INDIVIDUAL VARIATION IN PLASMA-CHOLESTEROL RESPONSE TO DIETARY SATURATED FAT
INDIVIDUAL VARIATION IN PLASMA-CHOLESTEROL RESPONSE TO DIETARY SATURATED FAT
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DOI：
10.1136/bmj.311.7015.1260
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发表时间：
1995-11-11
影响因子：
105.7
通讯作者：
BALL, M
中科院分区：
文献类型：
--
作者：
COX, C;MANN, J;BALL, M
目的-确定个体血浆脂质浓度对饱和脂肪变化的持续敏感程度；检查是否可以定义始终有较大或较小反应的群体；设计-双交叉设计，其中两种饮食（S，从饱和脂肪中提供 21% 能量，P，提供 10%）按 SPSP 或 PSPS 序列进行六周。设置-67 名自由生活受试者，总胆固醇 5.5-7.9 mmol/l。主要结果测量-胆固醇反应与重复饮食变化以及潜在预测因子和胆固醇反应的关系。结果 相似的平均变化胆固醇掩盖了广泛的个体反应。响应与合规性无关。在所有参与者中，当膳食脂肪的性质改变时，两次交叉观察到的胆固醇变化是相关的（r=0.31，P=0.01）； 46 名一致响应者的两组响应之间的相关程度高于 21 名可变响应者（r=0.71 v r=0.21）。在两次交叉期间，饮食 S 和饮食 P 之间的胆固醇平均差异对于一致的高反应者为 1.16 (SD 0.35) mmol/l 和 0.95 (0.26) mmol/l，对于一致的最低反应者为 0.18 (0.26) mmol/l 和 0.18 (0.25) mmol/l。在一致的反应者中，随着饱和脂肪增加而发生的总胆固醇变化与基线胆固醇酯转移活性相关（r=0.32，P=0.03）；总胆固醇（r=0·37，P=0.01）；甘油三酯（r=0.30，P=0.04）；和载脂蛋白B（r=0.54，P=0.01）。结论——胆固醇对改变膳食脂肪指令的反应存在一定程度的一致性，这不能用饮食依从性来解释，并且在高胆固醇血症个体群体中存在一致的高反应者和最低反应者群体。已经确定了几个预测反应的因素。这些结果与旨在降低脂蛋白介导的冠心病风险的饮食方法相关。
Objective-To determine the extent to which plasma lipid concentrations of individuals are consistently sensitive to changes in saturated fats; to examine whether groups that consistently have large or small responses can be defined; and to identify factors which predict response of lipids to dietary change.Design-A double crossover design in which two diets (S, providing 21% energy from saturated fat, and P, providing 10%) were followed for periods of six weeks in the sequence SPSP or PSPS.Setting-67 free living subjects, total cholesterol 5.5-7.9 mmol/l.Main outcome measures-Relation of cholesterol responses to repeated dietary changes and of potential predictors and cholesterol response.Results Similar average changes in cholesterol mask a wide range of individual responses. Response was not related to compliance. In all participants the change in cholesterol observed when the nature of dietary fat was changed on the two crossovers was correlated (r=0.31, P=0.01); the degree of correlation between the two sets of responses was greater in the 46 consistent responders than in the 21 variable responders (r=0.71 v r=0.21). Mean differences in cholesterol between diet S and diet P during the two crossovers were 1.16 (SD 0.35) mmo/l and 0.95 (0.26) mmol/l for consistent hyperresponders and 0.18 (0.26) mmol/l and 0.18 (0.25) mmol/l for consistent minimal responders. in consistent responders, changes in total cholesterol in response to increasing saturated fats correlated with baseline cholesteryl ester transfer activity (r=0.32, P=0.03); total cholesterol (r=0 37, P=0.01); triglycerides (r=0.30, P=0.04); and apolipoprotein B (r=0.54, P=0.01).Conclusions-There is a degree of consistency in cholesterol response to instructions to change dietary fat which is not explained by dietary compliance, and there are groups of consistent hyperresponders and minimal responders within population of hypercholesterolaemic individuals. Several factors predicting response have been identified. These results have relevance to dietary approaches aimed at reducing the Lipoprotein mediated risk of coronary heart disease.