_LAPOUSHS

Î·È ÙˆÓ ÂÈ¤‰ˆÓ ÙˆÓ ÏÈȉ›ˆÓ

Û ̷ıËÙ¤˜ ËÏÈΛ·˜ 12-15 ÂÙÒÓ

ÁÏ˘ÎÂÚȉ›ˆÓ ÙˆÓ ÂÍÂÙ·˙fiÌÂÓˆÓ ·ÙfïÓ, Ô˘ ·Ó‹Î·Ó Û ‰È·ÊÔÚÂÙÈΤ˜ ηÙËÁÔ-ڛ˜ ¢ª™ (ηÓÔÓÈÎÔ›, ˘¤Ú‚·ÚÔÈ, ·¯‡Û·ÚÎÔÈ) F(2,117)=18,01 p< ,000 Î·È ÛÙ· Â›‰· Ù˘ HDL-C F(2,117)=4,53 p< ,013. ™˘ÌÂÚ·ÛÌ·ÙÈο, Ô Î›Ó‰˘ÓÔ˜ ÁÈ· ÌÂÏÏÔÓÙÈΤ˜ ηډȷΤ˜ ·ı‹ÛÂȘ ·fi Ù· ·˘ÍË̤ӷ Â›‰· ÏÈȉ›ˆÓ, ÌÈ· ‰È·‰Èηۛ· Ô˘ ÌÔÚ› Ó· ÍÂÎÈÓ‹ÛÂÈ ·fi ÙËÓ ·È‰È΋ ËÏÈΛ·, ÌÔÚ› Ó· ÌÂȈı› ̤ۈ Ù˘ ÂÏ¿ÙÙˆÛ˘ ÙÔ˘ ‚¿ÚÔ˘˜. §¤ÍÂȘ ÎÏÂȉȿ: ‰Â›ÎÙ˘ Ì¿˙·˜ ÛÒÌ·ÙÔ˜, ·¯˘Û·ÚΛ·, ÙÚÈÁÏ˘ÎÂÚ›‰È· ¯ÔÏËÛÙÂÚ›ÓË, HDL-C, LDL-C. Abstract

The purpose of this study was to assess the lipids level and their relation to the Body Mass Index (BMI). Dyslipidemia and obesity are primary risk factors for cardiovascular disease. The study sample was 120 students aged 12-15 years. To assess the levels of cholesterol, HDL-C, LDL-C and triglycerides, blood volume of 10 ml, was taken from each student, after 12-hour fast and analyzed in Automatic Biochemical Analyzer (OLYMPUS AU-560). Also body mass index was computed. To investigate the differences in lipid levels because of body mass index, age and gender, one-way Anova (ANOVA) test was used and multiple comparisons Scheffe post-hoc. Results revealed that there were no differences in lipid concentration in relation to age and gender. Also results revealed that there was a statistically significant difference in triglyceride levels of the examined individuals belonging to different categories of body mass index (normal, overweight, obese), F(2,117)=18,01, p <0,00 and levels of HDL -C F(2,117)=4,53 p <0,013. In conclusion, the risk for future heart disease than elevated levels of lipids, a process that may begin in childhood, may be reduced by lowering the weight.

Key words: body mass index, obesity, cholesterol, triglycerides, HDL-C, LDL-C. 1. ∂ÈÛ·ÁˆÁ‹ √È ·Ú¿ÁÔÓÙ˜ ÎÈÓ‰‡ÓÔ˘ ÁÈ· ÙËÓ ÂÌÊ¿ÓÈÛË Î·Ú‰È·ÁÁÂÈ·ÎÒÓ ·ÛıÂÓÂÈÒÓ (∫∞∞) ÛÙÔ˘˜ Ó¤Ô˘˜, fiˆ˜ Â›Ó·È Ë ·¯˘Û·ÚΛ·, Ë ÌÂȈ̤ÓË Ê˘ÛÈ΋ ‰Ú·ÛÙËÚÈfiÙËÙ· Î·È Ô Î·ıÈÛÙÈÎfi˜ ÙÚfiÔ˜ ˙ˆ‹˜, ˘ÈÔıÂÙÔ‡ÓÙ·È ϤÔÓ ˆ˜ ÙÚfiÔ˜ ˙ˆ‹˜ ·fi ÌÂÁ¿ÏË ÌÂÚ›‰· ÙˆÓ Ó¤ˆÓ (Eisenmann, 2003). Œ¯ÂÈ ·Ô‰ÂȯÙ› fiÙÈ ÔÈ ·Ú·¿Óˆ ·Ú¿ÁÔÓÙ˜ ÚÔÛÌÂÙÚÔ‡ÓÙ·È ·ıÚÔÈÛÙÈο ÛÙËÓ ·‡ÍËÛË ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜ Î·È Â›Ó·È

‰˘Ó·ÙfiÓ Ó· ÂȉڿÛÔ˘Ó ÛÙËÓ ÂÌÊ¿ÓÈÛË ·¯˘Û·ÚΛ·˜ Û ·˘Ù¤˜ ÙȘ ËÏÈ˘ (Goran, Kaskoun & Shuman, 1995). ªÂϤÙ˜, ÔÈ Ôԛ˜ ‰ÈÂÍ‹¯ıËÛ·Ó Û ӤԢ˜ Î·È ÂÊ‹-‚Ô˘˜ ÛÂ Â˘Úˆ·˚Τ˜ ¯ÒÚ˜, ηٿ ÙË ‰È¿ÚÎÂÈ· ÙˆÓ ÙÂÏÂ˘Ù·›ˆÓ ÂÙÒÓ, ‰Â›¯ÓÔ˘Ó fiÙÈ ˘¿Ú¯ÂÈ ÌÈ· ÁÂÓÈ΋ Ù¿ÛË, ÁÈ· ¤Ó·Ó ÌË ˘ÁÈÂÈÓfi ÙÚfiÔ ‰È·‚›ˆÛ˘ Ì ٷ˘Ùfi¯ÚÔÓË ·‡ÍËÛË ÙˆÓ ˘¤Ú‚·ÚˆÓ Î·È ·¯‡Û·ÚÎˆÓ ·ÙfïÓ. ÀÔÏÔÁ›˙ÂÙ·È fiÙÈ ÙÔ 15% ÙˆÓ ·È‰ÈÒÓ Î·È ÙˆÓ ÂÊ‹‚ˆÓ Â›Ó·È ˘¤Ú‚·Ú· ¤¯ÔÓÙ·˜, ¢ª™ ›ÛÔ ‹ ÌÂÁ·Ï‡ÙÂÚÔ ·fi ÙÔ 95Ô ÂηÙÔÛÙËÌfiÚÈÔ Î·È ·˘Ùfi ÙÔ ÔÛÔÛÙfi Û˘Ó¯Ҙ ·˘Í¿ÓÂÙ·È (Ogden, Flegel, Carroll & Johnson, 2002). To ÁÂÁÔÓfi˜ ·˘Ùfi ÂȂ‚·ÈÒÓÂÙ·È Î·È ·fi ÙËÓ ÚfiÛÊ·-ÙË ÌÂϤÚfiÛÊ·-ÙË NHANES (2003-2004), Ô˘ ‰Â›¯ÓÂÈ fiÙÈ ÔÛÔÛÙfi 17,4% ÙˆÓ ÂÊ‹‚ˆÓ (12-19 ÂÙÒÓ) Î·È 18,8% ÙˆÓ ·È‰ÈÒÓ (6-11 ÂÙÒÓ) Â›Ó·È ˘¤Ú‚·ÚÔ (Ogden, Carroll, Curtin, McDowell, Tabak, Flegal & 2006). ∫·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙˆÓ ÂÙÒÓ 1999-2004 ·Ú·ÙËÚËı‹Î·Ó ÛËÌ·ÓÙÈΤ˜ ·ÏÏ·Á¤˜ ÛÙȘ ‰È·¯ÚÔÓÈΤ˜ Ù¿ÛÂȘ ÙˆÓ ·È‰ÈÒÓ Î·È ÙˆÓ ÂÊ‹‚ˆÓ, Ô˘ ›¯·Ó ˆ˜ ·ÔÙ¤ÏÂÛÌ· ÙËÓ ·‡ÍËÛË ÙÔ˘ ÂÈÔÏ·ÛÌÔ‡ Ù˘ ·¯˘-Û·ÚΛ·˜ ·fi 14,0% Û 18,2% (Hayman, Meininger, Daniels, McCrindle, Helden, Ross, et al. 2007). ∏ ‡·ÚÍË ˘ÂÚ‚ÔÏÈÎÔ‡ ‚¿ÚÔ˘˜ Î·È Ë ·¯˘Û·ÚΛ· ÛÙÔ˘˜ Ó¤Ô˘˜ Î·È ÂÊ‹‚Ô˘˜ ¤¯ÂÈ Î·Ù·ÛÙ› ·ÁÎfiÛÌÈ· ÚfiÎÏËÛË ÁÈ· ÙË ‰ËÌfiÛÈ· ˘Á›· Î·È ·Ó·ÁÓˆÚ›˙ÂÙ·È ˆ˜ ¤Ó·˜ ÛËÌ·ÓÙÈÎfi˜ ·Ú¿ÁÔÓÙ·˜ ÎÈÓ‰‡ÓÔ˘ ÁÈ· ηډȷÁÁÂȷΤ˜ ·Ûı¤ÓÂȘ ηٿ ÙËÓ ÂÓ‹ÏÈÎË ˙ˆ‹ (Ogden, et al., 2006 ). ª·ÎÚÔ¯ÚfiÓȘ ÌÂϤÙ˜ Û ÂÓËÏ›ÎÔ˘˜, fiˆ˜ Â›Ó·È Ë ÌÂϤÙË Framingham, ¤¯Ô˘Ó ‰Â›ÍÂÈ fiÙÈ ÙÔ ÛˆÌ·ÙÈÎfi ‚¿ÚÔ˜ ÙÔ˘ ·ÙfiÌÔ˘ ¤¯ÂÈ ¿ÌÂÛË Û¯¤ÛË Ì ÙËÓ ÂÌÊ¿ÓÈÛË Î·Ú‰È·ÁÁÂÈ·ÎÒÓ ·ÛıÂÓÂÈÒÓ (Kannel, D’Agostino & Cobb 1996). ∆Ô Ê·ÈÓfiÌÂÓÔ Â›Ó·È ·ÓËÛ˘¯ËÙÈÎfi, ‰ÈfiÙÈ Ë ·˘ÍË̤ÓË Û˘¯ÓfiÙËÙ· ÂÌÊ¿ÓÈÛ˘ Ù˘ ·¯˘Û·ÚΛ·˜ Û˘Óԉ‡ÂÙ·È ÙȘ ÂÚÈÛÛfiÙÂÚ˜ ÊÔÚ¤˜ Î·È ·fi ¿ÏÏÔ˘˜ ·Ú¿ÁÔÓÙ˜ ηډȷÁÁÂÈ·ÎÔ‡ ÎÈÓ‰‡ÓÔ˘, ·ÎfiÌË Î·È ÛÙËÓ ÂÊË‚È΋ ËÏÈΛ· (Freedman, Serdula, Srinivasan & Berenson, 1999).

