P < 0.01), and the ratios of total to HDL cholesterol and LDL to HDL cholesterol (both P < 0.001) in males. These relations were independent of birth weight, present adiposity, energy and fat intakes, maturity, and income. Birth weight < or = 2.6 kg was associated with elevated LDL cholesterol (9.9 mg/dL; P < 0.01) and an elevated ratio of LDL to HDL cholesterol (0.22; P < 0.10) only in males. In females, MAFA related positively to total (15.5 mg/dL; P < 0.05) and LDL (11.9 mg/dL; P < 0.05) cholesterol.

CONCLUSIONS

In this Filipino population, mothers with low energy status during pregnancy gave birth to male offspring who had a high CVD risk in adolescence, as indicated by lipid profiles. The findings in females are less consistent with the fetal origins hypothesis and suggest sex differences in the relation between fetal nutrition and postnatal lipid metabolism.

The emergence of coronary heart disease in populations of Chinese descent

Most countries in oriental Asia have not yet experienced the 'western' coronary heart disease (CHD) epidemic despite substantial economic development. An exception has been Singapore. We compared mortality and CHD risk factors in Singapore with two Oriental locations, Hong Kong and mainland China, which have not experienced the CHD epidemic. Mortality data from World Health Statistics Annuals age standardised for each location and were supplemented by local data. Risk factor data was obtained from population-based surveys using similar protocols in each location. Measures included diet, blood lipids, blood pressure, height and weight. CHD mortality in the year chosen for comparison, 1994, was significantly higher for Singapore Chinese males [108 (95.2-119.1)] than Chinese males in Hong Kong [44.3 (40.2-48.2)] or China [45.5 (44.2-46.8)]. Female CHD mortality was also relatively higher in Singapore Chinese. The only CHD risk factor markedly higher in Singapore Chinese was serum cholesterol; Singapore males [5.65 (5.55-5.75)], females [5.60 (5.50-5.70)], Hong Kong males [5.21 (5.11-5.31)], females [5.20 (5.10-5.29)] and China males [4.54 (4.46-4.62)], females [4.49 (4.42-4.55)]. Dietary differences in saturated fat consumption were consistent with this. Although there was little difference in total fat intake, a higher consumption of dietary saturated fat and lower consumption of polyunsaturated fat, accompanied by higher serum cholesterol, appear to explain the relatively high CHD mortality in Singapore compared with Hong Kong and mainland China. Differences in body mass index, blood pressure and smoking between locations did not explain the differences in CHD mortality.

Association of the longevity-associated mitochondrial DNA 5178 A/C polymorphism with serum protein fraction levels in healthy Japanese women

Mitochondrial DNA 5178 adenine/cytosine (mt5178 A/C) polymorphism was reported to be associated with longevity and susceptibility to adult-onset diseases in Japanese. To examine whether mt5178 A/C genotypes are associated with serum protein fraction profiles, we genotyped 461 healthy Japanese individuals, and studied the relationship of mt5178 A/C genotypes to both proportion and levels of serum protein fraction. The mt5178 A/C was genotyped using polymerase chain reaction-restriction fragment length polymorphism method. The alpha-1, alpha-2, and beta globulin proportions in females carrying mt5178A were significantly higher than those in females carrying mt5178C (P=0.002, 0.006, and 0.008, respectively). Moreover, the alpha-1, alpha-2, and beta globulin levels in females carrying mt5178A were significantly higher than those in females carrying mt5178C (P=0.001, 0.002, 0.018, respectively). This difference in globulin fraction level between the two genotypes was more evident in premenopausal females than in postmenopausal females. However, no such difference was found in males. These results provide the first evidence that the mt5178 A/C polymorphism may influence the serum protein fraction levels of the healthy Japanese women.

Coronary heart disease mortality among men aged 35-44 years by prefecture in Japan in 1995-1999 compared with that among white men aged 35-44 by state in the United States in 1995-1998: vital statistics data in recent birth cohort

The levels of risk factors for coronary heart disease (CHD) in men in the post World War II (WWII) birth cohort are almost similar between Japan and the USA, except for the considerably higher prevalence of cigarette smoking in Japan and the much higher prevalence of obesity in the USA. The present study evaluated the CHD mortality among men in the post WWII birth cohort by prefecture in Japan in 1995-1999 and then compared the data with those for white men in different states in the USA. There was a greater than 2-fold difference in CHD mortality among men aged 35-44 by prefecture in Japan: 5.3/100,000 in Kumamoto vs 12.6/100,000 in Tochigi. CHD mortality among men aged 35-44 in the top 3 prefectures in Japan is about half that of white men in the USA and is similar to that of white men in the lowest 3 states. The much lower CHD mortality in Japan does not appear to be caused by differences in the classification of causes of death and the results suggest that there may be strong and important protective factors that reduce the risk of CHD in Japan.

[Strategy for primary prevention of coronary heart disease based on results of health check-up]

To investigate one of the strategies for effective primary prevention of coronary heart disease (CHD) in employees, the future morbidity of CHD was predicted from the results of an annual health check-up. The decrease in morbidity by measures against coronary risk factors was estimated with simulations. By a CHD risk prediction algorithm based on the Framingham Study, the 10-yr incidence of CHD was predicted in 6,444 male employees of a manufacturing company according to the results of a health check-up in 1998: age, total cholesterol (TC), HDL-cholesterol (HDL-C), blood pressure (BP), diabetes mellitus, and smoking habit. The decrease in CHD incidence obtained by a decrease in TC, increase in HDL-C, decrease in BP, control of diabetes mellitus, or quitting the smoking habit was estimated with simulations by means of the algorithm. The mean +/- SD in 6,444 employees was 45 +/- 11 yr for age; 121 +/- 16 and 79 +/- 10 mmHg for systolic and diastolic BP, respectively; 193 +/- 34, 53 +/- 13, and 98 +/- 18 mg/dl for TC, HDL-C, and fasting blood sugar, respectively; 4.80 +/- 0.58% for HbA1c; and 44% for the frequency of the smoking habit. Among 6,444 males, 455 (7.1%) were predicted to suffer from CHD for 10 yr ahead. If TC was decreased to less than 200 mg/dl in all 2,614 males (N) with TC > or = 200 mg/dl, the decrease (D) in the predicted number of employees with CHD was 64; namely, a reduction of TC to less than 200 mg/dl in 41 males (N/D) with TC > or = 200 mg/dl was estimated to decrease the number of CHD patients by one. Similarly, the D and N/D were 38 and 35 for reduction in BP to less than 140/90 mmHg; 20 and 17 for control of diabetes mellitus; and 90 and 32 for quitting the smoking habit, respectively. A measure against diabetes mellitus was the most effective in respect of N/D, but the predicted total reduction was small (D = 20). On the other hand, a measure against the smoking habit was estimated to have a relatively small N/D as well as the largest D. In 5,386 employees with at least one of the risk factors of TC > or = 200 mg/dl, HDL-C < 45 mg/dl, BP > or = 130/85 mmHg, diabetes mellitus, and the smoking habit, the normalization of all risk factors was estimated to decrease by 230 CHD patients (D = 230, N/D = 23). These results suggest that the strategy for effective primary prevention of CHD in employees of a company should include at first, quitting the smoking habit supported by total prohibition of smoking within company facilities, followed by measures against hyperlipidemia, hypertension and diabetes mellitus.