Daytime sleepiness: an epidemiological study of young adults.

OBJECTIVES: Although excessive daytime sleepiness is associated with increased risks for accidents, decreased productivity, and interpersonal difficulties, information on its epidemiology is scarce. This paper examines correlates of and suspected risk factors for daytime sleepiness from a longitudinal epidemiological study of young adults. METHODS: The sample consisted of 1007 randomly selected young adults from a large health maintenance organization in southeast Michigan. Data were gathered in personal interviews conducted with 97% of the sample 5.5 years after baseline. Information on sleep characteristics in the last 2 weeks, including daytime sleepiness, nocturnal sleep onset, snoring, and hours of sleep, was collected on a self-administered instrument. Psychiatric disorders were measured by the National Institute of Mental Health's Diagnostic Interview Schedule. RESULTS: The average length of nocturnal sleep on weekdays was 6.7 hours. Daytime sleepiness was inversely related to hours of sleep and positively related to the ease of falling asleep at night; it varied significantly by employment and marital status. Snoring was associated with increased daytime sleepiness, as was recent major depression. CONCLUSIONS: Factors that might increase daytime sleepiness among young adults include social factors (being single and being employed full time) and pathological conditions (frequent snoring and major depression).     

Dietary regulation of serum lipids in healthy, young adults.

When healthy medical students and their wives were fed a diet providing 2,375 kcal per day, 33 per cent of which was derived from fat, and received a cholesterol intake of less than 250 mg. per day, their serum cholesterol levels were significantly reduced. Differences in the change in the phospholipids of the students and their wives suggest a different response of the sexes to the diet. Since increasing the P:S ratio from 0.3 to 1.2 produced comparable lowering of serum lipids, data suggest that cholesterol intake and caloric balance are of prime importance in maintaining the level of serum cholesterol.     

Associations of oral contraceptive use with serum lipids and lipoproteins in young women: The Bogalusa Heart Study

PURPOSE: Cross-sectional and longitudinal associations of serum lipids and lipoproteins with oral contraceptive (OC) use were examined among white and black women aged 18–27 years in 1985–1986 and 1988–1991 in the Bogalusa Heart Study, a study of cardiovascular disease in a Southern community.

METHODS: Analyses of covariance.

RESULTS: In 1985–1986, white OC users had significantly (p < 0.05) higher adjusted mean total and low density lipoprotein (LDL) cholesterols, and lower high density lipoprotein (HDL) cholesterol compared with nonusers; black OC users had higher triglycerides and LDL cholesterol, and lower HDL cholesterol. In 1988–1991, white OC users had higher total cholesterol, triglycerides, and LDL cholesterol, while black OC users had higher triglycerides. OC use was unrelated to mean HDL cholesterol levels in 1988–1991; however, a lower percentage of white OC users than nonusers in 1988–1991 had HDL cholesterol levels < 35 mg/dl. Longitudinally, white OC nonusers at baseline who used OCs at follow-up had significant increases from baseline levels in total cholesterol, triglycerides, and very low density lipoprotein (VLDL) and LDL cholesterols; black women showed an increase only in LDL cholesterol. White women who stopped using OCs by follow-up had a decrease in VLDL and LDL cholesterols, and an increase in HDL cholesterol. White OC users at both exams also had a significant increase in HDL cholesterol, whereas women who began using OCs by follow-up did not.

CONCLUSIONS: The unfavorable lipid profile associated with OC use was not apparent upon discontinued use. Lack of an adverse effect of OC use on HDL cholesterol at follow-up may be the result of changing formulations, and requires further examination.     

川崎病儿童载脂蛋白和脂蛋白及血脂水平变化的临床研究

[目的]研究川崎病(Kawasaki disease ,KD)患儿血清脂类(载脂蛋白、脂蛋白、血脂)在病程各临床分期中的变化情况. [方法]120例川崎病患儿在疾病的不同临床分期及120名对照组儿童均进行血清脂类测定. [结果]川崎病组血清脂类无年龄与性别差异,病程中TG、ApoB100、ApoE比对照组高(P＜0.01),TC、HDL-C、ApoAI比对照组低(P＜0.01),LDL-C、Lpa与正常儿童相比差异无显著性(P均＞0.05).急性期明显下降的项目有:TC、HDL-C、ApoAI、Lpa;除了ApoE,其余项目亚急性期均比急性期高.TC、HDL-C在亚急性期已接近正常水平,TG、LDL-C、Lpa、ApoAI、ApoB100在恢复期时基本达到正常水平.ApoE在KD病程中各期差异无显著性(P＞0.05),但水平始终高于对照组(P＜0.01). [结论]KD患儿血清脂类除ApoE外,在临床各期均有不同程度变化,但基本上是一过性的,到恢复期时基本上接近正常水平.KD患儿在疾病过程中存在的血脂代谢紊乱对其可能有长远的影响,临床应重视对血脂结果的分析,及早干预.     