π‰È·›ÙÂÚ· ÛËÌ·ÓÙÈο Â›Ó·È Ù· Â˘Ú‹Ì·Ù· Ô˘ ‰Â›¯ÓÔ˘Ó fiÙÈ Ë ÚˆÙ·Ú¯È΋ ÂÌÊ¿-ÓÈÛË ÙˆÓ Î·Ú‰È·ÁÁÂÈ·ÎÒÓ ·ÛıÂÓÂÈÒÓ ¤¯ÂÈ ÙȘ Ú›˙˜ Ù˘ ÛÙËÓ ·È‰È΋ Î·È ÂÊË‚È΋ ËÏÈΛ· (Dietz, 1998). ∆· ÌÈÎÚ¿ ·È‰È¿ Ì ·¯‡Û·ÚÎÔ˘˜ ÁÔÓ›˜ Ù›ÓÔ˘Ó Ó· Á›ÓÔ˘Ó ·¯‡Û·Úη ηٿ ÙËÓ ÂÓËÏÈΛˆÛË (Whitaker, Wright, Pepe, Seidel & Dietz, 1997), ÂÓÒ Ë ‡·ÚÍË ·¯˘Û·ÚΛ·˜ Û ӤԢ˜ Â›Ó·È ÚÔÁÓˆÛÙÈÎfi˜ ·Ú¿ÁÔÓÙ·˜ ÁÈ· ÙËÓ ·¯˘Û·ÚΛ· ηٿ ÙËÓ ÂÓ‹ÏÈÎÔ ˙ˆ‹, ·ÓÂÍ¿ÚÙËÙ· ·fi ÙÔ ÛˆÌ·ÙÈÎfi ‚¿ÚÔ˜ ÙˆÓ ÁÔÓ¤-ˆÓ (Whitaker, et al., 1997). √È Ì˯·ÓÈÛÌÔ›, Ô˘ Û˘Ó‰¤Ô˘Ó ÙÔ ˘ÂÚ‚ÔÏÈÎfi ‚¿ÚÔ˜ Ì ÙÔÓ Î·Ú‰È·ÁÁÂÈ·Îfi ΛӉ˘ÓÔ, ‰ÂÓ Â›Ó·È Û·ÊÒ˜ ηıÔÚÈṲ̂ÓÔÈ, ˆÛÙfiÛÔ Ë Û‡Ó‰ÂÛË Ù˘ ·¯˘Û·ÚΛ·˜ Ì ÙËÓ ˘ÂÚÏÈȉȷ̛· Â›Ó·È Û·ÊÒ˜ ·Ó·ÁÓˆÚÈṲ̂ÓË (Lind, Lithell & Pollare, 1993).

¢˘ÛÏÈȉ·ÈÌ›· Â›Ó·È Ë ‰È·Ù·Ú·¯‹ ÙˆÓ ÏÈȉ›ˆÓ ÙÔ˘ ·›Ì·ÙÔ˜ Î·È ÔÊ›ÏÂÙ·È ÛÙËÓ ·˘ÍË̤ÓË Û˘ÁΤÓÙÚˆÛË ÏÈȉ›ˆÓ ‹ ÏÈÔÚˆÙÂ˚ÓÒÓ. ∫·ıÔÚÈÛÙÈÎfi ÚfiÏÔ ÛÙË

‰ËÌÈÔ˘ÚÁ›· Ù˘ ‰È·‰Ú·Ì·Ù›˙ÂÈ Ë ÎÏËÚÔÓÔÌÈÎfiÙËÙ· Î·È ‰ËÌÔÁÚ·ÊÈÎÔ› ·Ú¿ÁÔ-ÓÙ˜, ÂÍ›ÛÔ˘ fï˜ ÛËÌ·ÓÙÈÎfi ÚfiÏÔ ·›˙ÂÈ Î·È Ô ÙÚfiÔ˜ ‰È·‚›ˆÛ˘ ÙÔ˘ ·ÙfiÌÔ˘ (Salminen, Lehtimaki, Fan, Vahlberg & Kivela, 2006). ∞ÚÎÂÙ¤˜ ¤Ú¢Ó˜ ‰ÈÂÍ‹-¯ıËÎ·Ó ÁÈ· ÙÔÓ Î·ıÔÚÈÛÌfi Ù˘ Û¯¤Û˘ ÙˆÓ ÏÈȉ›ˆÓ Ì ÙÔÓ ÙÚfiÔ ‰È·‚›ˆÛ˘ ÙÔ˘ ·ÙfiÌÔ˘, ÙËÓ ÚfiÛÏË„Ë ÙÚÔÊ‹˜ Î·È ÙÔÓ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜ (Nethononda, Essop, Mbewu & Galpin, 2004). ∆Ô ˘ÂÚ‚ÔÏÈÎfi ۈ̷ÙÈÎfi Ï›Ô˜ Û˘¯Ó¿ Û¯ÂÙ›˙ÂÙ·È Ì ·˘ÍË̤ӷ Â›‰· «Î·Î‹˜ ¯ÔÏËÛÙÂÚ›Ó˘» (LDL-C) Î·È ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ Î·È ÌÂȈ̤ӷ Â›‰· «Î·Ï‹˜ ¯ÔÏËÛÙÂÚ›Ó˘» (HDL-C) (Eisenmann, Womack, Reeves, Pivarnik & Malina, 2001). Œ¯ÂÈ ·Ô‰ÂȯÙ› fiÙÈ Ù· ˘„ËÏ¿ Â›‰· ¯ÔÏËÛÙÂÚfiÏ˘ (NCEP 2001), ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ (Satoh, Nishino, Tomita & Tsutsui, 2006), ÔÈ ¯·ÌËÏ‹˜ ˘ÎÓfiÙËÙ·˜ ÏÈÔÚˆÙ½Ó˜ (Marz, Scharnagl, Winkler, Tiran, Nauck, Boehm & Winkelmann, 2004) Î·È Ù· ¯·ÌËÏ¿ Â›‰· ¯ÔÏËÛÙÂÚfiÏ˘ ˘„ËÏ‹˜ ˘ÎÓfiÙËÙ·˜ (HDL-C) (Boden 2000) ‰ÚÔ˘Ó ‚Ï·ÙÈο ÛÙÔÓ ·˘Ïfi ÙˆÓ ·ÚÙËÚÈÒÓ ÂÈÙ·¯‡ÓÔÓÙ·˜ ÙËÓ ÂͤÏÈÍË Ù˘ ÛÙÂ-Ê·ÓÈ·›·˜ ÓfiÛÔ˘ (Sharrett, Ballantyne & Coady, 2001). ∫ÏÈÓÈο ‰Â‰Ô̤ӷ ‰Â›-¯ÓÔ˘Ó fiÙÈ ÔÈ ˘„ËϤ˜ Û˘ÁÎÂÓÙÚÒÛÂȘ ÔÏÈ΋˜ ¯ÔÏËÛÙÂÚfiÏ˘, ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ Î·È ¯·ÌËÏ‹˜ ˘ÎÓfiÙËÙ·˜ ÏÈÔÚˆÙÂ˚ÓÒÓ (LDL-C) Â›Ó·È ·Ú¿ÁÔÓÙ˜ ÎÈÓ‰‡ÓÔ˘ ÁÈ· ÂÌÊ¿ÓÈÛË Î·Ú‰È·ÁÁÂÈ·ÎÒÓ ÓÔÛËÌ¿ÙˆÓ (Sharrett, et al. 2001). ∂›Û˘, ¤¯ÂÈ ·Ó·ÊÂÚı› fiÙÈ Ù· ·˘ÍË̤ӷ Â›‰· ÏÈÔÚˆÙÂ˚ÓÒÓ ˘„ËÏ‹˜ ˘ÎÓfiÙËÙ·˜ (HDL-C) ÂȉÚÔ‡Ó ıÂÙÈο ÛÙË Ì›ˆÛË ÙÔ˘ ηډȷÁÁÂÈ·ÎÔ‡ ÎÈÓ‰‡ÓÔ˘ (Sharrett, et al., 2001). ∏ ÛËÌ·Û›· ÙˆÓ ÂÈ¤‰ˆÓ ÙˆÓ ÏÈȉ›ˆÓ ÛÙËÓ ·È‰È΋ Î·È ÂÊË‚È΋ ËÏÈΛ· Â›Ó·È ÂÍ›ÛÔ˘ ÛËÌ·ÓÙÈ΋. ªÂϤÙ˜ ·˘ÙÔ„›·˜ ·Ô‰ÂÈÎÓ‡Ô˘Ó fiÙÈ ÙÔ ÚÒÙÔ ÛÙ¿‰ÈÔ Ù˘ ·ıËÚÔÛÎÏ‹ÚˆÛ˘ ÍÂÎÈÓ¿ÂÈ Û˘¯Ó¿ ·fi ·˘Ù¤˜ ÙȘ ËÏÈ˘ Î·È Û¯ÂÙ›˙ÂÙ·È Ì ٷ ˘„ËÏ¿ Â›‰· Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘ Î·È Ù˘ LDL-C Î·È Ù· ¯·ÌËÏ¿ Â›‰· Ù˘ HDL-C (Knuiman, Hermus & Hautvast, 1980). ™ËÌ·ÓÙÈÎÔ› ·Ú¿ÁÔÓÙ˜ ÎÈÓ‰‡-ÓÔ˘ ÁÈ· ηډȷÁÁÂȷΤ˜ ·Ûı¤ÓÂȘ, fiˆ˜ Â›Ó·È Ù· ·˘ÍË̤ӷ Â›‰· LDL-C Î·È Ù· ¯·ÌËÏ¿ Â›‰· HDL-C Ù›ÓÔ˘Ó Ó· Û˘ÁÎÂÓÙÚÒÓÔÓÙ·È Û ӤԢ˜, Ì ·Ô-Ù¤ÏÂÛÌ· Ó· ˘¿Ú¯ÂÈ ·˘ÍË̤ÓÔ˜ ΛӉ˘ÓÔ˜ ÁÈ· ηډȷÁÁÂȷΤ˜ ·Ûı¤ÓÂȘ ÛÙË ÌÂÙ¤ÂÈÙ· ˙ˆ‹ ÙÔ˘˜ (Grundy, Bazzarre, Cleeman, D’Agostino, Hill & Houston–Miller, 2000). ∏ Ì›ˆÛË ÙˆÓ ÂÈ¤‰ˆÓ Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘ ÛÙÔ˘˜ Ó¤Ô˘˜ ÌÔÚ› Ó· Ô‰ËÁ‹ÛÂÈ Û ÛËÌ·ÓÙÈ΋ Ì›ˆÛË ÙˆÓ ÛÙÂÊ·ÓÈ·›ˆÓ ÂÂÈÛÔ‰›ˆÓ Î·È Ù˘ ıÓËÛÈÌfiÙËÙ·˜ ÂÍ·ÈÙ›·˜ ÙˆÓ Î·Ú‰È·ÎÒÓ ·ı‹ÛˆÓ. ∂Âȉ‹ fï˜ ‰ÂÓ ˘¿Ú¯Ô˘Ó Ì·ÎÚÔÚfiıÂÛ̘ ÌÂϤÙ˜ ÁÈ· ÙË Û¯¤ÛË ÙˆÓ ÂÈ¤‰ˆÓ ÙˆÓ ÏÈȉ›ˆÓ ÙÔ˘ ·›Ì·ÙÔ˜ Ô˘ ÌÂÙÚÈÔ‡ÓÙ·È ÛÙËÓ ·È‰È΋ ËÏÈΛ· Î·È ÙˆÓ Â·ÎfiÏÔ˘ıˆÓ ÛÙÂÊ·ÓÈ·›ˆÓ ηÚ-‰È·ÎÒÓ ·ı‹ÛÂˆÓ ÛÙË ÌÂÙ¤ÂÈÙ· ˙ˆ‹, Ë Û¯¤ÛË ·˘Ù‹ ÚÔ·ÙÂÈ ·fi ¤ÌÌÂÛ· ÛÙÔȯ›· (Lauer, Lee & Clarke, 1988).

