Hatanaka Yoko, Tamakoshi Akiko, Tsushita Kazuyo
DENSO Health Insurance Society, 2-41 Shintomichou, Kariya, Aichi 448-0045, Japan.
Sangyo Eiseigaku Zasshi. 2015;57(3):67-76. doi: 10.1539/sangyoeisei.B14008. Epub 2015 Mar 9.
In order to prevent ischemic heart disease in working adult males, we analyzed risk factors by age groups based on data from an eight-year follow-up study of male employees enrolled in the Denso Health Insurance Program.
Of the 27,945 male employees aged 30 to 55 enrolled in the program in 2003, the data of 19,742 (70.6%) who underwent regular health checkups were analyzed. Information obtained from health insurance claims for hospitalization and cause of death from discontinuation data were used to analyze risk factors for ischemic heart disease by age group. Hazard ratios and 95% confidence intervals were estimated from Cox proportional-hazards models.
In males aged 30-39 years, a BMI of 25.0-27.5 was associated with a 2.21 higher risk of ischemic heart disease (95%CI: 1.01-4.84) than those not overweight (BMI of <25.0); LDL of 160 mg/dl or more was associated with a 3.85 higher risk (95%CI:1.62-9.14) than LDL of less than 120 mg/dl; and FPG of 160 mg/dl or more was associated with a 6.43 higher risk (95%CI: 1.02-40.63) than a FPG of less than 110 mg/dl. For males aged 40-55 years, higher LDL was a risk factor of ischemic heart disease (1.95 (95%CI: 1.28-2.98) and 1.97 (95%CI: 1.34-2.90) for LDL of more than 160 mg/dl and 140-159 mg/dl, respectively), compared to those with LDL of less than 120 mg/dl. In the same age group, compared to those unaffected, the risk of ischemic heart disease was 1.94 times higher (95%CI: 1.27-2.97) and 1.61 times higher (95%CI: 1.08-2.40) for those treated for hypertension and hyperlipidemia, respectively. Furthermore, compared to non-smokers, those smoking more than 20 cigarettes a day had 3.12 higher risk (95%CI: 1.21-8.06) and 1.81 higher risk (95%CI: 1.25-2.62) of ischemic heart disease in the 30-39 and 40-55 years age groups, respectively. Interaction effects with age group were not significant.
In males aged 30-39 years having a high BMI, LDL, FPG, and smoking more than 20 cigarettes increased the risk of ischemic heart disease. For males aged 40-55 years taking medication for hypertension and hyperlipidemia increased the risk. To prevent ischemic heart disease during the prime of life, offering support for weight control and stopping smoking is necessary in younger age groups. Moreover, implementing a long-term risk management plan to prevent the onset of hypertension, diabetes, or hyperlipidemia is also important.
为预防在职成年男性患缺血性心脏病，我们基于参加电装健康保险计划的男性员工的八年随访研究数据，按年龄组分析了风险因素。
在2003年参加该计划的27945名30至55岁男性员工中，分析了19742名（70.6%）接受定期健康检查者的数据。从住院医疗保险理赔信息和中断数据中的死亡原因信息用于按年龄组分析缺血性心脏病的风险因素。从Cox比例风险模型估计风险比和95%置信区间。
在30 - 39岁男性中，体重指数（BMI）为25.0 - 27.5者患缺血性心脏病的风险比体重正常者（BMI<25.0）高2.21倍（95%置信区间：1.01 - 4.84）；低密度脂蛋白（LDL）≥160mg/dl者患缺血性心脏病的风险比LDL<120mg/dl者高3.85倍（95%置信区间：1.62 - 9.14）；空腹血糖（FPG）≥160mg/dl者患缺血性心脏病的风险比FPG<110mg/dl者高6.43倍（95%置信区间：1.02 - 40.63）。在40 - 55岁男性中，与LDL<120mg/dl者相比，LDL>160mg/dl和140 - 159mg/dl者患缺血性心脏病的风险分别为1.95（95%置信区间：1.28 - 2.98）和1.97（95%置信区间：1.34 - 2.90）。在同一年龄组中，与未患病者相比，患高血压和高脂血症者患缺血性心脏病的风险分别高1.94倍（95%置信区间：1.27 - 2.97）和1.61倍（95%置信区间：1.08 - 2.40）。此外，与不吸烟者相比，每日吸烟超过20支者在30 - 39岁和40 - 55岁年龄组患缺血性心脏病的风险分别高3.12倍（95%置信区间：1.21 - 8.06）和1.81倍（95%置信区间：1.25 - 2.62）。与年龄组的交互作用不显著。
在30 - 39岁男性中，高BMI、高LDL、高FPG以及每日吸烟超过20支会增加患缺血性心脏病的风险。在40 - 55岁男性中，服用治疗高血压和高脂血症的药物会增加风险。为预防盛年时期的缺血性心脏病，在较年轻年龄组提供体重控制支持和戒烟是必要的。此外，实施长期风险管理计划以预防高血压、糖尿病或高脂血症的发病也很重要。