Relationship of coffee consumption with serum lipids and lipoproteins in Japanese men

PURPOSE: To examine the relationship of instant coffee and brewed coffee with serum lipids and lipoproteins in Japanese men. METHODS: Study subjects were 4587 male self-defense officials aged 48-56 years who had a preretirement health examination at one of the three hospitals of the Self-Defense Forces from October 1986 to December 1992. A self-administered questionnaire ascertained lifestyle characteristics including consumption of a limited number of foods and beverages by all of the men. Serum concentrations of total cholesterol (TC), triglycerides (TG), and high density lipoprotein (HDL) cholesterol were measured, and low density lipoprotein (LDL) cholesterol levels were calculated from the values of TC, TG, and HDL cholesterol. RESULTS: While the consumption of brewed coffee was unrelated to any parameter of serum lipids and lipoproteins, instant coffee consumption showed a highly significant positive association with serum LDL cholesterol levels and an inverse association with serum TG levels. After adjustment for body mass index, smoking, alcohol use, green tea consumption, rank, and hospital, for each cup of instant coffee per day, LDL cholesterol levels were 0.82 mg/dl (95% confidence interval (CI) 0.29-1.35) higher, and TG levels in a natural log-scale were 0.014 mg/dl (95% CI 0.006-0.022) lower. There was also a tendency for a positive association between instant coffee intake and serum TC levels (trend p = 0.09). HDL cholesterol levels were unrelated to instant coffee consumption. These associations did not change after additional adjustment for selected foods and beverages associated with serum lipids and lipoproteins. CONCLUSIONS: The findings suggest that instant coffee, not brewed coffee, may be associated with raised levels of serum LDL cholesterol and decreased levels of serum TG.     

Distribution and cardiovascular risk correlates of serum triglycerides in young Japanese adults

To examine the distribution and cardiovascular risk correlates of serum triglycerides, a cross-sectional population study based on annual health examinations at the workplace was performed in 2199 young Japanese adults aged 23 to 37 years. Triglyceride levels showed significant sex (male > female) differences, and the percentages of those with high triglycerides (> or = 150 mg/dl) were 9.4% for males and 0.8% for females. In terms of conjoint trait of dyslipidemia, 86.1% of males displayed normal levels of both triglycerides (< 150 mg/dl) and high-density lipoprotein (HDL) cholesterol (> or = 40 mg/dl), while 98.7% of females had normal values. Age- and sex-specific triglyceride levels above the 75th percentile (equivalent to 82-116 mg/dl for males and 56-63 mg/dl for females) increased the risk (odds ratio (OR)) for having obesity, hypertension, and hyperuricemia by 2.9 (95% confidence interval (CI)=2.0-4.3),1.7 (CI=1.1-2.9), and 3.0 (CI=1.6-5.9), respectively. The respective ORs for triglyceride levels above the 75th percentile and HDL cholesterol below the 25th percentile (equivalent to 45-49 mg/dl for males and 58-63 mg/dl for females), compared with triglyceride levels the 75th percentile or less and HDL cholesterol levels the 25th percentile or more, were 8.7 (CI=5.8-12.9), 2.2 (CI=1.5-3.3), and 6.0 (CI=3.2-11.5). Our results suggest a threshold effect of triglyceride levels considered as normal on enhanced cardiovascular risk in young Japanese adults, especially in those with low HDL cholesterol levels.     