∆· ·ÔÙÂϤÛÌ·Ù·, fï˜ ,·ÚÎÂÙÒÓ ·È‰È·ÙÚÈÎÒÓ ÂÚ¢ÓÒÓ, Ô˘ ‰ÈÂÚ‡ÓËÛ·Ó ÙË Û¯¤ÛË ÌÂٷ͇ ÙˆÓ ·Ú·ÁfiÓÙˆÓ ÎÈÓ‰‡ÓÔ˘ ÁÈ· ηډȷÁÁÂȷΤ˜ ·Ûı¤ÓÂȘ Î·È ÙÔ˘ ÚÔÊ›Ï ÙˆÓ ÏÈȉ›ˆÓ, η٤ÏËÍ·Ó Û ·ÓÙÈÎÚÔ˘fiÌÂÓ· Û˘ÌÂÚ¿ÛÌ·Ù·, ÂÍ·ÈÙ›·˜ ÙˆÓ ÔÚÈÔıÂÙ‹ÛÂˆÓ Î·È ÙˆÓ ÂÚÈÔÚÈÛÌÒÓ Î¿ı ¤Ú¢ӷ˜ ‹ Î·È ÙˆÓ È‰È·›ÙÂÚˆÓ Û¯Â‰È·-ÛÌÒÓ Ô˘ ÂÊ·ÚÌfiÛıËÎ·Ó Û οı ̛· ·fi ·˘Ù¤˜ (Eisenmann, et al., 2001). ∂›-Û˘, Û ÔÏϤ˜ ·fi ·˘Ù¤˜ ÙȘ ¤Ú¢Ó˜ Û˘ÌÌÂÙ›¯·Ó Ó¤ÔÈ ‰È·ÊÔÚÂÙÈÎÒÓ ËÏÈÎÈÒÓ, Ì ·ÔÙ¤ÏÂÛÌ· Ó· ÌËÓ Â›Ó·È ¿ÌÂÛ· Û˘ÁÎÚ›ÛÈÌ· Ù· ·ÔÙÂϤÛÌ·Ù·, ÂÂȉ‹ Ë ËÏÈΛ· Î·È Ë ˆÚ›Ì·ÓÛË ÙˆÓ Ó¤ˆÓ ÂȉÚÔ‡Ó ÛËÌ·ÓÙÈο ÛÙÔ ÚÔÊ›Ï ÙˆÓ ÏÈȉ›ˆÓ Û ·˘Ù¤˜ ÙȘ ËÏÈ˘ (Berenson, Srinivasan, Cresanta, Foster & Webber, 1981).

