Di Castelnuovo Augusto, Quacquaruccio Gianni, Donati Maria Benedetta, de Gaetano Giovanni, Iacoviello Licia
Laboratory of Genetic and Environmental Epidemiology, Research Laboratories, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy.
Am J Epidemiol. 2009 Jan 1;169(1):1-8. doi: 10.1093/aje/kwn234. Epub 2008 Oct 8.
Spousal pairs permit assessment of determinants of diseases related to environment, because they share the same lifestyle and environment. The authors reviewed spouses' concordance for the major coronary risk factors. A search of the MEDLINE, PubMed, and EMBASE databases was performed. Seventy-one papers were selected for a total of 207 cohorts of pairs and 424,613 correlations in more than 100,000 couples. The most strongly correlated within-pairs factors were smoking and body mass index, with overall correlations of 0.23 (95% confidence interval: 0.12, 0.36) and 0.15 (95% confidence interval: 0.05, 0.25), respectively. Statistically significant positive correlations were also found for diastolic blood pressure, triglycerides, total and low density lipoprotein cholesterol, weight, and the waist/hip ratio. The overall odds ratios for concordance in hypertension, smoking, diabetes, and obesity were all statistically significant, ranging from 1.16 to 3.25. Assortative mating influenced concordance for blood pressure, smoking, glucose, low density lipoprotein cholesterol, weight, body mass index, and waist circumference. This systematic review shows a statistically significant positive spousal concordance for the majority of main coronary risk factors. However, the strength of the concordance was markedly different among factors and appeared to be quite modest for all of them. Interventions to reduce cardiovascular risk factors should be addressed jointly to both members of a marital couple.
配偶双方有助于评估与环境相关疾病的决定因素，因为他们拥有相同的生活方式和环境。作者回顾了配偶在主要冠心病危险因素方面的一致性。对MEDLINE、PubMed和EMBASE数据库进行了检索。共挑选出71篇论文，涉及207个配偶队列，超过10万对夫妻中的424,613个相关性数据。配偶间相关性最强的因素是吸烟和体重指数，总体相关性分别为0.23（95%置信区间：0.12, 0.36）和0.15（95%置信区间：0.05, 0.25）。舒张压、甘油三酯、总胆固醇和低密度脂蛋白胆固醇、体重以及腰臀比也存在统计学显著的正相关。高血压、吸烟、糖尿病和肥胖方面一致性的总体优势比均具有统计学意义，范围在1.16至3.25之间。选型交配影响血压、吸烟、血糖、低密度脂蛋白胆固醇、体重、体重指数和腰围的一致性。这项系统评价显示，大多数主要冠心病危险因素在配偶间存在统计学显著的正一致性。然而，各因素间一致性的强度差异明显，且所有因素的一致性似乎都相当有限。降低心血管危险因素的干预措施应针对夫妻双方共同开展。