Reference values for serum lipids and lipoproteins in Spanish adolescents: the AVENA study

Summary. Objectives To provide current reference values for serum lipid and lipoprotein levels in Spanish adolescents according to age and sex. Methods A cross sectional study conducted in five representative Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza) including a representative sample of 581 adolescents (299 male and 282 female), aged 13 to 18.5 years. Age- and sex-specific means, standard deviations and percentiles were determined for: Total (TC), high density lipoprotein (HDLc) and low density lipoprotein (LDLc) cholesterol, triglycerides, apolipoprotein A-1 and B-100, and lipoprotein(a). Results The 90^th percentile for TC was 4.95 mmol/L for males and 5.19 mmol/L for females. HDLc levels were significantly higher in females of all age groups. LDLc levels ranged from 2.32 to 2.54 mmol/L in males and from 2.38 to 2.62 mmol/L in females, peaking at 13 years of age in both sexes. Triglyceride levels tended to increase gradually and to peak at 17 years of age for both sexes. Apolipoprotein A-1 and B-100 levels paralleled those of HDLc and LDLc values, respectively. The geometric mean for lipoprotein(a) levels ranged from 0.44 to 0.57 μmol/L in males and from 0.50 to 0.67 μmol/L in females. Conclusions The present study provides reference data on the distribution of lipid and lipoprotein levels of Spanish adolescents. At the time of the study, MGC was with (3) Submitted: May 18, 2005 Accepted: December 12, 2005     

Reference values for serum lipids and lipoproteins in Spanish adolescents: the AVENA study

Objectives  

To provide current reference values for serum lipid and lipoprotein levels in Spanish adolescents according to age and sex.     

The association of serum lipids, lipoproteins and apolipoproteins with selected trace elements and minerals in phenylketonuric patients on diet

OBJECTIVE: Classical phenylketonuria (PKU) is an inborn error of metabolism characterized by high Phenylalanine (Phe) levels in blood and treated with a special low Phe diet which can be defined as "nonatherogenic". Since coronary heart disease (CHD) was reported to be a disease of zinc and copper imbalance, we aimed indirectly to evaluate the effect of the special diet on the size of LDL particles and to investigate whether some minerals and trace elements are involved in their lipoprotein metabolism. METHODS: Eighty-six (N=86) PKU patients were divided into two groups. Group A (N=44) on a strict diet and group B (N=42) who did not adhere to their treatment. Healthy children (N=98) were the controls. Serum total cholesterol (t-Chol), triacylglycerol, High-density lipoprotein (HDL) and t-Chol in very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) were measured with enzymatic methods, whereas Apolipoprotein AI (Apo AI), Apolipoprotein AII (Apo AII) and Apolipoprotein B (Apo B) were determined by nephelometric techniques. LDL/Apo B positively correlated with LDL size. Magnesium (Mg), calcium (Ca), copper (Cu) and zinc (Zn) measurements were performed by atomic absorption spectrometry. RESULTS: t-Chol, LDL, VLDL, Apo B, the ratio t-Chol/HDL, Apo AI/Apo B and LDL/Apo B as well as copper levels and the ratio Zn/Cu in group A statistically significantly differed as compared to those of group B and Controls. Positive correlations were found between Mg and HDL and Apo AI in all the groups whereas the mineral correlated with t-Chol, Apo B and the ratio LDL/Apo B only in the group A of patients. Copper negatively correlated with triacylglycerol, LDL, and Apo B and positively with t-Chol in group A. Zinc showed negative relationships in HDL and Apo A in all the studied groups. The ratio Zn/Cu negatively correlated with triacylglycerol and LDL in all the groups and positively with the ratios Apo AI/Apo B and LDL/Apo B in group A. CONCLUSION: Some of the minerals and trace elements were correlated with the lipids and lipoproteins and were also involved in the size of LDL particles in PKU patients on strict diet. Larger and less atherogenic LDL particles were associated with a high Zn/Cu ratio.     

Lack of an association between coffee consumption and lipoprotein lipids and apolipoproteins in young adults: The beaver county study

The relationship between coffee consumption and lipoprotein lipids and apolipoproteins was examined in 472 white men and women (20-24 years of age) in Beaver County, Pennsylvania, during 1981-1982. Coffee intake, expressed as nondrinker, one to two cups per day, and three or more cups per day, was unrelated to total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or apoproteins AI, AII, or B. After covariate adjustment for cigarette smoking, alcohol intake, body mass index, and adherence to a diet low in cholesterol and saturated fat, the results remained essentially unchanged. The only statistically significant finding was that women who consumed three or more cups of coffee per day had significantly lower triglyceride concentrations compared with coffee nondrinkers (P less than 0.05). Thus, these findings fail to substantiate a significant association of low to moderate coffee intake with an increased lipid and apoprotein risk profile in these young adults.     