ªÂ ‚¿ÛË Ù· ·Ú·¿Óˆ, ·ÏÏ¿ Î·È ÙËÓ ¤ÏÏÂÈ„Ë ·Ó¿ÏÔÁˆÓ ÂÚ¢ÓÒÓ ÛÙÔÓ ÂÏÏË-ÓÈÎfi ¯ÒÚÔ, Û ·˘Ù¤˜ ÙȘ ËÏÈ˘, ÛÎÔfi˜ Ù˘ ·ÚÔ‡Û·˜ ¤Ú¢ӷ˜ ‹Ù·Ó Ó· ‰ÈÂÚ¢-Ó‹ÛÂÈ Î·È Ó· ·ÍÈÔÏÔÁ‹ÛÂÈ, ηٿ fiÛÔ Ù· Â›‰· ÙˆÓ ÏÈȉ›ˆÓ ÛÙË Û¯ÔÏÈ΋ ËÏÈΛ· Û¯ÂÙ›˙ÔÓÙ·È Ì ÙËÓ ·¯˘Û·ÚΛ· Î·È ÈÔ Û˘ÁÎÂÎÚÈ̤ӷ Ì ÙÔÓ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·-ÙÔ˜ ÙÔ˘ ·ÙfiÌÔ˘. ª¤ıÔ‰Ô˜ Î·È ¢È·‰Èηۛ· ¢ÔÎÈÌ·˙fiÌÂÓÔÈ ∆Ô ‰Â›ÁÌ· Ù˘ ¤Ú¢ӷ˜ ·ÔÙ¤ÏÂÛ·Ó 120 Ì·ıËÙ¤˜ (59 ·ÁfiÚÈ· Î·È 61 ÎÔÚ›ÙÛÈ·) ËÏÈ-Λ·˜ 12-15 ÂÙÒÓ. ∏ Û˘ÌÌÂÙÔ¯‹ ÙˆÓ Ì·ıËÙÒÓ ‹Ù·Ó ÂıÂÏÔÓÙÈ΋ Î·È Ë ÂÈÏÔÁ‹ ¤ÁÈÓ ÌÂ Ù˘¯·›Ô ÙÚfiÔ. ™˘ÌÌÂÙ›¯·Ó ÌfiÓÔ ÔÈ Ì·ıËÙ¤˜ ÔÈ ÔÔ›ÔÈ ÚÔÛÎfiÌÈÛ·Ó ÙËÓ ¤ÁÁÚ·-ÊË ·Ô‰Ô¯‹ ÂΠ̤ÚÔ˘˜ ÙˆÓ ÁÔÓ¤ˆÓ ‹ ÎˉÂÌfiÓˆÓ ÙÔ˘˜, Û ÂȉÈÎfi ¤ÓÙ˘Ô. ªÂÙÚ‹ÛÂȘ µÈÔ¯ËÌÈΤ˜ ÂÍÂÙ¿ÛÂȘ. °È· ÙË Ï‹„Ë ÙÔ˘ ·›Ì·ÙÔ˜ ·fi ÙÔ˘˜ Ì·ıËÙ¤˜, ÂÓËÌÂÚÒıË-Î·Ó ÚÔËÁÔ˘Ì¤Óˆ˜ ÔÈ ÁÔÓ›˜ ÙÔ˘˜ ÁÈ· ÙÔ˘˜ ÛÎÔÔ‡˜ Ù˘ ¤Ú¢ӷ˜ Î·È ˘¤ÁÚ·-„·Ó ‰‹ÏˆÛË Û˘Ìʈӛ·˜ ÁÈ· ÙË Ï‹„Ë ÙÔ˘ ·›Ì·ÙÔ˜ ·fi ÂÍÂȉÈÎÂ˘Ì¤ÓÔ ÚÔÛˆÈ-Îfi. ∆· ·ÔÙÂϤÛÌ·Ù· ÙˆÓ ÂÍÂÙ¿ÛÂˆÓ ‹Ù·Ó ·˘ÛÙËÚÒ˜ ÚÔÛˆÈο. §‹ÊıËΠÔÛfiÙËÙ· ·›Ì·ÙÔ˜ 10 ml. ÌÂÙ¿ ·fi 12ˆÚË ÙÔ˘Ï¿¯ÈÛÙÔÓ ÓËÛÙ›·. ™Ù· ‰Â›ÁÌ·Ù· ·›Ì·ÙÔ˜ ¤ÁÈÓÂ Ê˘ÁÔΤÓÙÚËÛË ÌÂÙ¿ ÙËÓ ‹ÍË ÙÔ˘˜. ÃÚËÛÈÌÔÔÈ‹ıËΠ∞˘ÙfiÌ·ÙÔ˜ µÈÔ¯ËÌÈÎfi˜ ∞Ó·Ï˘Ù‹˜ OLYMPUS AU-560. ∏ Û˘ÁΤÓÙÚˆÛË ÙˆÓ ÙÚÈÁÏ˘ÎÂÚÈ-‰›ˆÓ ÌÂÙÚ‹ıËΠ̠ÙË Ì¤ıÔ‰Ô Ù˘ ÔÍÂȉ¿Û˘ Ù˘ ÁÏ˘ÎÂÚfiÏ˘ (GPO-PAP), Ë Û˘ÁΤÓÙÚˆÛË Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘ ÌÂÙÚ‹ıËΠ̠ÙË Ì¤ıÔ‰Ô Ù˘ ÔÍÂȉ¿Û˘ Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘ (CHOD-PAP) Î·È Ë Û˘ÁΤÓÙÚˆÛË Ù˘ HDL-C Ì ÙËÓ ·ÓÔÛÔ·-Ó·ÛÙ·ÏÙÈ΋ ̤ıÔ‰Ô. ∆¤ÏÔ˜, Ë LDL-C ˘ÔÏÔÁ›ÛÙËΠ̠ÙËÓ ÂÊ·ÚÌÔÁ‹ Ù˘

·Îfi-ÏÔ˘ı˘ Â͛ۈÛ˘: LDL-C=TC-(HDL-C+ÙÚÈÁÏ˘ÎÂÚ›‰È·/5) (Friedewald, Levy & Fredrickson, 1972). ™ˆÌ·ÙÈ΋ Ì¿˙· ∆Ô ‚¿ÚÔ˜ ÌÂÙÚ‹ıËΠ¯ˆÚ›˜ ·Ô‡ÙÛÈ·, Ì ÂÏ·ÊÚ¤˜ ÊfiÚ̘. ÃÚËÛÈÌÔÔÈ‹ıËΠÊÔÚËÙ‹ ËÏÂÎÙÚÔÓÈ΋ ˙˘Á·ÚÈ¿ ·ÎÚ›‚ÂÈ·˜ 0,2 kg. ∏ ·ÎÚ›‚ÂÈ· Ù˘ ˙˘Á·ÚÈ¿˜ ÂÏÂÁ¯fi-Ù·Ó Û˘¯Ó¿ Ì ÙË ¯ÚËÛÈÌÔÔ›ËÛË ÁÓˆÛÙÔ‡ ‚¿ÚÔ˜ 5 kg. ⁄„Ô˜ To ‡„Ô˜ ÙˆÓ Ì·ıËÙÒÓ ÌÂÙÚ‹ıËΠ۠fiÚıÈ· ı¤ÛË, ¯ˆÚ›˜ ·Ô‡ÙÛÈ·. ∆· fi‰È· ÙˆÓ ÂÍÂÙ·˙fiÌÂÓˆÓ ·Ú¤ÌÂÈÓ·Ó ÎÏÂÈÛÙ¿, ÂÓÒ ÔÈ ÊÙ¤ÚÓ˜, Ë Ï¿ÙË Î·È ÙÔ ÎÂÊ¿ÏÈ ÙˆÓ ÂÍÂÙ·˙ÔÌ¤ÓˆÓ ·ÎÔ˘ÌÔ‡Û·Ó ÛÙÔÓ ÙÔ›¯Ô. ∂ÎÙ›ÌËÛË ·¯˘Û·ÚΛ·˜ °È· ÙÔÓ ˘ÔÏÔÁÈÛÌfi ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜ ¯ÚËÛÈÌÔÔÈ‹ıËΠÙÔ ËÏ›ÎÔ ÙÔ˘ ‚¿ÚÔ˘˜ ÚÔ˜ ÙÔ ‡„Ô˜ ÛÙÔ ÙÂÙÚ¿ÁˆÓÔ (‚¿ÚÔ˜/‡„Ô˜2). ™Ù·ÙÈÛÙÈ΋ ·Ó¿Ï˘ÛË °È· ÙË ‰ÈÂÚ‡ÓËÛË ÙˆÓ ‰È·ÊÔÚÒÓ ÛÙ· Â›‰· ÙˆÓ ÏÈȉ›ˆÓ, ÂÍ·ÈÙ›·˜ ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜, Ù˘ ËÏÈΛ·˜ Î·È ÙÔ˘ ʇÏÔ˘ Î·È ÙËÓ Â‡ÚÂÛË ÙÔ˘ ‚·ıÌÔ‡ ÛËÌ·ÓÙÈ-ÎfiÙËÙ¿˜ ÙÔ˘˜, ¯ÚËÛÈÌÔÔÈ‹ıËΠ∞Ó¿Ï˘ÛË ¢È·Î‡Ì·ÓÛ˘ Ì ¤Ó·Ó ·Ú¿ÁÔÓÙ· (One Way Anova) Î·È ÙÔ ÙÂÛÙ ÔÏÏ·ÏÒÓ Û˘ÁÎÚ›ÛÂˆÓ Scheffe post-hoc. °È· ÙËÓ ÛÙ·ÙÈ-ÛÙÈ΋ ·Ó¿Ï˘ÛË Ù˘ ¤Ú¢ӷ˜ ¯ÚËÛÈÌÔÔÈ‹ıËΠÙÔ ÛÙ·ÙÈÛÙÈÎfi ·Î¤ÙÔ SPSS 17 (SPSS inc., Chicago, Illinois, USA) Î·È ˆ˜ Â›Â‰Ô ÛËÌ·ÓÙÈÎfiÙËÙ·˜ ÔÚ›ÛÙËΠÙÔ p<0.5.

∞ÔÙÂϤÛÌ·Ù·

√È Ì¤Û˜ ÙÈ̤˜ Ù˘ Û˘ÁΤÓÙÚˆÛ˘ ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ, Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘, Ù˘ LDL-C, Ù˘ HDL-C, Î·È ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜ ·Ó¿ ËÏÈΛ· Î·È Ê‡ÏÔ ·ÚÔ˘-ÛÈ¿˙ÔÓÙ·È ÛÙÔÓ ›Ó·Î· 1.

