Yeboah Joseph, Blaha Michael J, Michos Erin D, Qureshi Waqas, Miedema Michael, Flueckiger Peter, Rodriguez Carlos J, Szklo Moyses, Bertoni Alain G
Am J Epidemiol. 2017 Oct 15;186(8):935-943. doi: 10.1093/aje/kwx165.
We assessed the relationships among adult height, coronary artery calcium (CAC) score, incident atherosclerotic cardiovascular disease (ASCVD) events, and atrial fibrillation (AFib) in a multiethnic cohort. We used race/ethnicity-specific height (dichotomized by median value and in quartiles) as the predictor variable within the 4 racial/ethnic groups in the Multi-Ethnic Study of Atherosclerosis (n = 6,814). After a mean of 10.2 years of follow-up (2000-2012), 556 ASCVD events (8.2%) and 539 AFib events (7.9%) occurred. Adult height was not associated with prevalent CAC score (ln(CAC + 1) or categories). Tall stature (i.e., race/ethnicity-specific height ≥median) had a significant but opposite association with future ASCVD and AFib (hazard ratios were 0.72 (95% confidence interval: 0.56, 0.92) and 1.38 (95% confidence interval: 1.07, 1.79), respectively). We observed a gradient-response but opposite association between quartiles of race/ethnicity-specific height and ASCVD/AFib events in our multivariable models. A formal test of interaction between race/ethnicity-specific height and sex was not significant in the ASCVD model (P = 0.78) but was significant in the AFib model (P = 0.03). Tall stature was associated (in a gradient-response fashion) with reduced risk of ASCVD events and increased risk of AFib. Adult height may signal interactions between genetic and environmental factors and may provide risk information independent of current traditional risk factors and CAC score.
我们在一个多民族队列中评估了成人身高、冠状动脉钙化（CAC）评分、动脉粥样硬化性心血管疾病（ASCVD）事件以及心房颤动（AFib）之间的关系。在动脉粥样硬化多民族研究（n = 6814）的4个种族/民族群体中，我们将种族/民族特异性身高（按中位数和四分位数进行二分法划分）用作预测变量。经过平均10.2年的随访（2000 - 2012年），发生了556例ASCVD事件（8.2%）和539例AFib事件（7.9%）。成人身高与现患CAC评分（ln(CAC + 1)或类别）无关。高个子（即种族/民族特异性身高≥中位数）与未来的ASCVD和AFib存在显著但相反的关联（风险比分别为0.72（95%置信区间：0.56, 0.92）和1.38（95%置信区间：1.07, 1.79））。在我们的多变量模型中，我们观察到种族/民族特异性身高四分位数与ASCVD/AFib事件之间存在梯度反应但相反的关联。在ASCVD模型中，种族/民族特异性身高与性别之间的交互作用的正式检验不显著（P = 0.78），但在AFib模型中显著（P = 0.03）。高个子与ASCVD事件风险降低和AFib风险增加（呈梯度反应方式）相关。成人身高可能标志着遗传和环境因素之间的相互作用，并且可能提供独立于当前传统风险因素和CAC评分的风险信息。
