Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.
J Am Heart Assoc. 2016 Dec 20;5(12):e004067. doi: 10.1161/JAHA.116.004067.
A lifestyle cardiovascular risk score (LCRS) and a genetic risk score (GRS) have been independently associated with myocardial infarction (MI) in Hispanics/Latinos. Interaction or joint association between these scores has not been examined. Thus, our aim was to assess interactive and joint associations between LCRS and GRS, and each individual lifestyle risk factor, on likelihood of MI.
Data included 1534 Costa Rican adults with nonfatal acute MI and 1534 matched controls. The LCRS used estimated coefficients as weights for each factor: unhealthy diet, physical inactivity, smoking, elevated waist:hip ratio, low/high alcohol intake, low socioeconomic status. The GRS included 14 MI-associated risk alleles. Conditional logistic regressions were used to calculate adjusted odds ratios. The odds ratios for MI were 2.72 (2.33, 3.17) per LCRS unit and 1.13 (95% CI 1.06, 1.21) per GRS unit. A significant joint association for highest GRS tertile and highest LCRS tertile and odds of MI was detected (odds ratio=5.43 [3.71, 7.94]; P<1.00×10), compared to both lowest tertiles. The odds ratios were 1.74 (1.22, 2.49) under optimal lifestyle and unfavorable genetic profile, and 5.02 (3.46, 7.29) under unhealthy lifestyle but advantageous genetic profile. Significant joint associations were observed for the highest GRS tertile and the highest of each lifestyle component risk category. The interaction term was nonsignificant (P=0.33).
Lifestyle risk factors and genetics are jointly associated with higher odds of MI among Hispanics/Latinos. Individual and combined lifestyle risk factors showed stronger associations. Efforts to improve lifestyle behaviors could help prevent MI regardless of genetic susceptibility.
生活方式心血管风险评分（LCRS）和遗传风险评分（GRS）已被独立关联到西班牙裔/拉丁美洲人的心肌梗死（MI）。这些评分之间的相互作用或联合关联尚未被检验。因此，我们的目的是评估 LCRS 和 GRS 之间以及每个单独的生活方式危险因素之间的相互作用和联合关联，以确定 MI 的可能性。
数据包括 1534 名哥斯达黎加非致命性急性 MI 成年患者和 1534 名匹配对照者。LCRS 使用估计系数作为每个因素的权重：不健康的饮食、缺乏身体活动、吸烟、腰臀比升高、高低酒精摄入、低/高社会经济地位。GRS 包括 14 个与 MI 相关的风险等位基因。条件逻辑回归用于计算调整后的比值比。LCRS 单位每增加一个单位，MI 的比值比为 2.72（2.33，3.17），GRS 单位每增加一个单位，MI 的比值比为 1.13（95%CI 1.06，1.21）。与最低两个三分位组相比，检测到最高 GRS 三分位组和最高 LCRS 三分位组与 MI 发生几率的显著联合关联（比值比=5.43 [3.71，7.94]；P<1.00×10）。在最佳生活方式和不利遗传谱下，比值比为 1.74（1.22，2.49），而在不健康的生活方式但有利的遗传谱下，比值比为 5.02（3.46，7.29）。观察到最高 GRS 三分位组和每个生活方式成分风险类别的最高值之间存在显著的联合关联。交互项无统计学意义（P=0.33）。
生活方式危险因素和遗传因素与西班牙裔/拉丁裔人群中 MI 的发生几率增加相关。个体和联合生活方式危险因素的关联更强。努力改善生活方式行为可能有助于预防 MI，而不论遗传易感性如何。
