Dontas A S, Menotti A, Aravanis C, Ioannidis P, Seccareccia F
Centre of Studies of Age-Related Changes in Man, Athens, Greece.
J Epidemiol Community Health. 1998 Oct;52(10):638-44. doi: 10.1136/jech.52.10.638.
Mortality over 25 years has been low in the Italian and very low in the Greek cohorts of the Seven Countries Study; factors responsible for this particularity were studied in detail.
1712 Italian and 1215 Greek men, aged 40-59 years, cohorts of the Seven Countries Study, representing over 95% of the populations in designated rural areas.
Entry (1960-61) data included age, systolic blood pressure (SBP), smoking habits, total serum cholesterol, body mass index (BMI), arm circumference, vital capacity (VC), and forced expiratory volume in 3/4 seconds (FEV); the same data were obtained 10 years later. Multivariate Cox analysis was performed with all causes death in 25 years as end point.
Italian men had higher entry levels of SBP, arm circumference, BMI, and VC; Greek men had higher cholesterol levels, smoking habits, and FEV. Mortality of Italian men was higher throughout; at 25 years cumulative mortality was 48.3% and 35.3% respectively. Coronary heart disease and stroke mortality increased fivefold in Italy and 10-fold in Greece between years 10 and 25. The only risk factor with a significantly higher contribution to mortality in Italian men was cholesterol. However, differences in entry SBP (higher in Italy) and FEV (higher in Greece) accounted for, according to the Lee method, 75% of the differential mortality between the two populations. At 10 years increases in SBP, cholesterol, BMI, and decreases in smoking habits, VC, FEV, and arm circumference had occurred (deltas). SBP increased more and FEV and VC decreased more in Italy than in Greece. Deltas, fed stepwise in the original model for the prediction of 10 to 25 years mortality, were significant for SBP, smoking, arm circumference, and VC in Greece, and for SBP and VC in Italy.
Higher mortality in Italian men is related to stronger positive effects of entry SBP and weaker negative (protective) effects of FEV; in addition 10 year increases in SBP are higher and 10 year decreases in FEV are larger in Italy. Unaccounted factors, however, related to, for example, differences in the diet, may also have contributed to the differential mortality of these two Mediterranean populations.
在七国研究中，意大利队列25年的死亡率较低，希腊队列的死亡率则极低；对造成这种特殊性的因素进行了详细研究。
1712名意大利男性和1215名希腊男性，年龄在40 - 59岁之间，均为七国研究队列成员，代表了指定农村地区超过95%的人口。
入组（1960 - 1961年）数据包括年龄、收缩压（SBP）、吸烟习惯、总血清胆固醇、体重指数（BMI）、上臂围、肺活量（VC）以及3/4秒用力呼气量（FEV）；10年后获取相同数据。以25年全因死亡作为终点进行多变量Cox分析。
意大利男性入组时的SBP、上臂围、BMI和VC水平较高；希腊男性的胆固醇水平、吸烟习惯和FEV较高。意大利男性的死亡率在整个过程中都较高；25年时累积死亡率分别为48.3%和35.3%。在第10年至第25年期间，意大利冠心病和中风死亡率增加了5倍，希腊增加了10倍。对意大利男性死亡率有显著更高贡献的唯一危险因素是胆固醇。然而，根据Lee方法，入组时SBP（意大利较高）和FEV（希腊较高）的差异占这两个人群死亡率差异的75%。在第10年时，SBP、胆固醇、BMI有所增加，吸烟习惯、VC、FEV和上臂围有所下降（变化值）。意大利的SBP增加幅度更大，FEV和VC下降幅度比希腊更大。将这些变化值逐步纳入预测10至25年死亡率的原始模型中，希腊的SBP、吸烟、上臂围和VC以及意大利的SBP和VC变化值具有显著意义。
意大利男性较高的死亡率与入组时SBP的较强正向作用以及FEV较弱的负向（保护）作用有关；此外，意大利SBP在10年中的增加幅度更大，FEV在10年中的下降幅度也更大。然而，与饮食差异等相关的未明确因素也可能导致了这两个地中海人群死亡率的差异。
