Department of Public Health, Shihezi University School of Medicine, Shihezi, China.
Department of Pathology and Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi, China.
PLoS One. 2020 Mar 4;15(3):e0229598. doi: 10.1371/journal.pone.0229598. eCollection 2020.
Coronary heart disease (CHD) is a chronic complex disease caused by a combination of factors such as lifestyle behaviors and environmental and genetic factors. We conducted this study to evaluate the risk factors affecting the development of CHD in Xinjiang, and to obtain valuable information for formulating appropriate local public health policies.
We conducted a nested case-control study with 277 confirmed CHD cases and 554 matched controls. The association of the risk factors with the risk of CHD was assessed using the multivariate Cox proportional hazard model. Multiplicative interactions were evaluated by entering interaction terms in the Cox proportional hazard model. The additive interactions among the risk factors were assessed by the index of additive interaction.
The risk of CHD increased with frequent high-fat food consumption, dyslipidemia, obesity, and family history of CHD after adjustment for drinking, smoking status, hypertension, diabetes, family history of hypertension, and family history of diabetes. We noted consistent interactions between family history of CHD and frequent high-fat food consumption, family history of CHD and obesity, frequent high-fat food consumption and obesity, frequent high-fat food consumption and dyslipidemia, and obesity and dyslipidemia. The risk of CHD events increased with the presence of the aforementioned interactions.
Frequent high-fat food consumption, family history of CHD, dyslipidemia and obesity were independent risk factors for CHD, and their interactions are important for public health interventions in patients with CHD in Xinjiang.
冠心病（CHD）是一种由生活方式行为以及环境和遗传因素等多种因素共同作用引起的慢性复杂疾病。本研究旨在评估影响新疆 CHD 发展的危险因素，为制定适宜的当地公共卫生政策提供有价值的信息。
我们进行了一项巢式病例对照研究，共纳入 277 例确诊的 CHD 病例和 554 例匹配对照。采用多变量 Cox 比例风险模型评估危险因素与 CHD 风险的关联。通过在 Cox 比例风险模型中引入交互项来评估相乘性交互作用。采用相加交互作用指数评估危险因素之间的相加交互作用。
校正饮酒、吸烟状况、高血压、糖尿病、高血压家族史和糖尿病家族史后，经常食用高脂肪食物、血脂异常、肥胖和 CHD 家族史与 CHD 风险增加相关。我们注意到 CHD 家族史与经常食用高脂肪食物、CHD 家族史与肥胖、经常食用高脂肪食物与肥胖、经常食用高脂肪食物与血脂异常以及肥胖与血脂异常之间存在一致的交互作用。这些交互作用的存在增加了 CHD 事件的风险。
经常食用高脂肪食物、CHD 家族史、血脂异常和肥胖是 CHD 的独立危险因素，它们之间的相互作用对新疆 CHD 患者的公共卫生干预措施具有重要意义。
