Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
Angiology. 2021 Jan;72(1):24-31. doi: 10.1177/0003319720946976. Epub 2020 Aug 7.
Even though abdominal aortic aneurysm (AAA) and coronary heart disease (CHD) are both related to atherosclerosis, there could be important differences in risk factors. Based on Malmö Diet and Cancer Cohort, the incidence of AAA and CHD was followed prospectively. Cox regression was used to calculate the association of each factor with AAA and CHD and hazards ratio were compared using a modified Lunn-McNeil method; 447 participants developed AAA and 3129 developed CHD. After multivariate adjustments, smoking, antihypertensive medications, lipid-lowing medications, systolic and diastolic blood pressures, apolipoprotein (Apo) A1 (inversely), ApoB, ApoB/ApoA1 ratio, total leukocyte count, neutrophil count, and neutrophil to lymphocyte ratio were associated with the risks of both AAA and CHD. When comparing risk factor profiles for the 2 diseases, smoking, diastolic blood pressure, ApoA1, and ApoB/ApoA1 ratio had stronger associations with risk of AAA than with risk of CHD, while diabetes and unmarried status showed increased risk of CHD, but not of AAA (all values for equal association <.01). The results from this big population study confirm that the risk factor profiles for AAA and CHD show not only many similarities but also several important differences.
尽管腹主动脉瘤 (AAA) 和冠心病 (CHD) 均与动脉粥样硬化有关,但危险因素可能存在重要差异。基于马尔默饮食与癌症队列研究,前瞻性随访了 AAA 和 CHD 的发病情况。采用 Cox 回归计算各因素与 AAA 和 CHD 的相关性,并采用改良的 Lunn-McNeil 方法比较危险比;447 例患者发生 AAA,3129 例患者发生 CHD。多变量调整后,吸烟、降压药物、降脂药物、收缩压和舒张压、载脂蛋白 (Apo) A1(负相关)、ApoB、ApoB/ApoA1 比值、总白细胞计数、中性粒细胞计数和中性粒细胞与淋巴细胞比值与 AAA 和 CHD 的发病风险相关。比较两种疾病的危险因素谱时,与 CHD 相比,吸烟、舒张压、ApoA1 和 ApoB/ApoA1 比值与 AAA 的发病风险相关性更强,而糖尿病和未婚状态与 CHD 的发病风险增加有关,但与 AAA 无关(所有相等关联的 值均 <.01)。这项大型人群研究的结果证实,AAA 和 CHD 的危险因素谱不仅存在许多相似之处,而且还存在一些重要差异。