Medical Research & Biometrics Center, National Center for Cardiovascular Disease, Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China.
Chin Med J (Engl). 2012 Dec;125(23):4214-20.
Many researches report that low socioeconomic status (SES) is associated with a higher risk of coronary heart disease (CHD). This study aimed to determine whether levels of education, family income, and other SES were associated with acute myocardial infarction (AMI) in the Chinese population, and to compare the difference in this association between northern and southern regions in China.
We conducted a case-control study. Cases were first AMI (n = 2909). Controls (n = 2947) were randomly selected and frequency matched to cases on age and sex. SES was measured using education, family income, possessions in the household, and occupation.
Low levels of education (8 years) were more common in cases compared to controls (53.4% and 44.1%; P = 0.0001). After adjusting all risk factors, the level of education was associated with AMI risk in the Chinese population (P = 0.0005). The odds ratio (OR) associated with education of 8 years or less, compared with more than 12 years (trade school/college/university) was 1.33 (95%CI 1.12 - 1.59), and for education of 9 - 12 years 1.04 (95%CI 0.88 - 1.33). The proportion of higher income population was more in controls than cases (39.4% and 35.3%). Number of possessions and non-professional occupation were only weakly or not at all independently related to AMI. The adjusted OR associated with the lower education was 2.38 (95%CI 1.67 - 3.39) in women, and 1.18 (95%CI 0.99 - 1.42) in men (P = 0.0001, for heterogeneity). The interaction between levels of education and different regions was significant (P = 0.0206, for interaction).
Several socioeconomic factors including levels of education and income were closely associated with increase of AMI risk in China, most markedly in northeast and southern area. The effect of education was stronger towards AMI in women than men.
许多研究报告指出，低社会经济地位（SES）与冠心病（CHD）的风险增加有关。本研究旨在确定教育水平、家庭收入和其他 SES 是否与中国人群中的急性心肌梗死（AMI）有关，并比较中国南北地区之间这种关联的差异。
我们进行了一项病例对照研究。病例为首次 AMI（n=2909）。对照组（n=2947）随机选择，按年龄和性别与病例相匹配。SES 通过教育、家庭收入、家庭财产和职业来衡量。
与对照组相比，低教育水平（8 年）在病例中更为常见（53.4%和 44.1%；P=0.0001）。在调整所有危险因素后，教育水平与中国人群 AMI 风险相关（P=0.0005）。与 12 年以上（职业学校/学院/大学）相比，教育水平为 8 年或以下的 OR 为 1.33（95%CI 1.12-1.59），9-12 年为 1.04（95%CI 0.88-1.33）。高收入人群的比例在对照组中高于病例组（39.4%和 35.3%）。财产数量和非专业职业与 AMI 仅有微弱或根本没有独立相关性。与较低教育水平相关的调整 OR 为女性 2.38（95%CI 1.67-3.39），男性 1.18（95%CI 0.99-1.42）（P=0.0001，异质性检验）。教育水平和不同地区之间的交互作用具有统计学意义（P=0.0206，交互作用检验）。
包括教育水平和收入在内的几个社会经济因素与中国 AMI 风险的增加密切相关，在中国东北地区和南部地区最为显著。教育对女性 AMI 的影响大于男性。
