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血清C反应蛋白和纤维蛋白原浓度以及自我报告的心绞痛和心肌梗死:第三次全国健康与营养检查调查结果

Serum C-reactive protein and fibrinogen concentrations and self-reported angina pectoris and myocardial infarction: findings from National Health and Nutrition Examination Survey III.

作者信息

Ford E S, Giles W H

机构信息

Division of Nutrition and Physical Activity and Division of Adult Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.

出版信息

J Clin Epidemiol. 2000 Jan;53(1):95-102. doi: 10.1016/s0895-4356(99)00143-2.

Abstract

C-reactive protein may predict the risk of cardiovascular disease, but its association with angina pectoris in the general population has not been clearly established, however. We used data from National Health and Nutrition Examination Survey III conducted from 1988-1994 to examine the associations between serum C-reactive protein and plasma fibrinogen concentrations and self-reported angina pectoris and myocardial infarction among 7,948 U.S. men and women aged 40 years and older. C-reactive protein and fibrinogen concentrations were moderately correlated (r = 0.43). After adjustment for age, sex, race or ethnicity, education, smoking status, systolic blood pressure, serum cholesterol, high-density lipoprotein cholesterol, history of diabetes mellitus, body mass index, and physical activity, fibrinogen (but not C-reactive protein) concentration was significantly associated with self-reported angina pectoris. Neither fibrinogen or C-reactive protein concentrations were significantly associated with angina pectoris when entered in the model simultaneously. C-reactive protein and fibrinogen concentrations were positively associated with myocardial infarction when entered separately into models, but only C-reactive protein concentration was significantly associated with myocardial infarction when both variables were entered simultaneously. These cross-sectional data showed a significant positive association between C-reactive protein concentration and myocardial infarction but not self-reported angina pectoris in the U.S. population.

摘要

C反应蛋白可能预测心血管疾病风险,但它与普通人群心绞痛的关联尚未明确确立。我们使用了1988年至1994年开展的第三次全国健康和营养检查调查的数据,来研究7948名40岁及以上美国男性和女性中血清C反应蛋白及血浆纤维蛋白原浓度与自我报告的心绞痛和心肌梗死之间的关联。C反应蛋白和纤维蛋白原浓度呈中度相关(r = 0.43)。在对年龄、性别、种族或民族、教育程度、吸烟状况、收缩压、血清胆固醇、高密度脂蛋白胆固醇、糖尿病史、体重指数和身体活动进行校正后,纤维蛋白原(而非C反应蛋白)浓度与自我报告的心绞痛显著相关。当同时纳入模型时,纤维蛋白原和C反应蛋白浓度与心绞痛均无显著关联。当分别纳入模型时,C反应蛋白和纤维蛋白原浓度与心肌梗死呈正相关,但当两个变量同时纳入时,只有C反应蛋白浓度与心肌梗死显著相关。这些横断面数据表明,在美国人群中,C反应蛋白浓度与心肌梗死之间存在显著正相关,但与自我报告的心绞痛无关。

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