Prevalence and some epidemiological factors of beta thalassaemia trait in Sindhi community of Nagpur City, India

OBJECTIVE: To study the prevalence of Beta thalassaemia trait (bTT) in Sindhi community of Nagpur City and to study association between bTT and some epidemiological factors like age at menarche in females, past history of diagnosis and treatment of anaemia and the current haemoglobin concentration. METHODS: The present cross-sectional study was undertaken among 446, young, apparently healthy, unrelated (by blood) Sindhi individuals before marriage or before reproduction. Blood samples were processed for Beta thalassaemia trait (bTT) using two stage approaches. Two screening tests namely Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) and RBC indices including Mean Corpuscular Volume (MCV) were performed on all samples and those positive for either one or both screening tests were further investigated for HbA2 level estimation by Haemoglobin electrophoresis on Cellulose acetate paper. HbA2 level of > 4.5% was taken as confirmatory of bTT. RESULTS: The prevalence of bTT in Sindhis of Nagpur was found to be 16.81%. No significant association was found between bTT & a delayed age at menarche, however a significantly higher number of trait carrier females had past history of diagnosis and treatment of anaemia while a significantly higher number of both male and female trait carriers had current haemoglobin concentration in anaemic range. CONCLUSION: The present study confirmed high prevalence of bTT in Sindhis.     

Coffee consumption and serum cholesterol: an epidemiological study in Belgium

In a Belgian population group of 15,954 male and 2116 female soldiers and their spouses the relationship between coffee drinking and serum cholesterol has been studied. A moderate but highly significant monotonic positive relationship between coffee drinking and both serum total and non-high density lipoprotein (HDL)-cholesterol was observed in men (p less than 0.001) even when adjusted for the confounding effects of age, body mass index, smoking, alcohol, and dietary fat and cholesterol intake. Men drinking at least three cups of coffee daily had a mean level of serum total cholesterol about 4 mg/dl and of non-HDL-cholesterol about 3 mg/dl higher than those who did not drink coffee. No significant effect of coffee drinking on HDL-cholesterol was observed in men. In women coffee-drinking did not influence any of the measured serum lipids.     

Tracking of serum lipids and lipoproteins from childhood to adulthood. The Bogalusa Heart Study

Serum lipids (total cholesterol and triglycerides) and lipoprotein cholesterol fractions (low density lipoprotein (LDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, and high density lipoprotein (HDL) cholesterol) have been measured approximately every 3 years on children and young adults since 1973-1974 in Bogalusa, Louisiana, a community of approximately 22,000 individuals, one-third of whom are black and two-thirds of whom are white. A total of 1,586 children were examined both at baseline (1973-1974) and at the most recent survey (1984-1986), providing 12 years of follow-up. The decreases in levels noted during puberty for total cholesterol and LDL cholesterol, primarily for boys, were followed by a rise until age 26 years. HDL cholesterol levels, particularly for white boys, continued to drop after age 14 years, yielding increasingly high LDL cholesterol/HDL cholesterol ratios. Tracking, as measured by both correlation coefficients and persistence at extreme quartiles, was evident for all of the lipids and lipoproteins. The 12-year correlation coefficients were greatest for LDL cholesterol and no trend in the magnitude of the correlation coefficients with age was noted. Tracking for HDL cholesterol was better after age 9 years, particularly for white males. Approximately 50% of those children who had total cholesterol levels or LDL cholesterol levels above the 75th percentile at baseline remained elevated 12 years later. For HDL cholesterol, a trend with age was noted for white boys: 42% of those aged 9-14 years in the lower most quartile persisted in this rank 12 years later. The best predictor of follow-up lipid or lipoprotein level was baseline level. The next best predictor was increase in weight as defined by weight/height, an index of obesity. That serum lipid and lipoprotein levels continue to track from childhood into young adulthood points to the necessity of measurement early in life and, where indicated, the introduction of preventive and interventional programs aimed at developing healthy lifestyles.     

Black-white differences in plasma lipids and lipoproteins in adults: the Cincinnati Lipid Research Clinic population study.