¶›Ó·Î·˜ 1. ª¤Û˜ ÙÈ̤˜ Î·È Ù˘ÈΤ˜ ·ÔÎÏ›ÛÂȘ ÙˆÓ Û˘ÁÎÂÓÙÚÒÛˆÓ

ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ, Ù˘ ¯ÔÏËÛÙÂÚ›Ó˘, Ù˘ LDL-C, Ù˘ HDL-C, Ù˘ VO2 max Î·È ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜ ·Ó¿ ËÏÈΛ· Î·È Ê‡ÏÔ

∏ÏÈΛ· ∆ÚÈÁÏ˘- ÃÔÏË- LDL-C HDL-C ¢.ª.™

(¤ÙË) ¡ ÎÂÚ›‰È· ÛÙÂÚ›ÓË (mg/dl) (mg/dl) Kgr/m2

(mg/dl) (mg/dl) (TA) (TA) (∆A)

(∆∞) (TA) ∞ÁfiÚÈ· 12 11 59,27 165,45 96,09 57,45 19,44 (22,00) (31,73) (23,74) (12,77) (2,66) 13 16 61,81 170,88 105,31 53,19 22,20 (28,79) (28,43) (23,64) (10,24) (3,56) 14 21 60,43 168,57 103,86 52,71 22,18 (22,56) (30,50) (25,71) (10,44) (4,29) 15 11 67,82 159,00 98,36 47,09 25,87 (43,10) (36,55) (32,61) (13,57) (5,69) ∫ÔÚ›ÙÛÈ· 12 17 75,71 181,53 112,53 53,53 22,31 (46,99) (27,95) (19,58) (15,77) (4,27) 13 15 78,93 178,40 106,33 56,20 23,73 (29,23) (23,84) (25,40) (11,26) (4,60) 14 17 52,47 171,00 105,53 55,41 22,77 (17,92) (34,65) (29,79) (10,90) (4,14) 15 12 53,08 161,67 95,67 56,50 22,29 (11,20) (25,71) (23,81) (10,61) (3,94) ŒÁÈÓ ·Ó¿Ï˘ÛË ‰È·Î‡Ì·ÓÛ˘ (Anova) ÙˆÓ ÂÍ·ÚÙËÌ¤ÓˆÓ ÌÂÙ·‚ÏËÙÒÓ ÙÚÈÁÏ˘-ÎÂÚ›‰È·, ¯ÔÏËÛÙÂÚfiÏË, LDL-C Î·È HDL-C. ∞ÓÂÍ¿ÚÙËÙ˜ ÌÂÙ·‚ÏËÙ¤˜ ‹Ù·Ó ÔÈ Î·ÙËÁÔڛ˜ Ô˘ ·Ó‹ÎÂÈ ÙÔ Î¿ı ¿ÙÔÌÔ ·Ó¿ÏÔÁ· Ì ÙÔÓ ¢Â›ÎÙË ª¿˙·˜ ™ÒÌ·ÙÔ˜. ø˜ ÚÔ˜ ÙÔÓ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜, ÔÈ Ì·ıËÙ¤˜ ηÙËÁÔÚÈÔÔÈËı‹Î·Ó ÛÂ Ê˘ÛÈÔÏÔÁÈÎÔ‡˜, ˘¤Ú‚·ÚÔ˘˜ Î·È ·¯‡Û·ÚÎÔ˘˜ Ì ‚¿ÛË ÙËÓ ËÏÈΛ· Î·È ÙÔ Ê‡ÏÔ, Û‡Ìʈӷ Ì ٷ ‰ÈÂıÓÒ˜ ·Ô‰ÂÎÙ¿ fiÚÈ· ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜, ÁÈ· ÙËÓ ·ÍÈÔ-ÏfiÁËÛË ÙˆÓ ÛˆÌ·ÙÈο ˘¤Ú‚·ÚˆÓ Î·È ·¯‡Û·ÚÎˆÓ ·È‰ÈÒÓ ËÏÈΛ·˜ 2-18 ÂÙÒÓ (Cole Bellizzi, Flegal, Dietz, 2000). °È· ·Ú¿‰ÂÈÁÌ· ÛÙËÓ ËÏÈΛ· ÙˆÓ 14 ÂÙÒÓ ÛÙ·

·ÁfiÚÈ·, ÔÈ ÔÚȷΤ˜ ÙÈ̤˜ ÙÔ˘ ¢ª™ Â›Ó·È ÁÈ· ÙÔ Ê˘ÛÈÔÏÔÁÈÎfi ‚¿ÚÔ˜ ≤22,60 kg/m2, ÁÈ· ÙÔ ˘ÂÚ‚ÔÏÈÎfi ‚¿ÚÔ˜ ·fi 22,60-27,60 kg/m2 Î·È ÁÈ· ÙËÓ ·¯˘Û·ÚΛ· ≥27,60 kg/m2. °È· Ù· ÎÔÚ›ÙÛÈ· Ù˘ ›‰È·˜ ËÏÈΛ·˜ ÔÈ ·ÓÙ›ÛÙÔȯ˜ ÙÈ̤˜ Â›Ó·È ¢ª™≤23,30 kg/m2, 23,30≤¢ª™≤28,60 kg/m2 Î·È ¢ª™≥28,60 kg/m2. ∆· Â›‰· ÙˆÓ ÏÈÈ-‰›ˆÓ ÙÔ˘ ·›Ì·ÙÔ˜, Ù· ÔÔ›· ıˆڋıËÎ·Ó fiÙÈ ‚Ú›ÛÎÔÓÙ·È ¿Óˆ ·fi ÙÔ Ê˘ÛÈÔÏÔÁÈ-Îfi fiÚÈÔ, ‹Ù·Ó ÁÈ· ÙËÓ ¯ÔÏËÛÙÂÚfiÏË 200 mg/dL, ÁÈ· Ù· ÙÚÈÁÏ˘ÎÂÚ›‰È· 150 mg/dL, ÁÈ· ÙËÓ LDL-C 130 mg/dL, Î·È ÁÈ· ÙËÓ HDL-C <40 mg/dL (NCEP, 2001). ∂ÍÂÙ¿ÛÙËÎÂ, ‰ËÏ·‰‹, ηٿ fiÛÔ ˘¿Ú¯Ô˘Ó ‰È·ÊÔÚ¤˜ ÛÙ· Â›‰· ÙˆÓ ÏÈÈ-‰›ˆÓ ÏfiÁˆ ÙÔ˘ ¢ª™ οı ·ÙfiÌÔ˘. √È Ì¤Û˜ ÙÈ̤˜ Î·È ÔÈ Ù˘ÈΤ˜ ·ÔÎÏ›ÛÂȘ ÙˆÓ ÂÈ¤‰ˆÓ ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ, Ù˘ ¯ÔÏËÛÙÂÚ›Ó˘, Ù˘ LDL-C Î·È Ù˘ HDL-C, ·Ó¿ ηÙËÁÔÚ›· ¢Â›ÎÙË ª¿˙·˜ ™ÒÌ·ÙÔ˜ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÛÙÔÓ ›Ó·Î· 2. ¶›Ó·Î·˜ 2. ª¤Û˜ ÙÈ̤˜ ÙˆÓ ÂÈ¤‰ˆÓ ÙˆÓ ÏÈȉ›ˆÓ ·Ó¿ ηÙËÁÔÚ›· ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜ ∫·ÙËÁÔÚ›· ¡ ª¤ÛÔ˜ ∆˘È΋ ¢ª™ ŸÚÔ˜ ∞fiÎÏÈÛË ∆ÚÈÁÏ˘ÎÂÚ›‰È· (mg/dl) º˘ÛÈÔÏÔÁÈÎÔ› 91 56,46 20.04 À¤Ú‚·ÚÔÈ 22 86.23 45.62 ¶·¯‡Û·ÚÎÔÈ 7 88.71 40.45 ÃÔÏËÛÙÂÚ›ÓË (mg/dl) º˘ÛÈÔÏÔÁÈÎÔ› 91 170.79 32.71 À¤Ú‚·ÚÔÈ 22 169.18 18.72 ¶·¯‡Û·ÚÎÔÈ 7 169.71 22.95 LDL-C (mg/dl) º˘ÛÈÔÏÔÁÈÎÔ› 91 104,65 27.34 À¤Ú‚·ÚÔÈ 22 99.27 18.77 ¶·¯‡Û·ÚÎÔÈ 7 106.86 15.53 HDL-C (mg/dl) º˘ÛÈÔÏÔÁÈÎÔ› 91 55.24 11.29 À¤Ú‚·ÚÔÈ 22 51.91 14.31 ¶·¯‡Û·ÚÎÔÈ 7 44.57 7.87 ø˜ ÚÔ˜ ÙÔÓ ¢ª™ Ù· ·ÔÙÂϤÛÌ·Ù· ¤‰ÂÈÍ·Ó fiÙÈ ˘‹Ú¯Â ÛÙ·ÙÈÛÙÈο ÛËÌ·ÓÙÈ΋ ‰È·ÊÔÚ¿ ·) ÛÙ· Â›‰· ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ ÙˆÓ ÂÍÂÙ·˙fiÌÂÓˆÓ ·ÙfïÓ, Ô˘ ¿ÓË-Î·Ó Û ‰È·ÊÔÚÂÙÈΤ˜ ηÙËÁÔڛ˜ ¢ª™ (¿ÓË-ηÓÔÓÈÎÔ›, ˘¤Ú‚·ÚÔÈ, ·¯‡Û·ÚÎÔÈ) F(2,117) = 18,01 p< ,000 Î·È ‚) ÛÙ· Â›‰· Ù˘ HDL-C F(2,117) = 4,53 p< ,013. ∂›Û˘, ‚Ú¤ıËΠfiÙÈ ‰ÂÓ ˘‹Ú¯Â ÛÙ·ÙÈÛÙÈο ÛËÌ·ÓÙÈ΋ ‰È·ÊÔÚ¿ ˆ˜ ÚÔ˜ Ù·

