Perini W, Kunst A E, Snijder M B, Peters R J G, van Valkengoed I G M
Department of Public Health, Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Cardiology, Amsterdam UMC, University of Amsterdam, the Netherlands.
Department of Public Health, Amsterdam UMC, University of Amsterdam, the Netherlands.
Nutr Metab Cardiovasc Dis. 2019 Jan;29(1):15-22. doi: 10.1016/j.numecd.2018.09.004. Epub 2018 Sep 24.
Cardiovascular disease (CVD) risk factors may occur among a substantial proportion of normal weight individuals, particularly among some ethnic minorities. It is unknown how many of these individuals would be missed by commonly applied eligibility criteria for cardiovascular risk screening. Thus, we aim to determine cardiovascular risk and eligibility for cardiovascular risk screening among normal weight individuals of different ethnic backgrounds.
Using the HELIUS study (Amsterdam, The Netherlands), we determined cardiovascular risk among 6910 normal weight individuals of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Moroccan and Turkish background. High cardiovascular risk was approximated by high metabolic risk based on blood pressure, HDL, triglycerides and fasting glucose. Eligibility criteria for screening were derived from Dutch CVD prevention guidelines and include age ≥ 50 y, family history of CVD, or current smoking. Ethnic group comparisons were made using logistic regression. Age-adjusted proportions of high metabolic risk ranged from 12.6% to 38.4% (men) and from 2.7% to 11.5% (women). This prevalence was higher among most ethnic minorities than the Dutch, especially among women. For most ethnic groups, 79.9%-86.7% of individuals with high metabolic risk were eligible for cardiovascular risk screening. Exceptions were Ghanaian women (58.8%), Moroccan men (70.9%) and Moroccan women (45.0%), although age-adjusted proportions did not differ between groups.
Even among normal weight individuals, high cardiovascular metabolic risk is more common among ethnic minorities than among the majority population. Regardless of ethnicity, most normal weight individuals with increased risk are eligible for cardiovascular risk screening.
心血管疾病(CVD)风险因素可能在相当一部分体重正常的个体中出现,尤其是在一些少数族裔中。目前尚不清楚常用的心血管风险筛查合格标准会遗漏多少这类个体。因此,我们旨在确定不同种族背景的体重正常个体的心血管风险以及心血管风险筛查的合格情况。
利用HELIUS研究(荷兰阿姆斯特丹),我们确定了6910名具有荷兰、南亚苏里南人、非洲苏里南人、加纳人、摩洛哥人和土耳其人背景的体重正常个体的心血管风险。基于血压、高密度脂蛋白、甘油三酯和空腹血糖的高代谢风险可近似代表高心血管风险。筛查的合格标准源自荷兰心血管疾病预防指南,包括年龄≥50岁、心血管疾病家族史或当前吸烟情况。使用逻辑回归进行种族组间比较。年龄调整后的高代谢风险比例在男性中为12.6%至38.4%,在女性中为2.7%至11.5%。在大多数少数族裔中,这一患病率高于荷兰人,尤其是在女性中。对于大多数种族群体,79.9% - 86.7%的高代谢风险个体符合心血管风险筛查条件。例外情况是加纳女性(58.8%)、摩洛哥男性(70.9%)和摩洛哥女性(45.0%),不过各年龄调整组之间比例无差异。
即使在体重正常的个体中,心血管代谢高风险在少数族裔中也比多数人群更为常见。无论种族如何,大多数风险增加的体重正常个体都符合心血管风险筛查条件。