Schooling C Mary, Lam Tai Hing, Ho Sai Yin, Mak Kwok Hang, Leung Gabriel M
Dept of Community Medicine and School of Public Health, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
BMC Public Health. 2008 Jan 25;8:32. doi: 10.1186/1471-2458-8-32.
The male excess risk of premature ischemic heart disease (IHD) mortality may be partially due to an unknown macro-environmental influence associated with economic development. We examined whether excess male risk of IHD mortality was higher with birth in an economically developed environment.
We used multivariable logistic regression in a population-based case-control study of all adult deaths in Hong Kong Chinese in 1998 to compare sex differences in IHD mortality (1,189 deaths in men, 1,035 deaths in women and 20,842 controls) between Hong Kong residents born in economically developed Hong Kong or in contemporaneously undeveloped Guangdong province in China.
Younger (35-64 years) native-born Hong Kong men had a higher risk of IHD death than such women (odds ratio 2.91, 95% confidence interval 1.66 to 5.13), adjusted for age, socio-economic status and lifestyle. There was no such sex difference in Hong Kong residents who had migrated from Guangdong. There were no sex differences in pneumonia deaths by birth place.
Most of these people migrated as young adults; we speculate that environmentally mediated differences in pubertal maturation (when the male disadvantage in lipids and fat patterning emerges) may contribute to excess male premature IHD mortality in developed environments.
男性过早发生缺血性心脏病（IHD）死亡的额外风险可能部分归因于与经济发展相关的未知宏观环境影响。我们研究了在经济发达环境中出生的男性，其IHD死亡的额外风险是否更高。
在一项基于人群的病例对照研究中，我们采用多变量逻辑回归分析，对1998年所有成年香港华人死亡病例进行研究，以比较在中国经济发达的香港或同期经济欠发达的广东省出生的香港居民中，IHD死亡率的性别差异（男性死亡1189例，女性死亡1035例，对照20842例）。
经年龄、社会经济地位和生活方式调整后，出生在香港的较年轻（35 - 64岁）男性患IHD死亡的风险高于女性（比值比2.91，95%置信区间1.66至5.13）。从广东移民到香港的居民中不存在这种性别差异。不同出生地的肺炎死亡不存在性别差异。
这些人中大多数在年轻时就移民了；我们推测，环境介导的青春期成熟差异（此时男性在脂质和脂肪分布方面的劣势出现）可能导致发达环境中男性过早发生IHD死亡的额外风险增加。