Â›-‰· Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘ Î·È Ù˘ LDL-C. ∆¤ÏÔ˜, Ë Post Hoc ·Ó¿Ï˘ÛË Ì ÙËÓ Ì¤ıÔ-‰Ô Scheffe Ù˘ ÂÍ·ÚÙË̤Ó˘ ÌÂÙ·‚ÏËÙ‹˜ ÙÚÈÁÏ˘ÎÂÚ›‰È· Û ۯ¤ÛË Ì ÙËÓ Î·ÙËÁÔÚ›· Ô˘ ·Ó‹ÎÂÈ Ô ¢ª™ (Ê˘ÛÈÔÏÔÁÈÎÔ›, ˘¤Ú‚·ÚÔÈ, ·¯‡Û·ÚÎÔÈ) ¤‰ÂÈÍ fiÙÈ ˘¿Ú¯Ô˘Ó ÛÙ·ÙÈÛÙÈο ÛËÌ·ÓÙÈΤ˜ ‰È·ÊÔÚ¤˜ ÌÂٷ͇ ÙˆÓ Ê˘ÛÈÔÏÔÁÈÎÒÓ Î·È ÙˆÓ ˘¤Ú‚·ÚˆÓ Î·È ÌÂٷ͇ ÙˆÓ ·¯‡Û·ÚÎˆÓ Î·È ÙˆÓ ˘¤Ú‚·ÚˆÓ. ∆· ·ÔÙÂϤÛÌ·Ù· ¤‰ÂÈÍ·Ó fiÙÈ ‰ÂÓ ˘¿Ú¯ÂÈ ÛÙ·ÙÈÛÙÈο ÛËÌ·ÓÙÈ΋ ‰È·ÊÔÚ¿ ˆ˜ ÚÔ˜ Ù· Â›‰· Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘, Ù˘ LDL-C, Ù˘ HDL-C Î·È ÙˆÓ ÙÚÈÁÏ˘ÎÂÚÈ-‰›ˆÓ ˆ˜ ÚÔ˜ ÙËÓ ËÏÈΛ· (12-15 ÂÙÒÓ) ÙÔ˘ ÂÍÂÙ·˙fiÌÂÓÔ˘ ‰Â›ÁÌ·ÙÔ˜. ∂›Û˘, ‰ÂÓ ·Ú·ÙËÚ‹ıËΠηÌÈ¿ ÛÙ·ÙÈÛÙÈο ÛËÌ·ÓÙÈ΋ ‰È·ÊÔÚ¿ Û Â›Â‰Ô p<.05 ÛÙ· ÚÔ-·Ó·ÊÂÚı¤ÓÙ· Â›‰· ÙˆÓ ÏÈȉ›ˆÓ Û ۯ¤ÛË Ì ÙÔ Ê‡ÏÔ (·ÁfiÚÈ· – ÎÔÚ›ÙÛÈ·). √ ·ÚÈıÌfi˜ Î·È ÙÔ ÔÛÔÛÙfi ÙˆÓ Û˘ÌÌÂÙ¯fiÓÙˆÓ, ˆ˜ ÚÔ˜ ÙȘ ηÙËÁÔڛ˜ Ô˘ ·Ó‹Î·Ó (ÂÈı˘ÌËÙ‹, ÔÚȷο ÂÈΛӉ˘ÓË Î·È Î·ÙËÁÔÚ›· ˘„ËÏÔ‡ ÎÈÓ‰‡ÓÔ˘) ÁÈ· ÙÔ˘˜ ÂÍÂÙ·-˙fiÌÂÓÔ˘˜ ·Ú¿ÁÔÓÙ˜ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÛÙÔÓ ›Ó·Î· 3. ¶›Ó·Î·˜ 3. ∫·Ù·ÓÔÌ‹ Û˘ÌÌÂÙ¯fiÓÙˆÓ ÛÙË ÌÂϤÙË ˆ˜ ÚÔ˜ Ù· Â›‰· ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ, Ù˘ ÔÏÈ΋˜ ¯ÔÏËÛÙÂÚfiÏ˘ ÔÚÔ‡, Ù˘ HDL-C, Ù˘ LDL-C Î·È ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜ ∫·ÙËÁÔÚ›· ∂Èı˘ÌËÙ‹ √Úȷο ÂÈΛӉ˘ÓË À„ËÏfi˜ ΛӉ˘ÓÔ˜ ∞ÚÈıÌfi˜ ¶ÔÛÔÛÙfi ∞ÚÈıÌfi˜ ¶ÔÛÔÛÙfi ∞ÚÈıÌfi˜ ¶ÔÛÔÛÙfi Û˘ÌÌÂÙ¯. (%) Û˘ÌÌÂÙ¯. (%) Û˘ÌÌÂÙ¯. (%) ∆ÚÈÁÏ˘ÎÂÚ›‰È· 118 98,8 1 0,8 1 0,8 ÃÔÏËÛÙÂÚfiÏË 103 85,8 14 11,7 3 2,5 HDL-C 35 29,2 75 62,5 10 8,3 LDL-C 103 85,8 12 10,0 5 4,2 µªπ 66 55,0 34 28,3 20 16,7 ™˘˙‹ÙËÛË ∏ ¤Ú¢ӷ ¤ÁÈÓ Ì ÛÎÔfi Ó· ‰È·ÈÛÙˆı› Ë Û¯¤ÛË ÌÂٷ͇ Ù˘ ۈ̷ÙÈ΋˜ Ì¿˙·˜ (·¯˘Û·ÚΛ·˜) ˆ˜ ·Ú¿ÁÔÓÙ· ÎÈÓ‰‡ÓÔ˘ ÁÈ· ηډȷÁÁÂȷΤ˜ ·Ûı¤ÓÂȘ Î·È ¿ÏÏˆÓ Î‡ÚÈˆÓ ·Ú·ÁfiÓÙˆÓ ÎÈÓ‰‡ÓÔ˘ (·˘ÍË̤ÓË LDL-C, ÙÚÈÁÏ˘ÎÂÚ›‰È·, ¯ÔÏËÛÙÂÚfiÏË Î·È ÌÂȈ̤ÓË HDL-C) Û ӤԢ˜. ™ÙËÓ ·ÚÔ‡Û· ¤Ú¢ӷ ·Ô‰ÂÈÎÓ‡ÂÙ·È fiÙÈ ˘¿Ú-¯ÂÈ ÛËÌ·ÓÙÈ΋ Û˘Û¯¤ÙÈÛË ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜ ÛÙȘ ÂÍÂÙ·˙fiÌÂÓ˜ ËÏÈ˘ ÌÂ

Ù· Â›‰· ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ Î·È Ù˘ HDL-C. √È Ê˘ÛÈÔÏÔÁÈÎÔ‡ ‚¿ÚÔ˘˜ ÂÍÂÙ·-˙fiÌÂÓÔÈ Ì·ıËÙ¤˜ ›¯·Ó ÌÂȈ̤ӷ Â›‰· ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ Î·È ·˘ÍË̤ӷ Â›‰· ηϋ˜ ¯ÔÏËÛÙÂÚfiÏ˘, Û˘ÁÎÚÈÓfiÌÂÓÔÈ Ì ÙÔ˘˜ ˘¤Ú‚·ÚÔ˘˜. ∆· ·ÔÙÂϤÛÌ·Ù· ¤Ú¯ÔÓÙ·È ÛÂ Û˘Ìʈӛ· Ì ÚÔËÁÔ‡ÌÂÓ˜ ·Ó·ÊÔÚ¤˜ ÙˆÓ Hu, Hannah, Gray, Jablonski, Henderson, Robbins, Lee, Welty Î·È Howard (2000) Î·È ÙˆÓ Donahue, Orchard, Kuller Î·È Drash (1985) ÛÙËÓ Beaver County Lipid Study, Û‡Ìʈӷ Ì ÙȘ Ôԛ˜ o ¢ª™ Û¯ÂÙ›˙ÂÙ·È ıÂÙÈο Ì ٷ ÙÚÈÁÏ˘ÎÂÚ›‰È· Î·È Ì ÙËÓ HDL-C. ∂›-Û˘, Û˘ÌʈÓÔ‡Ó Ì ٷ ·ÔÙÂϤÛÌ·Ù· Ù˘ ¤Ú¢ӷ˜ (Stea, Wandel, Mansoor, Uglem, & FrÔlich, 2009) Û ӤԢ˜, Û‡Ìʈӷ Ì ÙËÓ ÔÔ›· ÙÔ Â›Â‰Ô ÙÔ˘ ¢ª™ Û¯ÂÙ›˙ÂÙ·È ·ÚÓËÙÈο Ì ÙËÓ Û˘ÁΤÓÙÚˆÛË Ù˘ HDL-C. ¢Â Û˘ÌʈÓÔ‡Ó fï˜, Ì ٷ Â˘Ú‹Ì·Ù· Ù˘ ›‰È·˜ ¤Ú¢ӷ˜, fiÔ˘ ‚Ú¤ıËÎÂ Û˘Û¯¤ÙÈÛË ÛÙ· Â›‰· ÙÔ˘ ¢ª™ Î·È Ù˘ LDL-C. ∆¤ÏÔ˜, Ù· ·ÔÙÂϤÛÌ·Ù· Û˘ÌʈÓÔ‡Ó Ì ¤Ú¢Ó˜ Û ӤԢ˜ (Sempos, et. al., 2003) Ô˘ ηٷϋÁÔ˘Ó ÛÙÔ fiÙÈ Ë Ì›ˆÛË ÙˆÓ ˘„ËÏÒÓ ÔÛÔÛÙÒÓ ÙˆÓ ÏÈÈ-‰›ˆÓ Û¯ÂÙ›˙ÂÙ·È Ì ÙË Ì›ˆÛË Ù˘ ·¯˘Û·ÚΛ·˜. ∏ ·ÚÔ˘Û›· ˘„ËÏÒÓ ÙÈÌÒÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ ÛÙÔ ·›Ì· ÌÔÚ› Ó· ¢ı‡ÓÂÙ·È ÁÈ· ·ÚÎÂÙ¿ ÚÔ‚Ï‹Ì·Ù· ˘Á›·˜. ∏ Û¯¤ÛË ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ Î·È Î·Ú‰È·ÁÁÂÈ·ÎÒÓ ·ÛıÂ-ÓÂÈÒÓ Â›Ó·È ÔÏ˘Û‡ÓıÂÙË, ÂÓÒ ˘„ËÏ¿ Â›‰· ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ ıˆÚÂ›Ù·È fiÙÈ Â›Ó·È ÂÚÈÛÛfiÙÂÚÔ ÂÈΛӉ˘Ó· Û ·¯‡Û·Úη ¿ÙÔÌ·. ∏ ·ÏÏ·Á‹ ÙÔ˘ ÙÚfiÔ˘ ˙ˆ‹˜ ıˆ-ÚÂ›Ù·È ·ÔÙÂÏÂÛÌ·ÙÈÎfi ̤ÛÔ ÁÈ· ÙË Ì›ˆÛË ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ ¯ˆÚ›˜ Ê·Ú̷΢-ÙÈΤ˜ ·ÚÂÌ‚¿ÛÂȘ. ∏ Ì›ˆÛË ÙÔ˘ ‚¿ÚÔ˘˜, fiÙ·Ó Û˘Ó‰˘¿˙ÂÙ·È Ì ٷÎÙÈ΋ ۈ̷ÙÈ-΋ ¿ÛÎËÛË Â›Ó·È ‰˘Ó·ÙfiÓ Ó· ÌÂÈÒÛÂÈ Ù· Â›‰· ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ ·ÓÂÍ¿ÚÙËÙ· ·fi ¿ÏÏÔ˘˜ ·Ú¿ÁÔÓÙ˜ (NCEP, 1988). ¢ÂÓ ˘‹ÚÍ·Ó ‰È·ÊÔÚ¤˜ ÛÙȘ Û˘ÁÎÂÓÙÚÒÛÂȘ Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘ Î·È Ù˘ LDL-C ÛÙȘ ÂÍÂÙ·˙fiÌÂÓ˜ ËÏÈ˘. ™Â ·˘Ù¤˜ ÙȘ ËÏÈ˘ Ù· Â›‰· Ù˘ ¯ÔÏËÛÙÂÚfiÏ˘ Â›Ó·È Û¯ÂÙÈο ÛÙ·ıÂÚ¿, ÌÂÈÒÓÔÓÙ·È Î·Ù¿ ÙËÓ ‰È¿ÚÎÂÈ· Ù˘ ÂÊ˂›·˜ Î·È ·˘Í¿ÓÔ-ÓÙ·È ·ÚÁfiÙÂÚ· ηٿ ÙËÓ ÂÓËÏÈΛˆÛË (Berenson, et. al., 1981).

