Liang Li-Rong, Wong Nathan D, Shi Ping, Zhao Lian-Cheng, Wu Liu-Xin, Xie Gao-Qiang, Wu Yang-Feng
Department of Epidemiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Prev Med. 2009 Aug;49(1):62-7. doi: 10.1016/j.ypmed.2009.05.006. Epub 2009 May 22.
To assess the cross-sectional and longitudinal association of cigarette smoking with carotid atherosclerosis in middle-aged and older Chinese adults.
The study population consisted of 1132 residents in Beijing (748 women and 384 men) aged 35 to 64 years. Information on baseline smoking characteristics, including smoking status and pack-years was collected in 1993-1994. The cohort was resurveyed in 2002 and common carotid artery intima-media thickness (CCA-IMT) and carotid plaques were measured by B-mode ultrasound.
The multivariable-adjusted mean CCA-IMT at resurvey was significantly associated with smoking status at both resurvey and baseline, and was 0.72 mm for consistent current smokers, 0.71 mm for former and inconsistent smokers, and 0.70 mm for consistent never smokers at both surveys, respectively (p-trend<0.01). The multivariable-adjusted odds ratio [OR, 95% confidence interval (CI)] of having carotid plaques was 1.5 (1.0-2.1) for consistent current smokers vs consistent never smokers. In addition, there was a significant dose-response relationship between baseline smoking pack-years and multivariable-adjusted mean CCA-IMT and risk of having carotid plaques at resurvey.
Smoking is associated with carotid atherosclerosis in middle-aged and older Chinese adults both cross-sectionally and longitudinally. Smoking cessation may play a significant role in prevention and control of cardiovascular diseases in China.
评估中国中老年成年人吸烟与颈动脉粥样硬化的横断面及纵向关联。
研究人群包括1132名年龄在35至64岁之间的北京居民(748名女性和384名男性)。于1993 - 1994年收集了包括吸烟状况和吸烟包年数在内的基线吸烟特征信息。该队列于2002年进行了再次调查,通过B型超声测量了颈总动脉内膜中层厚度(CCA - IMT)和颈动脉斑块。
再次调查时,多变量调整后的平均CCA - IMT与再次调查及基线时的吸烟状况均显著相关,两次调查中,持续吸烟者的平均CCA - IMT为0.72毫米,既往吸烟者和非持续吸烟者为0.71毫米,持续不吸烟者为0.70毫米(P趋势<0.01)。与持续不吸烟者相比,持续吸烟者有颈动脉斑块的多变量调整后的比值比[OR,95%置信区间(CI)]为1.5(1.0 - 2.1)。此外,基线吸烟包年数与再次调查时多变量调整后的平均CCA - IMT及有颈动脉斑块的风险之间存在显著的剂量反应关系。
在中国中老年成年人中,吸烟在横断面和纵向上均与颈动脉粥样硬化相关。戒烟可能在中国心血管疾病的预防和控制中发挥重要作用。