Fava M, Littman A, Lamon-Fava S, Milani R, Shera D, MacLaughlin R, Cassem E, Leaf A, Marchiò B, Bolognesi E
Department of Psychiatry, Massachusetts General Hospital, Boston 02114.
Am J Cardiol. 1992 Dec 1;70(18):1412-6. doi: 10.1016/0002-9149(92)90291-6.
Differences in psychological, behavioral and biochemical risk factors for coronary artery disease (CAD) among male corporate managers of 2 countries (United States and Italy), with very different age-specific rates of mortality for CAD were evaluated. In all, 129 American (mean age 43 +/- 7 years) and 80 Italian (mean age 45 +/- 7 years) managers volunteered to participate in this study. Each subject was administered several questionnaires assessing various psychological and behavioral risk factors for CAD, and all 129 Americans and 55 of 80 Italians had their blood drawn between 8:00 and 9:30 AM after overnight fasting for the measurement of plasma levels of dehydroepiandrosterone-sulfate (DHEA-S), total cholesterol, triglycerides, and apolipoproteins A-I and B. Italian managers reported significantly more cynicism and hostility, and less enjoyment in leisure activities than did American ones. Furthermore, 40 Italian (51%) and only 18 American (14%) managers were smokers (this difference being statistically significant). Although no significant differences were found in factors positively related with CAD (cholesterol, triglycerides and apolipoprotein B), there were clear differences in parameters inversely correlated with the incidence of CAD. Italian managers had significantly lower levels of plasma DHEA-S and apolipoprotein A-I than did American ones. In conclusion, this study found that Italian managers had a significantly more unhealthy psychological and behavioral profile than did American ones, and had lower levels of those biochemical parameters (apolipoprotein A-I and DHEA-S) thought to have a protective role against development of CAD.
对两个国家（美国和意大利）男性企业经理中冠状动脉疾病（CAD）的心理、行为和生化风险因素差异进行了评估，这两个国家的CAD年龄别死亡率差异很大。共有129名美国经理（平均年龄43±7岁）和80名意大利经理（平均年龄45±7岁）自愿参与本研究。每位受试者都接受了几份评估CAD各种心理和行为风险因素的问卷，并且所有129名美国人以及80名意大利人中的55人在禁食过夜后于上午8点至9点30分之间抽血，以测量血浆硫酸脱氢表雄酮（DHEA-S）、总胆固醇、甘油三酯以及载脂蛋白A-I和B的水平。与美国经理相比，意大利经理表现出明显更多的愤世嫉俗和敌意，并且在休闲活动中的乐趣更少。此外，40名意大利经理（51%）是吸烟者，而美国经理中只有18名（14%）是吸烟者（这一差异具有统计学意义）。尽管在与CAD呈正相关的因素（胆固醇、甘油三酯和载脂蛋白B）方面未发现显著差异，但在与CAD发病率呈负相关的参数方面存在明显差异。意大利经理的血浆DHEA-S和载脂蛋白A-I水平明显低于美国经理。总之，本研究发现，意大利经理的心理和行为状况明显比美国经理更不健康，并且那些被认为对CAD发展具有保护作用的生化参数（载脂蛋白A-I和DHEA-S）水平较低。