™ÙËÓ ·ÚÔ‡Û· ¤Ú¢ӷ ‰È·ÈÛÙÒıËΠfiÙÈ ÔÈ Ì¤Û˜ ÙÈ̤˜ ÙˆÓ ÏÈȉ›ˆÓ ‹Ù·Ó ·Ú·Ï‹ÛȘ, Û ۯ¤ÛË Ì ÚfiÛÊ·ÙË ÌÂϤÙË (CHASE) Ô˘ ¤ÁÈÓ Û ·È‰È¿ (Donin, Nightingale, Owen, Rudnicka, McNamara, Prynne Î·È Û˘Ó. 2010), (170,4 mg/dl ¤Ó·ÓÙÈ 174,4 mg/dl ÛÙËÓ ÔÏÈ΋ ¯ÔÏËÛÙÂÚfiÏË, 103,7 mg/dl ¤Ó·ÓÙÈ 101,3 mg/dl ÛÙËÓ LDL-C, 54,1 mg/dl ¤Ó·ÓÙÈ 59,9 mg/dl ÛÙËÓ HDL-C Î·È 63,8 mg/dl ¤Ó·ÓÙÈ 71,74 mg/dl ÛÙ· ÙÚÈÁÏ˘ÎÂÚ›‰È·). ™ÙË ÌÂϤÙË ‰Â ‚Ú¤ıËΠ‰È·ÊÔÚ¿ ÛÙȘ Û˘ÁÎÂÓÙÚÒ-ÛÂȘ ÙˆÓ ÏÈȉ›ˆÓ ÌÂٷ͇ ÙˆÓ ˘¤Ú‚·ÚˆÓ Î·È ·¯‡Û·ÚÎˆÓ ÂÍÂÙ·˙fiÌÂÓˆÓ, ÁÂÁÔ-Ófi˜ Ô˘ ¤Ú¯ÂÙ·È ÛÂ Û˘Ìʈӛ· Ì ¿ÏÏ· ·ÔÙÂϤÛÌ·Ù· ÙˆÓ (Choi, Paio & Kim 2002) Û ·¯‡Û·ÚÎÔ˘˜ Ó¤Ô˘˜.

¢Â ‚Ú¤ıËΠÛËÌ·ÓÙÈ΋ ‰È·ÊÔÚ¿ ÌÂٷ͇ ÙˆÓ ·ÁÔÚÈÒÓ Î·È ÎÔÚÈÙÛÈÒÓ ÛÙȘ ÙÈ̤˜ ÙˆÓ ÂÍÂÙ·˙fiÌÂÓˆÓ ÏÈȉ›ˆÓ, Û ·ÓÙ›ıÂÛË Ì ٷ Â˘Ú‹Ì·Ù· ¿ÏÏ˘ ÌÂϤÙ˘, Ô˘

·Ó·-ʤÚÂÈ fiÙÈ Ù· ÎÔÚ›ÙÛÈ· ¤¯Ô˘Ó ÛËÌ·ÓÙÈο ˘„ËÏfiÙÂÚ˜ ÙÈ̤˜ TC Î·È LDL–C ·fi Ù· ·ÁfiÚÈ· (Hayman, Meininger, Daniels, McCrindle, Helden, Ross, et al., 2007 ), ‚Ú¤ıËΠfï˜ ˘„ËÏfiÙÂÚÔ˜ ̤ÛÔ˜ fiÚÔ˜ ÔÏÈ΋˜ ¯ÔÏËÛÙÂÚfiÏ˘ (170,4 mg/dl) Û ۯ¤ÛË Ì ·Ï·ÈfiÙÂÚË ÏËı˘ÛÌȷ΋ ÌÂϤÙË (NHANES III) ÙˆÓ ÂÙÒÓ 1988–1994. H ÌÂϤÙË ÙˆÓ ‰È·ÊÔÚÒÓ ÙˆÓ Â›‰ˆÓ ÙˆÓ ÏÈȉ›ˆÓ ˆ˜ ÚÔ˜ ÙÔ Á¤ÓÔ˜ Â›Ó·È ÔÏ˘-Û‡ÓıÂÙÔ ˙‹ÙËÌ· Î·È Ë ‰È·¯ÚÔÓÈ΋ ·Ú·ÎÔÏÔ‡ıËÛË ·È‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ ·Ó·Ê¤ÚÂÈ fiÙÈ Ë ÂÚ›Ô‰Ô˜ Ù˘ ·Ó¿Ù˘Í˘ Âȉڿ ¤ÓÙÔÓ· ÛÙȘ ÙÈ̤˜ Ù˘ ¯ÔÏËÛÙÂÚ›Ó˘ Î·È fiÙÈ Ë ·Ó¿Ù˘ÍË Â›Ó·È ‰È·ÊÔÚÂÙÈ΋ ÌÂٷ͇ ·ÁÔÚÈÒÓ Î·È ÎÔÚÈÙÛÈÒÓ (Labarthe, Nichaman, Harrist, Grunbaum & Da, 1997).

∞fi Ù· ·ÔÙÂϤÛÌ·Ù· Ù˘ ¤Ú¢ӷ˜ ÚÔ·ÙÂÈ fiÙÈ ÔÛÔÛÙfi ÂÚ›Ô˘ 15% ÙˆÓ Ó¤ˆÓ Ù˘ ¤Ú¢ӷ˜ ›¯Â Â›‰· TC>200 mg/dl, ÔÛÔÛÙfi Ô˘ Â›Ó·È ÌÂÁ·Ï‡ÙÂÚÔ Î·Ù¿ 5% Û ۯ¤ÛË Ì ÙËÓ ÌÂϤÙË ÙˆÓ Hickman, Briefel, Carroll, Rifkind, Cleeman, Maurer & Johnson (1998). ∂›Û˘, Ô Ì¤ÛÔ˜ fiÚÔ˜ ÙˆÓ ÙÈÌÒÓ ÙˆÓ ÂÍÂÙ·-˙fiÌÂÓˆÓ ÏÈȉ›ˆÓ ‚Ú¤ıËΠ·˘ÍË̤ÓÔ˜ Î·È Ù›ÓÂÈ ϤÔÓ Ó· ÏËÛÈ¿ÛÂÈ ÙȘ ̤ÁÈÛÙ˜ ÙÈ̤˜ ÙˆÓ ÌÂÙÚ‹ÛÂˆÓ ÂΛӢ Ù˘ ÂÚÈfi‰Ô˘ (Hickman, et. al., 1998).

