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) andapoB (-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%, / > <.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. (Arterioscler Thromb. 1993;13:1429-1440 KEY
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.
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