Basra Sukhdeep Singh, Pokharel Yashashwi, Hira Ravi S, Bandeali Salman J, Nambi Vijay, Deswal Anita, Nasir Khurram, Martin Seth S, Vogel Robert A, Roberts Arthur J, Ballantyne Christie M, Virani Salim S
Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Methodist DeBakey Heart and Vascular Center, Houston, Texas.
Am J Cardiol. 2014 Dec 15;114(12):1836-40. doi: 10.1016/j.amjcard.2014.09.021. Epub 2014 Sep 28.
Retired National Football League (NFL) linemen have an increased prevalence of risk factors for atherosclerosis and have an increased risk of cardiovascular death compared with nonlinemen and the general population. We evaluated whether playing in lineman position is independently associated with an increased risk of the presence and severity of subclinical atherosclerosis. Players were categorized as linemen if they reported playing on the offensive or defensive line during their careers. Subclinical atherosclerosis was assessed using coronary artery calcium (CAC) scores in 931 retired NFL players (310 linemen, 621 nonlinemen). CAC scores were evaluated for absence of subclinical atherosclerosis (CAC = 0), presence of mild subclinical atherosclerosis (CAC 1 to 100), and moderate to severe subclinical atherosclerosis (CAC ≥100). We performed multivariate logistic regression to determine whether the lineman position is independently associated with the presence and severity of subclinical atherosclerosis. Linemen were noted to have a lesser likelihood of absence of subclinical atherosclerosis (CAC = 0, 33.8% vs 41.7%, p = 0.02), a similar likelihood of mild subclinical atherosclerosis (CAC 1 to 100, 33.2% vs 31.8%, p = 0.7), and a greater likelihood of moderate to severe subclinical atherosclerosis (CAC >100, 32.9% vs 26.4%, p = 0.04) compared with nonlinemen. Adjusting for demographic and metabolic covariates, lineman status remained independently associated with mild subclinical atherosclerosis (CAC 1 to 100, odds ratio [OR] 1.41, 95% confidence interval [CI] 1.05 to 2.2, p = 0.04) and moderate to severe subclinical atherosclerosis (CAC ≥100, OR 1.67, 95% CI 1.05 to 2.2). The association was attenuated after adjustment for race (CAC 1 to 100, OR 1.24, 95% CI 0.82 to 1.8; CAC >100, OR 1.59, 95% CI 1.01 to 2.49). In conclusion, lineman status in retired NFL players is associated with presence and severity of subclinical atherosclerosis, which is partly explained by race.
与非前锋球员及普通人群相比，已退役的美国国家橄榄球联盟（NFL）前锋球员患动脉粥样硬化风险因素的患病率更高，心血管死亡风险也更高。我们评估了担任前锋位置是否与亚临床动脉粥样硬化的存在及严重程度增加独立相关。如果球员报告其职业生涯中曾在进攻线或防守线位置打球，则被归类为前锋。我们使用冠状动脉钙化（CAC）评分对931名已退役的NFL球员（310名前锋，621名非前锋）进行亚临床动脉粥样硬化评估。评估CAC评分以确定是否存在亚临床动脉粥样硬化（CAC = 0）、轻度亚临床动脉粥样硬化（CAC 1至100）以及中度至重度亚临床动脉粥样硬化（CAC≥100）。我们进行多因素逻辑回归分析以确定前锋位置是否与亚临床动脉粥样硬化的存在及严重程度独立相关。结果发现，与非前锋球员相比，前锋球员不存在亚临床动脉粥样硬化（CAC = 0）的可能性较小（33.8%对41.7%，p = 0.02），轻度亚临床动脉粥样硬化（CAC 1至100）的可能性相似（33.2%对31.8%，p = 0.7），中度至重度亚临床动脉粥样硬化（CAC>100）的可能性更大（32.9%对26.4%，p = 0.04）。在对人口统计学和代谢协变量进行调整后，前锋状态仍与轻度亚临床动脉粥样硬化（CAC 1至100，比值比[OR]为1.41，95%置信区间[CI]为1.05至2.2，p = 0.04）以及中度至重度亚临床动脉粥样硬化（CAC≥100，OR为1.67，95% CI为1.05至2.2）独立相关。在对种族进行调整后，这种关联减弱（CAC 1至100，OR为1.24，95% CI为0.82至1.8；CAC>100，OR为1.59，95% CI为1.01至2.49）。总之，已退役NFL球员中的前锋状态与亚临床动脉粥样硬化的存在及严重程度相关，种族因素可部分解释这一现象。