H ·ÚÔ‡Û· ¤Ú¢ӷ ¤¯ÂÈ ‰Â›ÍÂÈ fiÙÈ Û‹ÌÂÚ· ÙÔ ÚÔÊ›Ï ÙˆÓ ÏÈȉ›ˆÓ ÙˆÓ Û˘ÌÌÂ-Ù¯fiÓÙˆÓ Ó¤ˆÓ ¤¯ÂÈ ˘„ËÏfiÙÂÚ˜ ÙÈ̤˜ Û ۯ¤ÛË Ì ÙȘ ÙÈ̤˜ ÙˆÓ ·ÌÂÚÈηÓÒÓ Ó¤ˆÓ Ù˘ ÌÂϤÙ˘ ¡HANES πππ (1988-1994). ™˘ÁÎÚÈÓfiÌÂÓ· Ì ٷ ·ÔÙÂϤÛÌ·Ù· ·˘Ù‹˜ Ù˘ ÌÂϤÙ˘, Ë ·ÚÔ‡Û· ·ÚÔ˘ÛÈ¿˙ÂÈ ˘„ËÏÔÙ¤Ú· Â›‰· LDL-C (+8,79 ml/dl), ÔÏÈ΋˜ ¯ÔÏËÛÙÂÚfiÏ˘ (+5,43 ml/dl) Î·È HDL-C ηٿ 5,16 ml/dl (Hayman, et al., 2007). ∆· ·ÔÙÂϤÛÌ·Ù· Â›Ó·È ÛËÌ·ÓÙÈο Î·È Ú¤ÂÈ Ó· ÏËÊıÔ‡Ó ˘fi„Ë ÁÈ· ÙËÓ ÂͤÏÈÍË Ù˘ ÌÂÙ¤ÂÈÙ· ˘Á›·˜ ÙˆÓ Ì·ıËÙÒÓ, ‰ÈfiÙÈ Û‡Ìʈӷ Ì ٷ ‰Â‰Ô̤ӷ Ù˘ ÌÂϤÙ˘ Bogalusa, ÔÛÔÛÙfi 70% ÙˆÓ Ì·ıËÙÒÓ Ô˘ ›¯·Ó ·˘ÍË̤ӷ Â›‰· ¯ÔÏË-ÛÙÂÚfiÏ˘ ‰È·ÙËÚÔ‡Û·Ó ·˘Ù¿ Ù· ·˘ÍË̤ӷ Â›‰· Î·È Î·Ù¿ ÙËÓ ‰È¿ÚÎÂÈ· Ù˘ ÂÓË-ÏÈΛˆÛ˘ (Webber Srinivasan, Wattigney, Berenson 1991).

™ÙËÓ ·ÚÔ‡Û· ¤Ú¢ӷ ÚÔÙÈÌ‹ıËÎÂ Ë ÂͤٷÛË ÙÔ˘ ‰Â›ÎÙË Ì¿˙·˜ ÛÒÌ·ÙÔ˜, ·ÚfiÏÔ Ô˘ ¤¯ÂÈ ‰Ôı› ÌÂÁ¿ÏË ¤ÌÊ·ÛË ÁÈ· ÙÔÓ ÚfiÏÔ Ô˘ ‰È·‰Ú·Ì·Ù›˙ÂÈ Ë ÎÂÓÙÚÈ-΋ ·¯˘Û·ÚΛ·, Ë ÂÓ·fiıÂÛË ‰ËÏ·‰‹ Ï›Ô˘˜ ÛÙËÓ ÎÔÈÏÈ·ÎÂÓÙÚÈ-΋ ¯ÒÚ·, ˆ˜ ·Ú¿ÁÔÓÙ·˜ ·˘ÍË̤ÓÔ˘ ηډȷÁÁÂÈ·ÎÔ‡ ÎÈÓ‰‡ÓÔ˘, (Larsen, Bengtsson, Björntorp, Lapidus, Sjöström, Svärdsudd Î·È Û˘Ó. 1992). ∆ÚÂȘ ÏfiÁÔÈ ÌÔÚÔ‡Ó Ó· ÂÍËÁ‹ÛÔ˘Ó, ÁÈ·Ù› ÛÙÔ˘˜ Ó¤Ô˘˜ Î·È ÂÊ‹‚Ô˘˜ Ô ¢ª™ ÂÍ·ÎÔÏÔ˘ı› Ó· ·ÔÙÂÏ› ÛËÌ·ÓÙÈÎfi ·Ú¿ÁÔÓÙ· ÛÙËÓ Ì›ˆÛË ÙÔ˘ ÎÈÓ‰‡ÓÔ˘ ÁÈ· ηډȷÁÁÂȷΤ˜ ·Ûı¤ÓÂȘ. ¶ÚÒÙÔÓ, ÔÈ ·ÏÏ·Á¤˜ ÛÙÔ Ì¤ÁÂıÔ˜ ÙÔ˘ ÛÒÌ·ÙÔ˜ Â›Ó·È ÁÓˆÛÙfi fiÙÈ ÂÌÊ·Ó›˙ÔÓÙ·È Î·Ù¿ ÙËÓ ‰È¿ÚÎÂÈ· Ù˘ ˆÚ›Ì·ÓÛ˘ ÛÙËÓ ÂÊË‚È΋ ËÏÈΛ· (Freedman, et. al., 1999). ¢Â‡ÙÂÚÔÓ, ÔÈ Ó¤ÔÈ ¤¯Ô˘Ó ηٿ ηÓfiÓ· ÌÈÎÚfiÙÂÚË ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ·, ‰ËÏ·‰‹ ÂÓ·fiıÂÛË Ï›Ô˘˜ ÛÙËÓ ÎÔÈÏȷ΋ ¯ÒÚ· ·fi ÙÔ˘˜ ÂÓ‹ÏÈΘ (Goran, Kaskoun & Shuman, 1995), ÂÔ̤ӈ˜ Ô ÚfiÏÔ˜ Ù˘ ÂÓ·fiıÂÛ˘ Ï›Ô˘˜ ÛÙËÓ ÎÔÈÏȷ΋ ¯ÒÚ· ¤¯ÂÈ ÌfiÏȘ ·Ú¯›ÛÂÈ Ó·

ÂÌÊ·-Ó›˙ÔÓÙ·È Û ÂÊ‹‚Ô˘˜ (Sangi & Mueller, 1991). ∆Ú›ÙÔÓ, ˘¿Ú¯Ô˘Ó ‰È·ÊÔÚ¤˜ ÌÂÙ·-͇ ÙˆÓ ‰˘Ô Ê‡ÏˆÓ Ô˘ Û˘Ó‰¤ÔÓÙ·È Ì ÙËÓ ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ·, fiÔ˘ ÔÈ ¿Ó‰Ú˜ Ù›ÓÔ˘Ó Ó· ¤¯Ô˘Ó ÌÂÁ·Ï‡ÙÂÚË Û ̤ÁÂıÔ˜ ÂÚÈʤÚÂÈ· ̤Û˘ ·fi ÙȘ Á˘Ó·›Î˜ (National Cholesterol Education Program, 2002).

∂ÈÙÒÛÂȘ Î·È ÌÂÏÏÔÓÙÈΤ˜ ¤Ú¢Ó˜ ∆· Â˘Ú‹Ì·Ù· Ù˘ ¤Ú¢ӷ˜ Â›Ó·È ‰˘Ó·Ùfi Ó· ÂËÚ¿ÛÔ˘Ó ÙËÓ ÚfiÏË„Ë ÙˆÓ Î·Ú-‰È·ÁÁÂÈ·ÎÒÓ ·ÛıÂÓÂÈÒÓ ÛÙÔ˘˜ Ó¤Ô˘˜ Î·È ¤ÊË‚Ô˘˜. ™‡Ìʈӷ Ì ٷ ·ÔÙÂϤÛÌ·-Ù·, Ë ÚˆÙ·Ú¯È΋ ÚfiÏË„Ë Ú¤ÂÈ Ó· ÍÂÎÈÓ¿ Ì ·ÚÂÌ‚¿ÛÂȘ ÛÙÔÓ ÙÚfiÔ ˙ˆ‹˜, fiÔ˘ ı· Ú¤ÂÈ Ó· ‰›ÓÂÙ·È ¤ÌÊ·ÛË ÛÙË ‚ÂÏÙ›ˆÛË Ù˘ ·ÂÚfi‚È·˜ ÈηÓfiÙËÙ·˜ Î·È ÙË ‰È·Ù‹ÚËÛË ÙÔ˘ ‚¿ÚÔ˘˜ ÛÙ· Ê˘ÛÈÔÏÔÁÈο ÁÈ· ÙËÓ ËÏÈΛ· Î·È ÙÔ Ê‡ÏÔ Â›‰·. ∂È-ϤÔÓ, ÌÂϤÙ˜ Ú¤ÂÈ Ó· ‰ÒÛÔ˘Ó ¤ÌÊ·ÛË Û ·ÚÂÌ‚¿ÛÂȘ, Ô˘ ı· ¤¯Ô˘Ó ˆ˜ ÛÙfi¯Ô ÙËÓ ÙÚÔÔÔ›ËÛË ÙÔ˘ ÙÚfiÔ˘ ‰È·‚›ˆÛ˘, ÙËÓ ·‡ÍËÛË Ù˘ ¿ÛÎËÛ˘ Î·È Ù˘ Ê˘ÛÈ΋˜ ‰Ú·ÛÙËÚÈfiÙËÙ·˜ Î·È ÙË ‚ÂÏÙ›ˆÛË Ù˘ ‰È·ÙÚÔÊ‹˜, ÙfiÛÔ ÛÙÔ Û¯ÔÏÈÎfi fiÛÔ Î·È ÛÙÔ ÔÈÎÔÁÂÓÂÈ·Îfi ÂÚÈ‚¿ÏÏÔÓ. µÈ‚ÏÈÔÁÚ·Ê›·

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