早年从冠心病风险高的国家迁移到风险较低的国家，可降低中年男性亚临床动脉粥样硬化的风险。

Migration at early age from a high to a lower coronary heart disease risk country lowers the risk of subclinical atherosclerosis in middle-aged men.

作者信息

Jartti L, Rönnemaa T, Raitakari O T, Hedlund E, Hammar N, Lassila R, Marniemi J, Koskenvuo M, Kaprio J

机构信息

Department of Geriatric Medicine, University of Turku, Turku, Finland.

出版信息

J Intern Med. 2009 Mar;265(3):345-58. doi: 10.1111/j.1365-2796.2008.02018.x.

DOI:10.1111/j.1365-2796.2008.02018.x

PMID:19207372

Abstract

BACKGROUND

Study of migrants offers a natural model to assess environmental risk of coronary heart disease (CHD) in countries differing in CHD occurrence. In Sweden, CHD risk has been markedly lower than in Finland from where a large migration occurred in the 1970s.

OBJECTIVES

To study the structural and functional markers of subclinical atherosclerosis in twin pairs discordant for migration with the main focus on age at migration, length of residence and integration into Swedish society after migration from a high to a lower CHD risk country.

METHODS

Carotid intima-media thickness (IMT) and brachial artery endothelial function (EF) were assessed with high-resolution ultrasound and a set of cardiovascular, socio-economic and psychosocial risk factors were estimated in 76 middle-aged male twin pairs discordant for migration from Finland to Sweden.

RESULTS

Men who had migrated in adolescence had lower IMT values compared with their co-twins living in Finland (0.665 +/- 0.114 vs. 0.802 +/- 0.167 mm, P = 0.009). Also men who integrated well to Swedish society had lower (0.720 +/- 0.154 vs. 0.799 +/- 0.207 mm, P = 0.013) IMT values than their twin brothers living in Finland. Associations between IMT and migration age and between IMT and integration remained significant in multivariate analyses of several CHD risk factors. The intrapair difference in IMT was significantly associated with immigration age and integration (ANOVA, P = 0.0082), the difference being greatest among pairs where the brother living in Sweden had migrated at early age and integrated well to Swedish society. EF was better in men who had migrated to Sweden before the age of 21 years, but not later, compared with their co-twins in Finland (6.4 +/- 4.6% vs. 3.8 +/- 3.6%, P = 0.025).

CONCLUSIONS

Migration at an early age and good integration are beneficial to vascular health associated with moving from a high to a lower CHD risk country, suggesting that an environment-sensitive period influences atherogenesis before adulthood.

摘要

背景

对移民的研究提供了一个自然模型，用于评估冠心病（CHD）发病率不同的国家中冠心病的环境风险。在瑞典，冠心病风险明显低于芬兰，20世纪70年代有大量芬兰人移民至瑞典。

目的

研究移民情况不一致的双胞胎亚临床动脉粥样硬化的结构和功能标志物，主要关注移民年龄、居住时间以及从冠心病高风险国家移民到低风险国家后融入瑞典社会的情况。

方法

采用高分辨率超声评估76对从芬兰移民到瑞典的中年男性双胞胎的颈动脉内膜中层厚度（IMT）和肱动脉内皮功能（EF），并评估一系列心血管、社会经济和心理社会风险因素。

结果

青春期移民的男性与留在芬兰的双胞胎相比，IMT值更低（0.665±0.114 vs. 0.802±0.167mm，P = 0.009）。融入瑞典社会良好的男性的IMT值也低于留在芬兰的双胞胎兄弟（0.720±0.154 vs. 0.799±0.207mm，P = 0.013）。在对多种冠心病风险因素的多变量分析中，IMT与移民年龄以及IMT与融入情况之间的关联仍然显著。IMT的双胞胎内差异与移民年龄和融入情况显著相关（方差分析，P = 0.0082），在瑞典的兄弟早年移民并很好地融入瑞典社会的双胞胎对中，差异最大。21岁之前移民到瑞典的男性的EF优于留在芬兰的双胞胎，21岁之后移民则不然（6.4±4.6% vs. 3.8±3.6%，P = 0.025）。