文章摘要
司佳卉,孟若谷,余灿清,郭彧,卞铮,谭云龙,裴培,陈君石,陈铮鸣,吕筠,李立明.疾病家族史与冠心病发生风险的关联研究[J].中华流行病学杂志,2018,39(2):173-178
疾病家族史与冠心病发生风险的关联研究
Family history and risk of coronary heart disease
收稿日期:2017-05-05  出版日期:2018-02-10
DOI:10.3760/cma.j.issn.0254-6450.2018.02.007
中文关键词: 家族史;冠心病;急性冠心病事件;缺血性心脏病
英文关键词: Family history;Coronary heart disease;Major coronary events;Ischemic heart disease
基金项目:国家自然科学基金(81390540,81390544,81390541);国家重点研发计划精准医学研究重点专项(2016YFC0900500,2016YFC0900501,2016YFC0900504);中国香港Kadoorie Charitable基金;英国Wellcome Trust (202922/Z/16/Z,088158/Z/09/Z,104085/Z/14/Z)
作者单位E-mail
司佳卉 100191 北京大学公共卫生学院流行病与卫生统计学系  
孟若谷 100191 北京大学公共卫生学院流行病与卫生统计学系  
余灿清 100191 北京大学公共卫生学院流行病与卫生统计学系  
郭彧 100010 北京, 中国医学科学院  
卞铮 100010 北京, 中国医学科学院  
谭云龙 100010 北京, 中国医学科学院  
裴培 100010 北京, 中国医学科学院  
陈君石 100020 北京, 国家食品安全风险评估中心  
陈铮鸣 英国牛津大学  
吕筠 100191 北京大学公共卫生学院流行病与卫生统计学系 lvjun@bjmu.edu.cn 
李立明 100191 北京大学公共卫生学院流行病与卫生统计学系
100010 北京, 中国医学科学院 
 
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中文摘要:
      目的 分析疾病家族史对急性冠心病事件(MCE)及缺血性心脏病(IHD)发病风险的影响。方法 研究对象来自中国慢性病前瞻性研究,剔除基线时患有恶性肿瘤、心脏病及脑卒中的个体,纳入485 784人进行分析。统计分析采用Cox比例风险模型。结果 研究人群随访M=7.2年,随访期间新发MCE 3 934例,IHD 24 537例。与无家族史者相比,有家族史者发生MCE及IHD的风险均较高,HR值(95% CI)分别为1.41(1.19~1.65)和1.25(1.18~1.33)。与双亲型家族史相比,同胞型家族史与早发MCE的关联更强(HR=2.97,95% CI:1.80~4.88);超重/肥胖者中家族史与MCE、IHD的关联更强;吸烟者中家族史与MCE的关联更强。结论 有家族史者发生MCE及IHD的风险较高。结果提示应鼓励个体根据疾病家族史信息,及早开展生活方式干预和相关基础疾病的治疗管理。
英文摘要:
      Objective To evaluate the association of family history with risk of major coronary events (MCE) and ischemic heart disease (IHD). Methods After excluding participants with heart disease, stroke or cancer at baseline survey, a total of 485 784 participants from the China Kadoorie Biobank, who had no missing data on critical variables, were included in the analysis. Cox regression analysis was used to estimate the hazard ratios (HR) and 95% CI. Subgroup analyses were performed according to the baseline characteristics. Results During a median of 7.2 years of follow-up, we documented 3 934 incident cases of MCE and 24 537 cases of IHD. In multivariable-adjusted models, family history was significantly associated with risk of MCE and IHD. The adjusted HRs (95% CI) were 1.41 (1.19-1.65) and 1.25 (1.18-1.33), respectively. History of disease among siblings was more strongly associated with early-onset MCE than parental history (HR=2.97, 95% CI:1.80-4.88). Moreover, the association of family history with MCE and IHD was stronger in persons who were overweight or obesive, and the association between family history and MEC was stronger in smokers. Conclusion This large-scale, prospective study indicated that family history was an independent risk factor for MCE and IHD in China. The intervention targeting major known lifestyle risk factors and the management of chronic diseases should be strengthened for Chinese population, especially for the individuals with family history were at high risk.
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