Black—white lipoprotein differences were studied in 43 pairs of adult males and 51 pairs of adult females to test the hypothesis that in a heterogeneous suburban biethnic setting, blacks have higher levels of high density lipoprotein cholesterol (C-HDL), lower levels of low density lipoprotein cholesterol (C-LDL), and lower levels of triglyceride (TG) when pair-matched by total plasma cholesterol, age, and sex with whites. With essentially identical total plasma cholesterol levels and comparable degrees of ponderosity, black males had lower plasma TG (P < 0.05) and higher plasma C-HDL levels (P < 0.005). There were no significant male black—white differences in C-LDL, but the ratio of C-LDL to C-HDL was lower in black males (P < 0.01). There were no significant differences in any lipoprotein fractions or the C-LDL/C-HDL ratio between black and white females, although black females had slightly lower plasma TG and slightly higher C-HDL than white females.     

Effect of altered feeding patterns on serum lipids and lipoproteins in adult males

Effects of a three meal per day versus a six meal per day feeding pattern on selected serum lipids and lipoproteins in 17 males were examined. After a two week acclimatization period, subjects were randomly assigned to one of two groups. Each group followed a three meal per day pattern for six weeks and a six meal per day pattern for another six weeks. Serum total cholesterol and LDL-cholesterol levels were not significantly affected by the altered feeding patterns. There was a significant decrease in the triglyceride levels of one group, but not the other, during the six meal per day pattern. For both groups the HDL-cholesterol levels differed significantly (P≤0.05) between the two feeding patterns. However, the findings were dissimilar in that for one group the HDL-cholesterol was higher after the six meal per day pattern and, for the other group, the opposite was true. Only during Phase I, the acclimatization period when both groups were consuming three meals per day, were any significant differences in dietary intakes noticed. Specifically, subjects in Group I consumed significantly more total fat and saturated fat (P=0.01 and P=0.04, respectively). Throughout the study there were no significant differences between the two groups relative to polyunsaturated to saturated fat (P/S) ratios of the diets.     

Tracking of serum lipids and lipoproteins in children over an 8-year period: the Bogalusa Heart Study

Although children initially identified as having elevated levels of coronary heart disease risk factors tend to have elevated follow-up levels (track), a substantial proportion show regression to the mean. Relationships of both genetic and environmental factors to tracking of serum lipids and lipoproteins over an 8-year period were examined in children from a biracial community. Associations between initial and follow-up levels were similar at 3, 5, and 8 years of follow-up; however, differences between the race-sex groups were observed. Two initial measurements reduced the number of nontrackers (children with high initial and decreased follow-up levels). Fathers of children showing persistently elevated levels of either serum total cholesterol or triglycerides were more likely to have diabetes mellitus or to have had heart attacks than were fathers of nontrackers. Children tracking for elevated low-density lipoprotein cholesterol levels had larger increases in triceps skinfold thickness than did the nontrackers. Children consuming alcohol tended to have elevated levels of high-density and decreased levels of low-density lipoprotein cholesterol at follow-up. These observations indicate that the use of repeated serum lipid and lipoprotein determinations, along with measurements of obesity and information concerning family history of heart attack and diabetes mellitus, can aid in the prediction of future elevated serum lipid and lipoprotein levels.     

Blood pressure in young adults as influenced by diet,anthropometrics, calcium status,and serum lipids

A sample of 197 males and 174 females between the ages of 19 to 35 yr were assessed for blood pressure, health and exercise status, family history of heart disease, use of food supplements, and anthropometrics, Systolic and diastolic pressures were summed and ranked from highest to lowest for each sex. From this sample, a subsample of individual with blood pressure above (elevated blood pressure group; 11 males, 10 females) the 80th and below (low were recalled to assess the relationship of diet, calcium status, blood lipids, and other variables with blood presure. Individuals selected in the elevated blood pressure group were normotensives and matched to the low blood pressure group for age, and smoking and alcohol habits. Calcium status was assessed by use of 3-day diet records, fasting total serum calcium levels, serum ionized calcium lipids (total cholesterol, HDL-cholesterol, and triglycerides) did not differ (p>0.05) by blood pressure groups for either sex. However, males in the elevated blood pressure group did have greater calcium excretion compared to the males with lower blood pressure (p≤0.01). This relationship was not observed for females. Wt:ht was greater in the elevated blood pressure groups for both sexes (p≤0.01). Most of the subjects in the subsample appeared to have adequate calcium status.