Lai Yun-Ju, Chen Hsi-Chung, Chou Pesus
Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan.
PLoS One. 2015 Aug 31;10(8):e0136634. doi: 10.1371/journal.pone.0136634. eCollection 2015.
To investigate the interaction effects of diabetes and hypertension on stroke, and also investigate the independent and interaction effects of parental history and environmental factors on diabetes and hypertension in a cross-sectional elderly population.
The Shih-Pai Community Medical Service Program was a community-based, fixed cohort study conducted between June 1999 and November 2002. Socio-demographic and clinical data of subjects aged 65 years and older were collected by well-trained interviewers during home visits. Interaction effects were analyzed using Rothman's synergy index (SI).
In total, 4,124 subjects were included in the study, with 2,284 males and 1,840 females. The synergistic interaction of diabetes and hypertension on stroke was statistically significant in women (SI = 3.16, 95% CI: 1.35-7.39). The synergistic interaction of parental diabetes and being overweight on diabetes was only statistically significant in men, and not in women (SI = 3.30, 95% CI: 1.00-10.83 in men, and SI = 1.15, 95% CI: 0.30-4.39 in women).
A synergistic interaction was found for diabetes and hypertension in both sexes when parental history and being overweight were combined. Furthermore, combining diabetes and hypertension in elderly women was significant in terms of the risk of stroke. Strategies to control risk factors in individuals at additional high risk are urgently needed.
研究糖尿病和高血压对中风的交互作用，同时在一个横断面老年人群中研究家族史和环境因素对糖尿病和高血压的独立及交互作用。
石牌社区医疗服务项目是一项基于社区的固定队列研究，于1999年6月至2002年11月进行。65岁及以上受试者的社会人口学和临床数据由训练有素的访员在家庭访视期间收集。使用Rothman协同指数（SI）分析交互作用。
该研究共纳入4124名受试者，其中男性2284名，女性1840名。糖尿病和高血压对中风的协同交互作用在女性中具有统计学意义（SI = 3.16，95%CI：1.35 - 7.39）。父母患糖尿病与超重对糖尿病的协同交互作用仅在男性中具有统计学意义，在女性中无统计学意义（男性SI = 3.30，95%CI：1.00 - 10.83；女性SI = 1.15，95%CI：0.30 - 4.39）。
当家族史和超重因素同时存在时，糖尿病和高血压在两性中均存在协同交互作用。此外，老年女性中糖尿病和高血压并存对中风风险具有显著影响。迫切需要针对额外高风险个体的危险因素控制策略。
