按冠心病10年风险划分的生活方式及新出现风险因素的分布情况。

Distribution of lifestyle and emerging risk factors by 10-year risk for coronary heart disease.

作者信息

Ajani Umed A, Ford Earl S, McGuire Lisa C

机构信息

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

出版信息

Eur J Cardiovasc Prev Rehabil. 2006 Oct;13(5):745-52. doi: 10.1097/01.hjr.0000230099.70900.f6.

DOI:10.1097/01.hjr.0000230099.70900.f6

PMID:17001214

Abstract

BACKGROUND

The Framingham risk score has been used for coronary heart disease (CHD) risk assessment. Recently, additional risk factors not included in the Framingham algorithm have received much attention and may help improve risk assessment. We examined the distributions of lifestyle and emerging risk factors by 10-year risk of CHD.

METHODS

We calculated 10-year CHD risk (<10%, 10-20%, and >20%) for 8355 participants in the National Health and Nutrition Examination Survey (NHANES) 1999-2002 using the Framingham risk score as modified by the National Cholesterol Education Program Adult Treatment Panel III guidelines. We examined the prevalence of lifestyle risk factors [body mass index (BMI) and waist circumference] and various emerging risk factors [C-reactive protein (CRP), white blood cell count, fibrinogen, homocysteine, glycosylated hemoglobin, and albuminuria] as well as prevalence of high CHD risk by levels of these risk factors.

RESULTS

All examined CHD risk factors were significantly associated with increasing 10-year CHD risk among men and women. Odds of being in the highest CHD risk group were greater at higher levels of examined risk factors. Means for most risk factors were slightly higher for women than the means for men. Sizeable proportions of participants with lower 10-year CHD risk had high levels of lifestyle and emerging risk factors: 60.8% were overweight, 33.8% had high CRP concentrations, 24.1% had serum fibrinogen >400 mg/dl and 6% had an albumin/creatinine ratio >/=30.

CONCLUSIONS

Lifestyle and emerging risk factors, in addition to those included in the Framingham risk score, may be important in CHD risk assessment.

摘要

背景

弗雷明汉风险评分已用于冠心病（CHD）风险评估。最近，弗雷明汉算法中未包含的其他风险因素受到了广泛关注，可能有助于改善风险评估。我们根据冠心病的10年风险研究了生活方式和新出现的风险因素的分布情况。

方法

我们使用国家胆固醇教育计划成人治疗小组III指南修订的弗雷明汉风险评分，计算了1999 - 2002年国家健康和营养检查调查（NHANES）中8355名参与者的10年冠心病风险（<10%、10 - 20%和>20%）。我们研究了生活方式风险因素[体重指数（BMI）和腰围]以及各种新出现的风险因素[C反应蛋白（CRP）、白细胞计数、纤维蛋白原、同型半胱氨酸、糖化血红蛋白和蛋白尿]的患病率，以及这些风险因素水平下的高冠心病风险患病率。

结果

所有研究的冠心病风险因素在男性和女性中均与10年冠心病风险增加显著相关。在所研究的风险因素水平较高时，处于最高冠心病风险组的几率更大。大多数风险因素的均值女性略高于男性。10年冠心病风险较低的参与者中，相当大比例的人生活方式和新出现的风险因素水平较高：60.8%超重，33.8%CRP浓度高，24.1%血清纤维蛋白原>400mg/dl，6%白蛋白/肌酐比值≥30。