Division of Cardiovascular Diseases, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States.
Int J Cardiol. 2013 Jan 20;162(3):228-33. doi: 10.1016/j.ijcard.2011.05.068. Epub 2011 Jun 8.
To better understand the basis for previously reported ethnic differences in ankle brachial index (ABI), we investigated whether these differences were present in individuals without known peripheral arterial disease (PAD).
We used data from National Health and Nutrition Examination surveys (NHANES 1999-2004) to determine whether ethnic differences were present in respondents without PAD (1 ≤ ABI ≤ 1.3). We assessed whether ethnicity was an independent predictor of ABI and ankle systolic blood pressure (SBP) in linear regression models that adjusted for conventional and novel cardiovascular risk factors. To minimize effects of atherosclerosis on ABI, we studied adults aged ≤ 60 years, and also repeated our analyses in a subset aged ≤ 50 years that did not have risk factors for PAD.
3348 participants aged ≤ 60 years were included in the study. Mean ABI was 1.11 in non-Hispanic Blacks (NHB) and 1.13 in non-Hispanic Whites (NHW) (P < 0.0001). In multivariable linear regression analysis that adjusted for age, gender, ethnicity, smoking, height, diabetes, brachial SBP, dyslipidemia, diabetes, renal function, concurrent cardiovascular disease, and plasma levels of homocysteine, fibrinogen and C-reactive protein, NHB had lower ABI than NHW (β = -0.03 ± 0.004, P < 0.00001). Although, NHBs had higher ankle SBP than NHWs (by 5.4 mm Hg), NHBs had a lower mean ankle SBP (β = -3.663 mm Hg ± 0.500, P < 0.0001) after adjusting for clinical covariates, including brachial SBP, in multivariable analysis.
Ethnic differences in ABI are present in middle-aged adults at low risk for peripheral atherosclerosis.
为了更好地理解先前报道的踝臂指数（ABI）种族差异的基础，我们研究了这些差异是否存在于无已知外周动脉疾病（PAD）的个体中。
我们使用国家健康和营养检查调查（NHANES 1999-2004）的数据来确定在无 PAD（1≤ABI≤1.3）的受访者中是否存在种族差异。我们评估了种族是否是ABI 和踝部收缩压（SBP）的独立预测因素，在调整了常规和新型心血管危险因素的线性回归模型中进行了评估。为了最大限度地减少动脉粥样硬化对 ABI 的影响，我们研究了年龄≤60 岁的成年人，并在不具有 PAD 危险因素的年龄≤50 岁的亚组中重复了我们的分析。
3348 名年龄≤60 岁的参与者被纳入研究。非西班牙裔黑人（NHB）的平均 ABI 为 1.11，非西班牙裔白人（NHW）为 1.13（P<0.0001）。在调整年龄、性别、种族、吸烟、身高、糖尿病、肱动脉 SBP、血脂异常、糖尿病、肾功能、并存心血管疾病和同型半胱氨酸、纤维蛋白原和 C-反应蛋白的血浆水平的多变量线性回归分析中，NHB 的 ABI 低于 NHW（β=-0.03±0.004，P<0.00001）。尽管 NHB 的踝部 SBP 高于 NHW（高 5.4mmHg），但在调整了临床协变量（包括肱动脉 SBP）后，NHB 的平均踝部 SBP 较低（β=-3.663mmHg±0.500，P<0.0001），在多变量分析中。
在外周动脉粥样硬化低危的中年成年人中，ABI 存在种族差异。
