疾病家族史与冠心病发生风险的关联研究

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

Abstract

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].Chinese journal of Epidemiology,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

Received:May 05, 2017

DOI：10.3760/cma.j.issn.0254-6450.2018.02.007

KeyWord: 家族史冠心病急性冠心病事件缺血性心脏病

English Key Word: Family history Coronary heart disease Major coronary events Ischemic heart disease

FundProject: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）

Author Name	Affiliation	E-mail
Si Jiahui	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Meng Ruogu	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Yu Canqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Guo Yu	Chinese Academy of Medical Sciences, Beijing 100010, China China National Center for Food Safety Risk Assessment, Beijing 100020, China
Bian Zheng	Chinese Academy of Medical Sciences, Beijing 100010, China China National Center for Food Safety Risk Assessment, Beijing 100020, China
Tan Yunlong	Chinese Academy of Medical Sciences, Beijing 100010, China China National Center for Food Safety Risk Assessment, Beijing 100020, China
Pei Pei	Chinese Academy of Medical Sciences, Beijing 100010, China China National Center for Food Safety Risk Assessment, Beijing 100020, China
Chen Junshi	Clinical Trial Service Unit and Epidemiological Studies Unit
Chen Zhengming	Nuffield Department of Population Health, University of Oxford, Oxford OX1 3QR, UK
Lyu Jun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China	lvjun@bjmu.edu.cn
Li Liming	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Chinese Academy of Medical Sciences, Beijing 100010, China China National Center for Food Safety Risk Assessment, Beijing 100020, China

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Abstract:

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。

English Abstract:

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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