School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan.
PLoS One. 2018 Mar 28;13(3):e0194813. doi: 10.1371/journal.pone.0194813. eCollection 2018.
Lower health literacy (HL) is associated with several cardiovascular disease (CVD) risk factors such as diabetes, hypertension, and metabolic syndrome (MS). The aim of our study was to investigate the association between HL and the Framingham 10-year risk score of CVD.
From 2015-2016, 1010 subjects aged 23 to 88 years receiving health check-up in Taipei Veterans General Hospital had complete clinical evaluations and laboratory examinations. Fatty liver was diagnosed by ultrasonography. The short form questionnaire adapted from the Mandarin Health Literacy Scale was used to assess HL. The Framingham risk score was calculated by patient characteristics.
Subjects with higher BMIs were associated with lower HL scores. The proportion of subjects with MS was higher in the lower health literacy score group (≤ 9) at 28.8%; further analysis found that lower HL was significantly associated with MS in women but not in men. The Spearman's rho demonstrated that the HL score was significantly associated with the BMI-based (rho = -0.11; P < 0.001) or lipid-based (rho = -0.09; P < 0.004) Framingham risk score.
Higher HL scores were associated with less CVD risk such as lower BMIs, less MS in women, and less fatty liver disease. Furthermore, HL had an inverse association with the Framingham risk score as expected. Therefore, HL in patients with CVD risk should be improved and considered as an important issue in terms of CVD reduction.
较低的健康素养（HL）与多种心血管疾病（CVD）风险因素有关，如糖尿病、高血压和代谢综合征（MS）。我们的研究旨在探讨 HL 与Framingham CVD 10 年风险评分之间的关系。
2015-2016 年，1010 名年龄在 23 至 88 岁之间在台北荣民总医院接受健康检查的受试者接受了完整的临床评估和实验室检查。通过超声诊断脂肪肝。采用普通话健康素养量表改编的短问卷评估 HL。Framingham 风险评分根据患者特征计算。
BMI 较高的受试者与 HL 评分较低相关。在健康素养评分较低（≤9）的组中，MS 的比例较高（28.8%）；进一步分析发现，在女性中，HL 较低与 MS 显著相关，但在男性中并非如此。Spearman's rho 表明，HL 评分与 BMI 基础（rho=-0.11；P<0.001）或脂质基础（rho=-0.09；P<0.004）Framingham 风险评分显著相关。
HL 评分较高与 CVD 风险降低有关，如 BMI 较低、女性 MS 较少和脂肪肝疾病较少。此外，HL 与Framingham 风险评分呈负相关，这是预期的结果。因此，应提高 CVD 风险患者的 HL，并将其视为 CVD 降低的一个重要问题。
