Effects of diet and sexual maturation on low-density lipoprotein cholesterol during puberty - The Dietary Intervention Study in Children (DISC)

被引:60
作者
Kwiterovich, PO
Barton, BA
McMahon, RP
Obarzanek, E
Hunsberger, S
SimonsMorton, D
Kimm, SYS
Friedman, LA
Lasser, N
Robson, A
Lauer, R
Stevens, V
VanHorn, L
Gidding, S
Snetselaar, L
Hartmuller, VW
Greenlick, M
Franklin, F
机构
[1] MARYLAND MED RES INST,BALTIMORE,MD 21210
[2] JOHNS HOPKINS UNIV,BALTIMORE,MD
[3] NHLBI,NIH,BETHESDA,MD 20892
[4] UNIV PITTSBURGH,PITTSBURGH,PA 15260
[5] UNIV MED & DENT NEW JERSEY,NEWARK,NJ 07103
[6] CHILDRENS HOSP,NEW ORLEANS,LA
[7] UNIV IOWA,IOWA CITY,IA 52242
[8] KAISER PERMANENTE CTR HLTH RES,PORTLAND,OR
[9] NORTHWESTERN UNIV,CHICAGO,IL 60611
[10] CHILDRENS HOSP,CHICAGO,IL
[11] NCI,ROCKVILLE,MD
[12] UNIV ALABAMA,BIRMINGHAM,AL
关键词
coronary disease; pediatrics; diet; hyperlipoproteinemia; lipoproteins;
D O I
10.1161/01.CIR.96.8.2526
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The Dietary Intervention Study in Children (DISC) is a multicenter, randomized, controlled clinical trial designed to examine the efficacy and safety of a dietary intervention to reduce serum LDL cholesterol (LDL-C) in children with elevated LDL-C. Methods and Results The effects of dietary intake of fat and cholesterol and of sexual maturation and body mass index (BMI) on LDL-C were examined in a 3-year longitudinal study of 663 boys and girls (age 8 to 10 years at baseline) with elevated LDL-C levels. Multiple linear regression was used to predict LDL-C at 3 years. For boys, LDL-C decreased by 0.018 mmol/L for each 10 mg/4.2 MJ decrease in dietary cholesterol (P<.05). For girls, no single nutrient was significant in the model, but a treatment group effect was evident (P<.05). In both sexes, BMI at 3 years and LDL-C at baseline were significant and positive predictors of LDL-C levels. In boys, the average LDL-C level was 0.603 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.01). In girls, the average LDL-C level was 0.274 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.05). Conclusions In pubertal children, sexual maturation, BMI, dietary intervention (in girls), and dietary cholesterol (in boys) were significant in determining LDL-C. Sexual maturation was the factor associated with the greatest difference in LDL-C. Clinicians screening for dyslipidemia or following dyslipidemic children should be aware of the powerful effects of pubertal change on measurements of lipoproteins.
引用
收藏
页码:2526 / 2533
页数:8
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