Rémond Marc G W, Stewart Simon, Carrington Melinda J, Marwick Thomas H, Kingwell Bronwyn A, Meikle Peter, O'Brien Darren, Marshall Nathaniel S, Maguire Graeme P
Baker Heart and Diabetes Institute, PO Box 6492, Melbourne, VIC, 3004, Australia.
Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
BMC Cardiovasc Disord. 2017 Aug 23;17(1):228. doi: 10.1186/s12872-017-0662-7.
Of the estimated 10-11 year life expectancy gap between Indigenous (Aboriginal and Torres Strait Islander people) and non-Indigenous Australians, approximately one quarter is attributable to cardiovascular disease (CVD). Risk prediction of CVD is imperfect, but particularly limited for Indigenous Australians. The BIRCH (Better Indigenous Risk stratification for Cardiac Health) project aims to identify and assess existing and novel markers of early disease and risk in Indigenous Australians to optimise health outcomes in this disadvantaged population. It further aims to determine whether these markers are relevant in non-Indigenous Australians.
METHODS/DESIGN: BIRCH is a cross-sectional and prospective cohort study of Indigenous and non-Indigenous Australian adults (≥ 18 years) living in remote, regional and urban locations. Participants will be assessed for CVD risk factors, left ventricular mass and strain via echocardiography, sleep disordered breathing and quality via home-based polysomnography or actigraphy respectively, and plasma lipidomic profiles via mass spectrometry. Outcome data will comprise CVD events and death over a period of five years.
Results of BIRCH may increase understanding regarding the factors underlying the increased burden of CVD in Indigenous Australians in this setting. Further, it may identify novel markers of early disease and risk to inform the development of more accurate prediction equations. Better identification of at-risk individuals will promote more effective primary and secondary preventive initiatives to reduce Indigenous Australian health disadvantage.
据估计，澳大利亚原住民（包括原住民和托雷斯海峡岛民）与非原住民之间的预期寿命差距为10至11年，其中约四分之一可归因于心血管疾病（CVD）。心血管疾病的风险预测并不完美，对澳大利亚原住民而言尤其有限。BIRCH（改善原住民心脏健康风险分层）项目旨在识别和评估澳大利亚原住民早期疾病和风险的现有及新标志物，以优化这一弱势群体的健康结果。该项目还旨在确定这些标志物在非澳大利亚原住民中是否具有相关性。
方法/设计：BIRCH是一项针对居住在偏远、地区和城市地区的澳大利亚原住民和非原住民成年人（≥18岁）的横断面和前瞻性队列研究。将通过超声心动图评估参与者的心血管疾病风险因素、左心室质量和应变，分别通过家庭多导睡眠监测或活动记录仪评估睡眠呼吸障碍和质量，并通过质谱分析血浆脂质组学特征。结局数据将包括五年内的心血管疾病事件和死亡情况。
BIRCH的结果可能会增进对澳大利亚原住民在这种情况下心血管疾病负担增加的潜在因素的理解。此外，它可能会识别早期疾病和风险的新标志物，为开发更准确的预测方程提供依据。更好地识别高危个体将促进更有效的一级和二级预防措施，以减少澳大利亚原住民的健康劣势。
