Epidemiology of low total plasma cholesterol concentration among young adults: The CARDIA study

被引:7
作者
Iribarren, C
Jacobs, DR
Slattery, ML
Liu, K
Sidney, S
Hebert, BJ
Roseman, JM
机构
[1] UNIV UTAH, SCH MED, DEPT ONCOL SCI, SALT LAKE CITY, UT 84112 USA
[2] NORTHWESTERN UNIV, SCH MED, DEPT COMMUNITY & FAMILY MED, CHICAGO, IL 60611 USA
[3] KAISER PERMANENTE MED CARE PROGRAM, DIV RES, OAKLAND, CA 94611 USA
[4] UNIV ALABAMA, SCH PUBL HLTH, BIRMINGHAM, AL 35294 USA
关键词
cholesterol; young adults; risk factors;
D O I
10.1006/pmed.1997.0151
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background. Data on stability of plasma total cholesterol levels and its determinants among young adults are lacking, Knowledge of factors associated with low levels of plasma total cholesterol during young adulthood may help clarify the nature of associations between hypocholesterolemia and health or illness, Methods. Tracking of plasma total cholesterol was investigated using data from the baseline (1985-1986), Year 5 (1990-1991), and Year 7 (1992-1993) examinations of the Coronary Artery Risk Development in Young Adults Study. Lifestyle (including dietary), physiological, medical, and psychological correlates of plasma total cholesterol were examined cross-sectionally at baseline using ANCOVA and multivariate logistic regression. The attributes of participants with persistently low plasma total cholesterol level after 7 years (i.e., remaining below the 10th percentile of sex- and race-specific distributions) were also examined. Results. The cohort in this analysis comprised 720 black men, 922 white men, 899 black women, and 944 white women who were between the ages of 18 and 30 years at baseline, Between 44 and 52% of those with plasma total cholesterol levels below the 10th percentile remained below the same percentile 7 years later, Among black men, a difference of 1 SD in age [3.7 years; odds ratio (OR) = 0.69; 95% CI = 0.52-0.91] and a difference of 1 SD in systolic blood pressure (10.5 mm Hg; OR = 0.73; 95% CI = 0.54-0.97) were independently associated with lower odds, respectively, of being in the lowest 10th percentile of the plasma total cholesterol distribution. Also among black men, current smoking and more calories from carbohydrates were associated with nonsignificantly higher odds of low total cholesterol level. Among white men, a 1 SD older age (3.4 years; OR = 0.78; 95% CI = 0.61-1.00) and a 1 SD higher physical fitness (118 sec; OR = 1.41; 95% CI = 1.09-1.82) predicted lower and higher odds, respectively, of low plasma total cholesterol. Among black women, a 1 SD difference in albumin (0.3 g/dL; OR = 0.80; 95% CI = 0.63-1.03) was related to lower odds of low plasma total cholesterol. Among white women, the factors independently associated with low plasma total cholesterol were body mass index (OR for a difference in 4.0 kg/m(2) = 0.73; 95% CI = 0.54-1.00) and gamma-glutamyl transferase (OR for an increase in 9.6 IU/L = 0.41; 95% CI = 0.18-0.93), The independent predictive factors of stably low total cholesterol levels were age and uric acid among black men (both inversely related) and age, Framingham Type A Behavior (inversely), and calories from carbohydrates (positively related) among white men. Conclusion: Young adults with low plasma total cholesterol level have characteristics generally associated with good cardiovascular health. However, adverse attributes such as current cigarette smoking (notably among black men) may confound future associations between low total cholesterol and disease. (C) 1997 Academic Press.
引用
收藏
页码:495 / 507
页数:13
相关论文
共 39 条
[1]  
BILD DE, IN PRESS AEP
[2]   TRACKING OF BLOOD-LIPIDS AND BLOOD PRESSURES IN SCHOOL AGE CHILDREN - MUSCATINE STUDY [J].
CLARKE, WR ;
SCHROTT, HG ;
LEAVERTON, PE ;
CONNOR, WE ;
LAUER, RM .
CIRCULATION, 1978, 58 (04) :626-634
[3]   Proposed Hostility and Pharisaic - Virtue Scales for the MMPI [J].
Cook, Walter W. ;
Medley, Donald M. .
JOURNAL OF APPLIED PSYCHOLOGY, 1954, 38 (06) :414-418
[4]   DISTRIBUTION OF LIPOPROTEINS AND APOLIPOPROTEINS IN YOUNG-ADULTS - THE CARDIA STUDY [J].
DONAHUE, RP ;
JACOBS, DR ;
SIDNEY, S ;
WAGENKNECHT, LE ;
ALBERS, JJ ;
HULLEY, SB .
ARTERIOSCLEROSIS, 1989, 9 (05) :656-664
[5]   THE FRAMINGHAM TYPE-A SCALE, VIGILANT COPING, AND HEART-RATE REACTIVITY [J].
EVANS, PD ;
MORAN, P .
JOURNAL OF BEHAVIORAL MEDICINE, 1987, 10 (03) :311-321
[6]   CHARACTERISTICS OF PERSONS WITH MARKED HYPOCHOLESTEROLEMIA - A POPULATION-BASED STUDY [J].
FRANZBLAU, A ;
CRIQUI, MH .
JOURNAL OF CHRONIC DISEASES, 1984, 37 (05) :387-395
[7]   CARDIA - STUDY DESIGN, RECRUITMENT, AND SOME CHARACTERISTICS OF THE EXAMINED SUBJECTS [J].
FRIEDMAN, GD ;
CUTTER, GR ;
DONAHUE, RP ;
HUGHES, GH ;
HULLEY, SB ;
JACOBS, DR ;
LIU, K ;
SAVAGE, PJ .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1988, 41 (11) :1105-1116
[8]  
HUGHES GH, 1987, CONTROL CLIN TRIALS, V8, pS68
[9]   LOW SERUM-CHOLESTEROL AND MORTALITY - WHICH IS THE CAUSE AND WHICH IS THE EFFECT [J].
IRIBARREN, C ;
REED, DM ;
CHEN, R ;
YANO, K ;
DWYER, JH .
CIRCULATION, 1995, 92 (09) :2396-2403
[10]   SERUM TOTAL CHOLESTEROL AND MORTALITY - CONFOUNDING FACTORS AND RISK MODIFICATION IN JAPANESE-AMERICAN MEN [J].
IRIBARREN, C ;
REED, DM ;
BURCHFIEL, CM ;
DWYER, JH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 273 (24) :1926-1932